Humana Collab Expands Value-Based Care for Medicare Advantage Members

Humana has partnered with an independent primary care network to enhance access to value-based care for Medicare Advantage members.

The 10-year collaboration with Aledade will allow Humana’s Medicare Advantage members to receive value-based primary care from in-network Aledade-enabled physicians.

The organizations have worked together since 2019, helping to increase access to primary care in a limited number of markets. In addition, their partnership reduced inpatient hospitalizations by 5 percent and readmissions by 12 percent. More than 100,000 patients in Humana’s network were receiving care under a value-based agreement with an Aledade physician practice by the end of 2022.

Under the recently announced partnership, the 10-year term includes a pathway to full risk and will be phased in for current and new statewide agreements.

“Humana and Aledade both have a longstanding commitment to value-based care, which focuses on more time with patients for personalized care tailored to the individual’s unique health needs,” George Renaudin, Humana’s President of Medicare and Medicaid, said in the press release.

“Aledade was one of the largest value-based care providers for Humana in 2022, and our relationship will continue our goal to improve access to proactive screenings to identify and treat illnesses early. With an increased focus on value-based care, our entire health care system can see the results through higher-quality care and lower health care costs.”

Aledade is a public benefit corporation that provides independent primary care practices with the technology and tools needed to participate in value-based care arrangements, such as data analytics, user-friendly care management, and patient outreach tools.

The company works with more than 1,500 practices and health centers across the country and has generated more than $1.2 billion in healthcare cost savings over the past eight years, according to the press release.

“Through this value-based relationship, Aledade and Humana are making a decade-long commitment to bringing better care to patients, better support to community-based primary care, and lower costs for society,” Farzad Mostashari, MD, co-founder and chief executive officer of Aledade, said. “Making a lasting change in our health care system requires a long-term commitment, and that’s exactly what Humana and Aledade are doing for patients all across the country.”

Health plan members who receive care from physicians in value-based agreements tend to undergo more preventive screenings, spend less time in the hospital, and pay less out-of-pocket than members affiliated with non-value-based physicians, according to Humana’s latest value-based care report.

Patients who received care from Humana Medicare Advantage value-based physicians were admitted to the hospital 6 percent less than patients who saw non-value-based providers. Value-based care was also associated with better patient engagement, as 86 percent of members affiliated with value-based physicians visited their primary care provider at least once in 2021.

Additionally, value-based physicians saw their patients visit an emergency room 9 percent less than non-value-based physicians.

Humana Medicare Advantage members affiliated with a value-based provider also received an average of $500 more in annual additional health plan benefits, including home care, healthy food cards, and prescription delivery.

Humana serves around 8.6 million Medicare beneficiaries nationwide, 5.6 million of whom are enrolled in a Medicare Advantage plan. The payer has more than 1,000 value-based relationships across 43 states and Puerto Rico.

In February 2023, Humana announced plans to leave the commercial insurance market and focus on the long-term growth of its Medicare Advantage, Medicare, and Medicaid health plans.

The collaboration with Aledade is not the first time this year the payer has prioritized expanding value-based primary care for its senior members enrolled in Medicare Advantage plans.

Last month, the health plan signed a five-year agreement with ChenMed, solidifying access to in-network, senior-focused primary care for Medicare Advantage members. The deal extends the current partnership between the two organizations and allows members to access ChenMed’s three medical center brands that have locations across 15 states.