Health 4, a clinically integrated health care delivery model co-owned by OhioHealth and The Medical Group of Ohio (MGO), and Humana Inc. (NYSE: HUM) have announced a new Accountable Care agreement that will serve Humana’s 41,000 Medicare Advantage members in Columbus and Central Ohio.
Health 4 was created in 2010 by The Medical Group of Ohio, an independent physician association, and OhioHealth, a family of not-for-profit hospitals and health care providers, to bring all health care parties together – patients, employers, insurers and health care providers – in a clinically integrated effort.
Humana’s Accountable Care Continuum is a pay-for-value system focused on promoting evidence-based, highly-integrated care, which can lead to improved medical member outcomes, a better customer experience and lower costs.
The new Health 4-Humana agreement includes value-based incentives tied to performance and will bring better patient care coordination, more cost effective care, improved outcomes, and a world-class patient experience to Humana members in Central Ohio.The arrangement will offer more personalized care and a broad range of population management tools, like predictive analytics and chronic care, disease management and wellness programs. The value-based arrangement emphasizes improved health outcomes with a focus on care coordination and leverages measures as defined by the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) like diabetes care and treatment, breast cancer screenings, colorectal cancer screenings and high-risk medication. “Health 4 physicians provide proven, high quality care to their patients,” said John Schmeling, MD, Chief Executive Officer for The Medical Group of Ohio. “As a result, more than 160,000 Health 4 patients are benefitting from a patient-centric, accountable approach to health care delivery. This partnership with Humana ensures that their population of patients will also benefit from this approach and will continue to receive excellent care.” Under the terms of the agreement, Humana will offer plan designs built around the new accountable care agreement and feature Health 4’s 34-county network stretching across central Ohio. The network is comprised of more than 2,300 MGO physicians who are committed to delivering the highest quality and value, and OhioHealth’s hospitals and health care organizations. “With sophisticated integration among its broad geographic array of hospitals, physician offices and ancillary care delivery settings, Health 4 is the ideal partner in central Ohio as we reshape the health care system to deliver a more patient-centered experience,” said Larry Costello, Humana’s President for Senior Markets in Ohio. Humana has a 25-year Accountable Care relationship history with more than one million members that are cared for by 33,000 primary care physicians, in more than 900 Accountable Care relationships across 40 states and Puerto Rico.