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Humana, Aledade Bring Value-Based Care to Medicare Advantage Members

The collaboration will enable physicians in Aledade ACOs to deliver quality care to Humana Medicare Advantage members.

Humana, Aledade bring value-based care to Medicare Advantage members

Source: Thinkstock

By Jessica Kent

- Humana and Aledade have announced a value-based care agreement that will increase access to value-based care for Medicare Advantage members.

The partnership will enable physicians in Aledade’s accountable care organizations (ACOs) in Louisiana, Pennsylvania, and West Virginia to deliver quality care to Humana’s Medicare Advantage members.

“We’re delighted to be able to deliver value-based care to an expanded patient population through this agreement with Humana,” said Dr. Farzad Mostashari, co-founder and CEO of Aledade.

“Humana shares our dedication to improving patient health and lowering health care costs by empowering independent physicians to thrive in value-based care arrangements.”

Aledade partners with independent primary care practices to build and lead ACOs that participate in value-based agreements. Aledade supports its physicians by providing them with cutting-edge data analytics, user-friendly care management, patient outreach tools, and local, hands-on support.

This new agreement with Humana will add to Aledade’s value-based care efforts. In December 2016, Aledade partnered with Highmark Blue Cross Blue Shield to deliver care through ACOs in Delaware and West Virginia. The collaboration benefitted about 40,000 Highmark health plan members.

This agreement will build on Humana’s commitment to value-based care, which includes more personal time with health professionals, as well as personalized care that is tailored to each person’s unique health situation.

Humana also emphasizes access to proactive health screenings and programs focused on preventing illness, and improved care for people living with chronic conditions.

Humana’s focus on holistic, quality healthcare has led to improved care delivery and outcomes for its members. The organization reports that in 2016, Humana providers in value-based reimbursement agreements had 26 percent higher Healthcare Effectiveness Data and Information Set (HEDIS) scores compared to providers in standard Medicare Advantage settings.

Moreover, in 2016, Medicare Advantage members who were affiliated with providers in value-based reimbursement agreements experienced six percent fewer hospital inpatient admissions, and seven percent fewer emergency department visits than members in standard Medicare Advantage settings.

Patients treated by physicians in Humana Medicare Advantage value-based agreements had more preventive care screenings and better health outcomes than those in Humana Medicare Advantage fee-for-service arrangements.

As of December 31, 2018, more than 2 million of Humana’s Medicare Advantage members and 115,000 commercial members received care through value-based arrangements.  

Humana’s total Medicare Advantage membership is approximately 3.6 million members.

With this new partnership, both Aledade and Humana will continue to work toward expanding value-based healthcare for Medicare Advantage members.

“Humana is pleased to expand the availability of value-based care in Louisiana, Pennsylvania, and West Virginia,” said Oraida Roman, Vice President of Humana’s Value-Based Strategies Organization.

“This agreement reflects a strong, mutual belief by Aledade and Humana that value-based care is key to enhancing both the patient experience and patient outcomes.”


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