Four health systems are the inaugural participants of Humana's new hospital incentive program.
The Cleveland Clinic, Florida; Jackson Health System in Florida; TriHealth in Ohio; and the WellStar Health System in Georgia will be compensated based on their quality improvement and performance in three key areas: patient experience, patient safety and patient outcomes.
Humana is working with the health systems to deliver integrated care and reduce duplicative services, hospital readmissions, and complication rates in acute care inpatient admissions.
The hospitals will be measured by their hospital-associated infection rates, care coordination, palliative care, and other factors. The metrics incorporate two care certification programs: the integrated care certification and hospital-based palliative care coordination certification. Both were developed by The Joint Commission, the nation's standards-setting and accrediting body in healthcare.
By focusing on more proactive and personalized care, such as giving consumers greater access to health screenings and providing more coordinated care for people living with chronic conditions, health outcomes improve and costs come down.
To do this, Humana said it leverages data analytics to connect physicians and coordinate care around the patient. Physician compensation is linked to health outcomes.
Humana launched the value-based program in April. It is open to general acute care hospitals participating in the insurer's commercial network.
Humana also has a big Medicare Advantage presence, which includes an estimated 2 million members affiliated with providers in value-based programs. Humana's total MA membership is more than 3.5 million.
ON THE RECORD
"We're delighted to collaborate with the first participants in our value-based care initiative for hospitals," said Oraida Roman, vice president of Humana's Value-Based Strategies Organization. "Humana is committed to providing dedicated support to our participants as they intensify their efforts to provide a coordinated experience for our members and help them achieve better health."
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