Humana Medicare Advantage members in the region of Colorado now have approach to a latest health care model known as value-based care, thanks to a relationship between population health leader FullWell and health and well-being leader Humana Inc. The arrangement is developed to provide a more proactive and wellness-focused health care experience and financially reward doctors for high quality care. This new value-based contract unites FullWell and Humana around the common aim of making better the health of the Humana Medicare members served in FullWell’s Colorado Health Neighborhoods Network member practices. Humana Medicare Advantage members will have approach to more than 150 FullWell primary care providers in the Denver metro place.
In the year of 2015, on average, Humana Medicare Advantage members served by providers under value-based care experienced: 6% fewer ER visits, larger screening rates, including those for colorectal cancer (+8%) and breast cancer (+6%), and healthier results versus members who were treated by providers in standard Medicare Advantage settings.
New value-based contracts represents an important shift from the historic model of health care known as fee-for-service, which concentrates on the expensive treatment of sickness rather than disease prevention and keeping individuals in good health. In the fee-for-service model, physicians are paid and incentivized deployed on volume, not better health outcomes for the patient. By contrast, transitioning to value-based payment models will make sure that physicians are reimbursed for the health results of the patients they serve, not the number of services they give. By concentrating on quality and health, Humana experienced 20% lower costs in total in the year of 2015 for members who were treated by providers in a value-based reimbursement model setting versus an estimation of original fee-for-service Medicare costs utilizing the CMS Limited Data Set Files.
“Our new value-based contract with FullWell is bolstering the future of health care right here to Colorado. We’re honor to support FullWell in building upon what is already a well-integrated care delivery system by giving Humana’s care management support to the relationship,” claimed Mark Iorio, Central West Region Medicare President for Humana.
For doctors considering about stepping into a new value-based contract, many cite not having right resources and support as key hurdles to adopting this new model. By working with Humana and FullWell, providers have approach to a number of different services to assist support their transition to value-based care.
As part of the new value-based contract, FullWell and Humana will establish strategies to make better the health of Humana’s Medicare Advantage members in Colorado, lower prices, and handle the ongoing health needs of the population. Participating practices will use FullWell and Humana population health management tools to assist recognize gaps in care, manage medication adherence, follow up on sufferers needing PCP visits, and recognize high ER utilizers and at-risk patients so they can get the adequate care before needing serious medical attention. Sufferers will also benefit from wellness programs, as well as screening and checking for chronic conditions like diabetes and heart disease.
As of Sept. 30, 2016, almost 63% of Humana individual Medicare Advantage members are in value-based payment relationships. The goal of Humana is to have 75% of individual Medicare Advantage members in value-based payment models by the end of 2017 year. For further information, visit humana.com/accountable-care or www.humana.com/valuebasedcare.
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