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Humana, University of Houston announce value-based care specialization program

The two entities have created this specialization to help bridge the VBC knowledge gap.

Jeff Lagasse, Associate Editor

Humana and the University of Houston have announced the launch of a Value-based Care Specialization online program to support providers, academia and other business and industry professionals – as well as the public – in learning about the fundamentals and real-world application of value-based care.

Surveys show that there is a varied understanding of the definition of value-based care within the healthcare industry. Through the Humana Integrated Health System Sciences Institute, Humana and the University of Houston have created this specialization to help bridge the VBC knowledge gap. The program is available to learners around the world through Coursera, a global online learning platform.

The program comprises six courses and a capstone project, with each course composed of two to three learning modules and a summation assignment. Participants can take any of the six courses independently, receiving a certificate for each, or as a collection for the specialization designation.

WHAT'S THE IMPACT?

Under value-based care, providers are reimbursed based on their ability to improve quality of care in a cost-effective manner or lower costs while maintaining standards of care, rather than the volume of care they provide. Such arrangements may also permit providers to address social determinants of health and disparities across the healthcare system. 

Moving toward a more value-driven healthcare system, according to the Centers for Medicare and Medicaid Services, allows states to provide Medicaid beneficiaries with efficient, high-quality care while improving health outcomes.

Value-based care may also help ensure that the nation's healthcare system is better prepared and equipped to handle unexpected challenges, including the ongoing COVID-19 pandemic.

THE LARGER TREND

In February, Humana said it was teaming with in-home medical care provider DispatchHealth to provide its members with advanced home healthcare services. The services will initially be available in Denver and in Tacoma, Washington, with expansion to additional markets in Texas, Arizona and Nevada planned for later this year.

Last November, the Centers for Medicare and Medicaid Services announced a waiver program to allow qualified healthcare providers to offer acute, hospital-level care in the home. The Dispatch-Humana agreement is believed to be the country's first program to provide hospital-level care involving a national payer, according to Humana.

Also last month, Humana launched a pilot called Humana Care Support, formerly known as the Enterprise Clinical Operating Model, for a select group of Medicare Advantage members.

Care Support is made up of customized, integrated and coordinated care-management services. The care team will have real-time access to a member's medical history and integrated clinician workflows through analytics and data integration from Microsoft's cloud technologies' Azure and Power BI. 

The pilot is designed to enhance the integrated care members already receive from their providers. Many of Humana's provider partners are in value-based care agreements serving Medicare Advantage members, which have their own care management capabilities already in place.

Financial documents show that Humana ended 2020 on a down note, posting a record net loss of $274 million in the fourth quarter. An earnings call transcript from the insurance giant reveals that a sharp increase in COVID-19 admissions occurred across its markets during the last couple months of the year, though most of those expenses were balanced out by a decline in non-coronavirus care.

ON THE RECORD

"This readily available and affordable option will support those who are working with practices and providers to create better outcomes for their patients," said Tray Cockerell, director of strategy advancement for Humana.

"It's more important than ever, with the tumult caused by COVID-19, that practices focus on prevention and care coordination. We learned in 2020 that providers in value-based care agreements were better positioned to withstand the financial impact the pandemic brought on the healthcare industry because they had established patient-centered medical practices.

"Because they could quickly pivot their resources into action to best serve patients, their income was not as drastically affected as those of their fee-for-service peers."

"It's essential that those who work to improve the health of their communities speak the same language," said Dr. LeChauncy Woodard, general internist and founding director, Humana Integrated Health System Sciences Institute at the University of Houston.

"The collaboration on this content assures that everyone, from the physician and nurse to social workers, pharmacists and claims representatives, as well as consumers of healthcare, understand what it takes to work together. These multi-sector partnerships help to ensure patients are receiving the best possible care and achieving the best outcomes at the lowest possible cost."

"The healthcare industry is rapidly changing, and high-quality, flexible learning can help support medical professionals preparing for the future," said Betty Vandenbosch, chief content officer at Coursera.

"We are excited to partner with leaders such as the University of Houston and Humana to offer job-relevant content in the emerging area of value-based care."
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com