- Humana said it is expanding an existing agreement with hospital operator Allina Health to provide value-based care to its Medicare Advantage members in the Minnesota market. Under the multi-year pact, reimbursement to physicians will be linked to patient health outcomes rather than based on a traditional fee-for-service model alone.
- Through the arrangement with Allina, Humana said its Medicare Advantage enrollees will gain access to more personalized care, health screenings and other preventive programs, and care for chronic conditions. Physicians will be able to use Humana's data analytics and other technologies to coordinate patient care. The new contract takes effect Jan. 1.
- The insurer also announced it has extended a value-based care partnership for Medicare Advantage members with Hutchinson Clinic, a physician group with 14 locations in central Kansas.
Humana's latest deals with Allina Health and Hutchinson Clinic reflect the insurer's ongoing focus on the value-based care model, which it says has both lowered costs and improved health outcomes for its members.
The agreements closely follow the insurer's big push into home health with the $5.7 billion purchase of the remaining 60% stake in Kindred at Home. The acquisition closed in the third quarter. Humana's ambitions for Kindred include transitioning the home health business to a value-based model, CEO Bruce Broussard said on the company's earnings call earlier this month.
Humana aims to cover 50% of its Medicare Advantage members through a value-based home health model in the next five years, with the effort expected to launch in the second quarter of next year. The company already has 270,000 members in value-based home care in south Florida and southeast Texas, Broussard said.
Humana in May also said it would offer value-based care for people with original Medicare in collaboration with providers through the Direct Contracting Model established by the CMS Innovation Center.
Allina Health system operates 11 hospitals, more than 90 clinics, and 15 retail pharmacies in Minnesota and western Wisconsin. The non-profit also offers services such as emergency medical transportation and home care. The agreement with Humana comes a year after Allina entered into a multiyear value-based deal with Blue Cross Blue Shield of Minnesota aimed at lowering the cost trend for care by 10% over five years.
Value-based care arrangements helped Humana reduce total medical costs by 13.4% in 2020, the company said in its eighth annual Value-Based Care Report released last week.
And the report showed hospital admissions were reduced by 7% and emergency room visits by 12% for Humana members whose primary care physicians were in value-based agreements, compared to those whose doctors were not in a value-based agreement.
CMS continues to expand its Medicare Advantage Value-Based Insurance Design Model, which tests an array of new plan designs geared toward improving care for Medicare beneficiaries, especially those with low incomes. The model will have 34 participating organizations next year, up from 14 in 2021.
Humana has HMO point-of-service and local PPO plans, including those with zero-dollar-premium options, in Minnesota.