Humana is partnering with orthopedic groups in Ohio to launch a value-based bundled payment care model for Humana Medicare Advantage members.
Here are five key notes on the new model:
1. The value-based payment care model is designed for total hip and knee replacement procedures to improve quality, outcomes and cost across an episode of care.
2. Humana will provide the participating orthopedic practices with data and analytics to better manage all aspects of patient care from diagnosis to recovery. The data sharing is expected to create a better coordinated care experience and reduce hospital readmissions and complications.
3. The program is part of the State of Ohio's State Innovation Model Grant through CMS. The grant provides funding to help make the transition from fee-for-service to value-based care.
4. Participating practices include Beacon Orthopaedics & Sports Medicine, Reconstructive Orthopaedics and Sports Medicine, Orthopaedic Institute of Dayton, Orthopaedic Associates of Zanesville and Wooster Orthopaedic & Sports Medicine.
5. Humana's population health capabilities such as patient data, analytics, chronic disease management and wellness programs will be integrated into the orthopedic practice's care for Humana members.
6. If the program is successful, Humana plans to expand the model to other states to generate expected outcomes improvement, coordinate member experience and realize cost savings.
"The orthopedic surgeon is the key to creating more effective healthcare for patients undergoing total hip or knee replacement," said Chip Howard, vice president of payment innovation at Humana. "Value-based care allows physicians to spend more time with patients, arms them with the tools they need to truly manage their patients' health, and aligns the healthcare system to be more responsive to the people it serves."