More on Reimbursement

Cleveland Clinic, Humana, partner on Medicare Advantage plans

Reimbursement to physicians is linked to the health outcomes of their patients.

Susan Morse, Senior Editor

Credit: <a href="">2old at wts wikivoyage</a>.Credit: 2old at wts wikivoyage.

Cleveland Clinic and Humana are joining forces to offer two, value-based Medicare Advantage health plans.

The new plans include a MA health maintenance organization plan for those with Medicare, and a Medicare Advantage dual-eligible special needs plan for those covered by both Medicare and Medicaid.

[Also: Anthem acquires Florida Medicare Advantage plan and network HealthSun]

Reimbursement to physicians is linked to the health outcomes of their patients, rather than the number of services they provide, said the Cleveland Clinic.

The plans have zero monthly premiums, zero PCP office visit copays, a zero copay for a 30-day supply of Tier 1 prescription drugs, and no requirement for a referral to see an in-network specialist.

[Also: Kaiser Permanente first in Medicare Advantage consumer satisfaction, study finds]

The Humana Cleveland Clinic Preferred Medicare Plan will be offered for people with Medicare in Cuyahoga County, Ohio during this year's Medicare Advantage and Prescription drug plan enrollment period starting October 15 and running through Dec. 7. Plan coverage begins on Jan. 1, 2018.

The collaboration builds on an existing value-based care agreement between Humana and Cleveland Clinic. It focuses on allowing for more personal time between physician and patient, access to health screenings and wellness programs and improved care for those with chronic conditions.

It leverages technologies, such as data analytics, to connect physicians to work as a team. It also combines Humana's experience in Medicare Advantage plans and Cleveland Clinic's clinical expertise.

Plan members have access to 3,500 physicians with the Cleveland Clinic Health System and also the independent physicians who are part of the Cleveland Clinic Quality Alliance.

Twitter: @SusanJMorse
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