Humana Launches Value-Based Care Oncology Program for MA Members
The new value-based care program aims to improve health outcomes for Humana Medicare Advantage members with cancer.
Source: Thinkstock
By Jessica Kent
- Humana is launching a new value-based care oncology program designed to deliver integrated cancer care for Humana Medicare Advantage and commercial members.
The national Oncology Model of Care (OMOC) program aims to improve the patient experience for patients with new or recurrent cancer diagnoses through coordinated, affordable care. Humana will offer analytics to providers, as well as compensation for enhanced care navigation based on incremental evaluation of quality and cost.
Quality and cost will be measured within several key care components, including inpatient admissions, emergency room visits, medical and pharmacy drugs, laboratory and pathology services, and radiology, as determined by metrics that address access to care, clinical status assessments, and patient education.
The program’s inaugural practices include Southern Cancer Center of Alabama, Highlands Oncology Group in Arkansas, St. Elizabeth Healthcare of Kentucky, and several others.
OMOC is Humana’s fourth specialty-care payment model and will build on the payer’s past efforts to deliver value-based, cost-effective care to its members. In April 2018, the organization partnered with OB-GYN practices to introduce a national value-based payment model to improve maternity care quality and reduce costs for Humana members with low- to moderate-risk pregnancies.
“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,” Caraline Coats, Vice President of Humana’s Provider Development Center of Excellence, said at the time.
“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.”
Additionally, in 2017, Humana expanded its orthopedic bundled payment programs to include eight new groups in Indiana and Kentucky. The model is focused on Medicare Advantage members who need total hip or knee joint replacement procedures.
“Humana’s approach is to provide orthopedic surgeons the tools they need to coordinate all aspects of their patients’ diagnosis, treatment, recovery and rehabilitation to in turn improve quality, lower cost and create a better experience for our members,” Chip Howard, Humana’s Vice President of Payment Innovation said at the time.
With this new specialty-care payment program, Humana will continue its commitment to value-based care, emphasizing more personal time with health professionals, personalized care delivery, and access to proactive screenings and services to prevent illness.
Humana also highlights the importance of leveraging data analytics that support care coordination, as well as physician reimbursement that is tied to outcomes rather than the quantity of services provided.
The payer expects that this new program will improve oncology care delivery and outcomes for their members.
“With the field of oncology rapidly evolving, we’re very pleased to announce the launch of a quality-based program specifically focused on the delivery of cancer care,” said Bryan Loy, MD, MBA, Corporate Medical Director of Humana’s Oncology, Laboratory, and Personalized Medicine Strategies Group. “Humana is committed to providing physician support and working together to improve coordination across the continuum of care for our members with cancer.”
