- Humana has launched a bundled payment model to improve outcomes and lower costs of maternity by partnering with OBG-YNs across the country.
Humana’s Maternity Episode-Based Model bundles payments that covers the cost of a mother’s prenatal care, labor and delivery care, and post-delivery care for low to moderate risk pregnancies.
Humana has established initial agreements with OBG-YN providers in Indiana, Ohio, Kansas, and Texas for episodes of care within the payer’s commercial market.
The payer will additionally support the model by using data analytics to improve care coordination, enhance quality of patient care, reduce duplicative services, and lower readmissions and complication rates.
Vice President of Humana’s Provider Development Center of Excellence Carlaine Coats explained that the model further supports the organization’s other value-based initiatives and bundled payment programs.
“Because quality maternity care is important for many of our members and a significant focus of specialty care services in our country, we’re very pleased to launch Humana’s newest specialty-care bundled payment model,” Coats said. “Humana is dedicated to working with OB-GYNs across the country to provide a better patient experience and improve patient outcomes, while also tackling the cost challenges inherent in perinatal care.”
Humana follows in the steps of public and private organizations that have experimented with similar methods to bundled payments for maternity care.
The Medicaid program is seen as a pioneer in the use of maternity care bundled payments by having partnered with health systems with large Medicaid populations.
A NEJM Catalyst case study found that Community Health Choice, a non-profit HMO plan for Medicaid beneficiaries, piloted a maternity care bundled payment model and noticed that utilizing provider scorecards and leveraging prior cost data is necessary for future iterations.
The authors of the study found that effective provider collaboration and data-sharing is needed to succeed with the bundles and inform stakeholders on how to operate the bundles.
Private payers have steadily introduced maternity care bundled payments but have lagged behind Medicaid’s use of maternity bundles.
Cigna previously implemented a bundled payment model for maternity care that helped lower costs, improve cesarean delivery rates, and patient satisfaction.
Humana’s new bundled payment program is another addition in its extensive value-based care portfolio, which contains nearly 1000 value-based partnerships with providers in 43 states.