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Humana Launches Value-Based Care Model for Expectant Mothers

The value-based care model will improve maternity and perinatal care quality, outcomes, and cost for Humana members.

Humana launches a value-based care model for expectant mothers

Source: Thinkstock

By Jessica Kent

- Humana has partnered with OB-GYN practices to introduce a national value-based payment model that will improve maternity care quality and reduce costs for Humana members with low- to moderate-risk pregnancies.

“Because quality maternity care is important for many of our members and a significant focus of specialty care services in our country, we’re very pleased to launch Humana’s newest specialty-care bundled payment model,” said Caraline Coats, Vice President of Humana’s Provider Development Center of Excellence.

“Humana is dedicated to working with OB-GYNs across the country to provide a better patient experience and improve patient outcomes, while also tackling the cost challenges inherent in perinatal care.”

Humana’s Maternity Episode-Based Model is designed to improve a member’s entire perinatal episode of care, including the mother’s prenatal, labor, delivery, and post-delivery-care, and will financially incentivize OB-GYNs who deliver better outcomes.

Humana will also provide robust data and analytics that will help enhance patient care, deliver a more coordinated experience, and reduce duplicative services and hospital readmission rates.

Humana has made inaugural maternity bundled payment agreements with participating practices in Indiana, Kansas, Ohio, and Texas.

The maternity model is Humana’s second specialty-care payment model, following its total joint replacement episode-based model for Humana Medicare Advantage members undergoing total hip or knee joint replacement procedures.

Since 2016, that program has expanded to approximately 40 orthopedic groups in 13 states across the country, enhancing Humana’s efforts to incorporate data analytics to drive better health outcomes for patients.  

“Humana is now moving to apply the approach to specialties, such as orthopedics, where highly coordinated care supported by population health data has the ability to potentially improve outcomes, lower cost and deliver a better healthcare experience for patients,” the organization said at the time.

Specialty-care bundled payment models are part of Humana’s commitment to value-based care, which aims to promote personalized care, increased access to proactive screenings, and improved chronic disease management.

The organization also works to enhance care coordination by using data analytics to connect physicians and help them work as a team.

Humana has seen great success with its value-based care platform. In 2016, the platform decreased costs by 20 percent for Medicare members, reduced emergency room visits by eight percent, and increased osteoporosis management by 13 percent.

As of December 31, 2017, Humana has 1.9 million Medicare Advantage members in value-based care relationships with providers, achieving its goal of having 66 percent of Medicare members seeing primary care physicians in value-based care relationships.

With the launch of this new value-based model, Humana will build on its efforts to promote quality care and reduce costs not just in primary care, but in specialty services as well.


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