Lancaster General Health Launches Accountable Care Arrangement with Humana

By a News Reporter-Staff News Editor at Managed Care Weekly Digest -- Lancaster General Health and Humana Inc. (NYSE:HUM), one of the country's leading health and well-being companies, announced that they have partnered on a new Accountable Care arrangement designed to improve the wellness and care experience for a growing population of more than 3,000 Medicare Advantage members in Lancaster County (see also Humana Inc.).

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The agreement became effective April 1 and reflects a shift in the health care system away from the current episodic model to place greater emphasis on health outcomes, preventive care and patient care experiences. Accountable care arrangements with rewards for quality and efficiency are emerging as payment innovation efforts and are being deployed across Pennsylvania and the United States. The LG Health/Humana partnership has established focused quality and cost goals that, if attained, will generate savings for individuals and employers.

The accountable care arrangement with Humana is being undertaken specifically by LG Health's accountable care organization, the LG Health Community Care Collaborative, which launched in 2014.

"Innovative partnerships like this will enhance care coordination, improve health outcomes and eliminate unnecessary spending," said Tom Beeman, President and CEO of Lancaster General Health. "This approach will encourage clinicians to provide the highest-quality care as efficiently as possible, while stabilizing costs for both patients and employers."

Humana's Medicare Advantage members will have access to LG Health's growing network in the greater Lancaster County region, which includes three hospitals, 300 family physicians and specialists and more than 40 offices.

"The value-based healthcare delivery and payment model is a critical evolution in how our health system works, and a much-needed one," explained Rich Vollmer, Humana's Senior Markets President for Pennsylvania. "This new pay-for-value model, which is in its early stages and quickly growing, fosters quality care, lower costs and a more patient-centric healthcare system."

The arrangement offers people more personalized care, and in addition to the services provided by Lancaster General Health's accountable care organization, connects them to a host of chronic care, disease management and wellness programs being offered by both Humana and LG Health. Humana will also provide actionable data to LG Health, including predictive analytics, creating a total patient population health picture.

The new Humana-LG Health accountable care agreement includes value-based incentives tied to performance improvement and quality outcomes, emphasizing standard measures defined by the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS), including Breast Cancer Screening, Colorectal Screening, Comprehensive Diabetes Care and High-Risk Medications.

Humana has nearly 30 years of accountable care experience, reflected in results from approximately one million Medicare Advantage members that showed significant improvements in quality, outcomes and costs in 2013.

Today, Humana has approximately 1.5 million individual Medicare Advantage and 230,000 commercial members, cared for by approximately 45,500 primary care physicians in more than 900 accountable care relationships across 43 states and Puerto Rico. For more information, visit humana.com/accountable-care. About Humana Humana Inc., headquartered in Louisville, Kentucky, is a leading health and well-being company focused on making it easy for people to achieve their best health with clinical excellence through coordinated care. The company's strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people we serve across the country.

Keywords for this news article include: Medicare, Wellness, Humana Inc., Health Policy, Insurance Companies.

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