Vanderbilt Health Affiliated Network, Humana Enter Value-Based Agreement to Benefit Medicare Advantage Patients

By a News Reporter-Staff News Editor at Managed Care Weekly Digest -- The Vanderbilt Health Affiliated Network, the region's largest alliance of leading hospitals and clinicians, and Humana, a leading health and well-being company, have entered into a value-based agreement that will benefit 4,000 Humana Medicare Advantage members in Middle Tennessee and Jackson, Tenn. The four-year agreement, which is the network's first value-based care arrangement for a Medicare Advantage plan, commits network clinicians and Humana to work together to achieve shared goals for their patients: better health, improved outcomes and lower costs (see also Humana Inc.).

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Both organizations have proven track records in value-based care, which aligns the efforts and incentives of clinicians to what matters most to patients: improving their health care experience and overall health while also controlling health care costs.

Over the last four years, providers who are part of the Vanderbilt Health Affiliated Network have improved the coordination of care for their patients while also delivering cost savings to benefit plan customers.

In 2015, on average, Humana Medicare Advantage members served by providers under value-based care experienced: 6 percent fewer ER visits, higher screening rates, including those for colorectal cancer (+8 percent) and breast cancer (+6 percent), and healthier outcomes versus members who were treated by providers in standard Medicare Advantage settings.

"Humana's new agreement with the Vanderbilt Health Affiliated Network is aligning high-quality physicians and facilities with Humana's expertise in value-based care, population health tools and data-driven insights around the same goal: improving the health of the people we serve," said Doug Haaland, Mid-South regional president for Humana.

"This agreement with Humana further validates Vanderbilt Health Affiliated Network's proven model for delivering quality and value. We are pleased to work together to bring the network's mission for providing more proactive, coordinated and affordable care to Humana's Medicare Advantage patients in our region," said C. Wright Pinson, MBA, M.D., deputy chief executive officer for Vanderbilt University Medical Center and chairman of the board for the Vanderbilt Health Affiliated Network.

The Vanderbilt Health Affiliated Network is the region's largest physician-led organization of healthcare professionals working to improve health and increase value to patients, providers, employers and other consumers of healthcare services. The network powers programs and benefit products with the goal of improving overall health across large populations while reducing per-capita costs for healthcare delivery. Currently, the network is responsible for delivering high-quality, cost-effective care to more than 130,000 people through benefit products with multiple insurance carriers. That number is growing constantly through new relationships such as the one announced.

"To truly transform the health of this region, we created a network of hospitals and physicians who are committed to excellence, innovation and collaboration. We have carefully chosen partners, like Humana, who share our vision for strong, healthy communities and who provide valuable support to help make our vision a reality," said Mark Cianciolo, executive director, Vanderbilt Health Affiliated Network. "We are looking forward to the valuable insights and the best practices that will come from our work together caring for Medicare Advantage patients."

This new agreement maintains Vanderbilt Health Affiliated Network coverage for patients with Humana Medicare Advantage plans, but provides additional resources to physicians to help them better manage the health of their patients.

As of Dec. 31, 2016, Humana has 1.8 million individual Medicare Advantage members and 200,000 commercial members who are cared for by 50,400 primary care providers, in more than 900 value-based relationships across 43 states and Puerto Rico.

As of Dec. 31, 2016, approximately 64 percent of Humana individual Medicare Advantage members are in value-based payment relationships. Humana's goal is to have 66 percent of individual Medicare Advantage members in value-based payment models by the end of 2017. For more information, visit humana.com/accountable-care or www.humana.com/valuebasedcare. About Humana Humana Inc., headquartered in Louisville, Ky., 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: Hospital, Medicare, Humana Inc., Health Policy.

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