Healthcare Analytics, Population Health Management, Healthcare Big Data

Population Health News

Humana Expands Population Health Management, Accountable Care

By Jennifer Bresnick

- Humana is embarking on several new population health management and accountable care programs this fall, bringing value-based reimbursement and coordinated care to providers in New York, Indiana, and Pennsylvania. 

Accountable care and population health management

The agreements will help to further the payer’s efforts to “change the conversation” around chronic disease management and population health by leveraging health IT and big data to reduce gaps in care and provide more preventative services to vulnerable populations.

North Shore-LIJ Health System, one of the larger provider systems in the New York metropolitan area, will further its collaboration with Humana by transition its previous fee-for-service arrangements into a value-based care plan for more than 1000 Medicare Advantage members. 

The shift will help to coordinate care for beneficiaries across the network of more than 5500 primary care providers, and will integrate predictive analytics, chronic disease management, and enhanced wellness programs for patients.

“We are proud to collaborate with Humana in the New York market, further increasing our value-based contracting,” said Howard Gold, Executive Vice President and Chief Managed Care Business Officer at North Shore-LIJ. “North Shore-LIJ and Humana are both committed to serving the Medicare population with exceptional care and service. The value-based plan allows us to focus on measurable patient outcomes, care coordination and aligning quality with payment incentives.”

“We’re delighted to deepen our relationship with North Shore-LIJ to focus on our mutual desire to help people on Medicare achieve their best health by focusing on patient-centered, integrated care that emphasizes prevention, chronic care and improved quality outcomes,” said Alexander Clague, Humana’s President for Senior Products in the Northeast Region. “We are excited to share our data to support North Shore-LIJ’s holistic focus on population health across all levels of care.”

Meanwhile, in Indiana, King’s Daughters’ Health will participate in an accountable care agreement aimed at a similar population of Medicare Advantage patients, using value-based incentives to drive improvements in preventative care delivery, quality, and outcomes as measured by national benchmarks.

“King’s Daughters’ provides exceptional health care to five counties in Southeast Indiana and North Central Kentucky,” said Holly Robinson, MD, Vice President of Quality King’s Daughters’ Health. “We look forward to putting an even greater emphasis on wellness, prevention, and disease management to improve the health of our community.”

“We respect that King’s Daughters has deep roots in the Madison community and has dedicated itself to bringing coordinated, personalized care to patients,” said Rich Vollmer, Humana’s Regional President for Senior Products in Kentucky. “It is very forward thinking of them, especially as the health industry moves toward taking care of people in a continuum.”

Doylestown Health Partners in Pennsylvania is entering a similar arrangement to further its patient-centered care delivery ideal. “Doylestown Health Partners is unique among networks in that primary care physicians, specialists and hospitals are clinically and financially integrated to deliver high-quality, low-cost health care, and to promote wellness throughout the community,” said Scott Levy, MD, Chairman of the DHP Managing Committee. “Our agreement with Humana is a natural progression to build on our strengths and partner with a leading insurer that shares our vision.”

Humana has been a leader in the accountable care space, covering the lives of approximately 1.5 million Medicare Advantage members and 200,000 commercial members in more than 900 accountable care arrangements.

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