Humana and four Tennessee orthopedic specialty groups partnered to bring Humana Medicare Advantage members undergoing total hip or knee procedures a value-based bundled payment care model.
Here are six key points:
1. Humana also is expanding the specialty care model in Ohio through its addition of two more specialty groups in the state.
2. Humana's model aims to enhance outcomes, quality and costs through a joint replacement patient's entire episode of care. Through the model, orthopedic practices have access to data and analytics to enhance a patient's treatment from diagnosis through recovery.
3. Humana devised the model based on the State of Tennessee's and the State of Ohio's State Innovation Model Grant, which devised standards for total joint replacement. CMS funded the model of care standards to help ease the transition to value-based care.
4. Humana will work with Appalachian Orthopaedic Associates in the Tri-Cities, OrthoTennessee and Tennessee Orthopaedic Clinics in Knoxville and Nashville-based Premier Orthopaedics & Sports Medicine.
5. Earlier this year, Humana partnered with five orthopedic specialty groups on their care model in Ohio. The expansion will entail Humana partnering with Columbus-based Adena Medical Clinic and University of Cincinnati Physicians.
6. Equipped with 30 years of experience helping physicians navigate value-based care arrangements, Humana released value-based care data in November 2015 which showed value-based care improved patient outcomes and lowered costs.
"Value-based care is a powerful new approach to more involved medical procedures like total joint replacement," said Chip Howard, Humana vice president of payment innovation. "It's the key to building a health system that focuses on improving quality, lowering cost and creating a better experience for our members. We look forward to continue expanding this model."
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