Announces Additional Participants in Bundled Payment Models for Spinal Fusion and Total Joint Replacement Surgeries
Launched earlier this year, Humana’s Spinal Fusion Episode-Based Model is designed specifically to provide coordinated care for Humana Medicare Advantage members of
Through four additional agreements with orthopedic and neurosurgical practices, the program now extends to nine groups in seven states, including, for the first time, in
“We’re delighted to support provider groups as they quarterback a more coordinated approach to care for their patients undergoing spinal fusion surgery,” said
The program offers the opportunity for additional payment to physicians and clinicians for improved health outcomes and cost across a member’s entire spinal surgery episode-of-care, as measured by three clinical indication rates – readmissions, cervical complications, and lumbar complications – as well as by average risk-adjusted episodic cost-of-care.
Humana Expands Availability of its Total Joint Replacement Episode-Based Model
Humana also is announcing further expansion of its very first orthopedic bundled payment program, the Total Joint Replacement Episode-Based Model for Humana Medicare Advantage members of HMO and PPO health plans undergoing total hip or knee joint replacement procedures. Launched in 2016, the program is designed to improve quality, outcomes, and cost across a member’s entire joint replacement episode of care, and it offers providers the opportunity for additional payment for better outcomes.
Humana’s newest agreements are with
In all, the program now is offered at more than 75 medical practices in 21 states, including, for the first time, in
Humana’s Longstanding Commitment to Value-Based Care
Humana’s Total Joint Replacement and Spinal Fusion episode-based models are two of the company’s four specialty-care payment models. Its third program, the Maternity Episode-Based Model, was launched in 2018 for Humana commercial members with low-to-moderate-risk pregnancies. Humana announced earlier this year the launch of its fourth program, the Oncology Model of Care (OMOC), designed to provide more integrated cancer care for Humana Medicare Advantage and commercial members.
The programs are in keeping with Humana’s longstanding commitment to value-based care, which emphasizes:
- More personal time with health professionals and personalized care that is tailored to each person’s unique health situation;
- Access to proactive health screenings and programs that are focused on preventing illness;
- Improved care for people living with chronic conditions with a focus on avoiding health complications;
- Leveraging technologies, such as data analytics, that connect physicians and help them work as a team to coordinate care around the patient; and
- Reimbursement to physicians linked to the health outcomes of their patients rather than based solely on the quantity of services they provide (fee-for-service).
Humana has an extensive and growing value-based care presence. As of
To accomplish that, we support physicians and other health care professionals as they work to deliver the right care in the right place for their patients, our members. Our range of clinical capabilities, resources and tools – such as in-home care, behavioral health, pharmacy services, data analytics and wellness solutions – combine to produce a simplified experience that makes health care easier to navigate and more effective.
More information regarding Humana is available to investors via the Investor Relations page of the company’s web site at www.humana.com, including copies of:
- Annual reports to stockholders
Securities and Exchange Commissionfilings
- Most recent investor conference presentations
- Quarterly earnings news releases and conference calls
- Calendar of events
- Corporate Governance information
Humana is a Medicare Advantage HMO and PPO organization with a Medicare contract. Enrollment in any Humana plan depends on contract renewal.