By Paige Minemyer | Mar 4, 2020 6:22pm
Humana is bringing its
value-based care know-how together with its aptitude for tackling social
determinants among its Medicare Advantage (MA) members.
The insurance giant announced
it's launching a new value-based care model to support providers in
identifying and addressing several social concerns. The program will cover
“enhanced” care coordination for patient screenings, documentation of
assessment findings and linking patients to resources.
The model initially
focuses on care to address food insecurity, housing, social isolation and
loneliness.
“Humana is dedicated
both to value-based care and to addressing social determinants of
health. This new program is a way for us to deepen those commitments, by
interweaving both into our work with clinicians, toward a more holistic approach
to care," Caraline Coats, vice president of population health
strategy at Humana, told FierceHealthcare.
"The new model
is, therefore, a logical ‘next step’ for us, as it broadens the scope of
patient care to more holistically improve health outcomes—social determinants
of health are linked to an increased risk of chronic medical conditions,
so it’s critical that we address these key barriers to good health," Coats
said.
The first health
system signed on to the model is Ochsner Health, the largest nonprofit health
system in Louisiana. Philip Oravetz, M.D., chief population health officer at
the health system, said the partnership will offer a critical tool in
personalizing care for varied communities.
The new model builds
on Humana’s existing portfolio of
value-based care programs, in which the
insurer avoided about $3.5 billion in healthcare costs in 2018.
About 2.4 million MA
members and 115,000 commercial members are enrolled in value-based models,
Humana said.
“This new model
is part of an ongoing expansion of Humana’s value-based program portfolio,
as we continue to align with clinicians to more holistically address
patients’ healthcare needs,” Oraida Roman, vice president of
value-based strategies at Humana, said in a statement.
“Humana is proud to
collaborate with providers in proactively addressing impediments to
well-being, instead of only treating people when they’re sick,” Roman said.
“We’re committed to addressing the critical challenges presented by nonmedical
health risk factors.”
The Centers for
Medicare & Medicaid Services has notably expanded what MA plans can
cover to target beneficiaries’ social issues, and experts say the changes mark a
“turning point” for Medicare.
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