Guthrie is teaming up with national health and well-being leader Humana Inc. (NYSE: HUM) on a value-based health care agreement designed to offer Humana’s 4,000 Medicare Advantage members in north central Pennsylvania and south central New York an option for a more coordinated, more personalized health care experience.
Value-based care, also known as accountable care, is a growing national trend representing a shift away from the historic health care model that focused on treating individual health events. Value-based care aligns all players in the health care system to focus on a person’s overall health and long-term well-being.
Guthrie, a non-profit integrated health care delivery system located in north central Pennsylvania and Upstate New York, includes four hospitals, more than 290 physicians and 175 mid-levels, 32 regional provider offices in 23 communities, and home health and home care services.
“Guthrie is committed to delivering the Triple Aim across our integrated health system – better health outcomes, a better patient experience, and less costly care,” said Frederick Bloom, MD, President of Guthrie Medical Group. “We are pleased that we have been able to take a partnership approach with Humana on part of this journey, to provide greater value to our patients. This approach will support our Humana Medicare patients to achieve improved outcomes and a better experience, like reduction in hospitalizations and ER visits, helping them to lead longer, healthier lives.”
Through the new agreement, Humana’s population health capabilities, including predictive analytics, chronic disease management and wellness programs, will complement Guthrie’s integrated health care network and patient centered medical home initiatives. The goal, according to Humana Senior Products President Rich Vollmer, is to place primary care physicians at the center of the health care system.
“The primary care physician is the key to creating a more effective health care system,” explained Vollmer. “Value-based care creates a framework that allows primary care physicians to spend more time with patients, arms them with the tools they need to truly manage their patients’ health, and aligns the health care system to be more responsive to the people it serves.”
The agreement includes value-based incentives tied to performance improvement and quality outcomes, emphasizing standard measures defined by the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) including breast cancer screening, colorectal screening, comprehensive diabetes care, and high-risk medications.
Humana has nearly 30 years of accountable care experience, reflected in results from approximately one million Medicare Advantage members that showed significant improvements in quality, outcomes and costs through partnerships like the one with University Hospitals. In data released in 2014, Humana members in accountable care relationships experienced fewer emergency room visits and hospital admissions, and improved clinical and management screening compliance for conditions such as diabetes and cardiovascular disease.
Today, Humana has approximately 1.5 million individual Medicare Advantage members and nearly 200,000 Commercial members, cared for by approximately 43,000 primary care physicians in more than 900 accountable care relationships across 43 states and Puerto Rico.
Guthrie is a non-profit integrated health system located in north central Pennsylvania and Upstate New York, serving patients from an 11-county service area. Guthrie is comprised of a research institute, home care/hospice, hospitals in Sayre, Pa., Corning, N.Y., Towanda, Pa., and Troy, Pa., as well as a multi-specialty group practice of more than 290 physicians and 175 mid-level providers in a regional office network encompassing sub-specialty and primary care sites in 23 communities throughout Pennsylvania and New York. Guthrie offers a wide range of services and programs designed to enhance the health and well-being of those it serves.
Humana Inc., headquartered in Louisville, Ky., is a leading health and well-being company focused on making it easy for people to achieve their best health with clinical excellence through coordinated care. The company’s strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people we serve across the country.