Humana Launches National Hospital Incentive Program to Improve Patient Experience and Health Outcomes for Humana Commercial Group Members

Business Wire

Quality Metrics Include Standards Developed by The Joint Commission

LOUISVILLE, Ky.--(BUSINESS WIRE)-- Leading health and well-being company Humana Inc. (NYSE: HUM) is announcing the launch of a national, value-based care Hospital Incentive Program (HIP) designed to provide higher-quality, more coordinated care for Humana commercial members.

Humana’s HIP aims to deliver more integrated care and reduce duplicative services, hospital readmissions, and complication rates in acute care inpatient admissions. The program provides compensation based on quality improvement and performance in three key areas - patient experience, patient safety, and patient outcomes – as determined by a number of measures that address healthcare-associated infection rates, care coordination, palliative care, and more. The metrics incorporate two care certification programs developed by The Joint Commission, the nation’s oldest and largest standards-setting and accrediting body in health care.

“By incorporating Integrated Care Certification and hospital-based Palliative Care Coordination Certification into its quality metrics, Humana has made a significant commitment to coordination of patient care through its Hospital Incentive Program,” said The Joint Commission’s Brian Enochs, J.D., Executive Vice President, Business Development and Marketing. “These key Joint Commission certifications require that participating hospitals engage patients more seamlessly across the entire continuum of care, and we’re pleased to work with Humana to create additional value for the hospitals that achieve them.”

“We’re excited to launch our value-based care initiative for hospitals, utilizing several quality standards that include certifications developed by The Joint Commission,” said Caraline Coats, Vice President of Humana’s Provider Development Center of Excellence. “This program expands Humana’s reach in value-based care as we broaden our efforts to provide a better experience for our members and help them achieve their best health.”

Humana is offering the HIP to general acute care hospitals. The program is part of 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 (watch Humana’s “Better Chronic Management Through Value-Based Care” video);
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 solely on the quantity of services they provide (fee-for-service).

Humana has an extensive and growing value-based care presence. As of December 31, 2017, Humana has 1.9 million individual Medicare Advantage members and approximately 140,000 commercial members who are cared for by 52,000 primary care physicians in more than 1,000 value-based relationships across 43 states and Puerto Rico. Humana reached its 2017 calendar year goal of having 66 percent of Humana’s 2.9 million total individual Medicare Advantage members seeing primary care physicians in value-based payment relationships. Humana’s total Medicare Advantage membership is approximately 3.3 million members, which includes members affiliated with providers in value-based and standard Medicare Advantage settings. For more information, visit humana.com/valuebasedcare.

About Humana

Humana Inc. is committed to helping our millions of medical and specialty members achieve their best health. Our successful history in care delivery and health plan administration is helping us create a new kind of integrated care with the power to improve health and well-being and lower costs. Our efforts are leading to a better quality of life for people with Medicare, families, individuals, military service personnel, and communities at large.

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: