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Humana and United Hospital System Establish Accountable Care Agreement for Medicare Members in Wisconsin

Humana teams up with one of the region’s most comprehensive health care systems to expand access for Medicare Advantage members in Kenosha County


Monday, December 22, 2014 2:00 pm EST



Public Company Information:

"Over the past several years, more and more retirees living in the communities that United Hospital System serves have selected Medicare Advantage plans"

KENOSHA, Wis.--(BUSINESS WIRE)--Humana Inc. (NYSE: HUM) and United Hospital System announced a new three-year Accountable Care agreement and partnership beginning on January 1, 2015. This relationship will not only increase access for Humana Medicare Advantage (MA) members but is also expected to enhance health care coordination, improve quality of care and drive down costs for members in southeast Wisconsin.

Accountable care is a fast-growing model for health care service delivery and health care provider payment. The model focuses on creating health in addition to treating sickness, utilizes the primary care physician to coordinate care for the patient, offers treatment options based on proven standards of care and better controls costs through integrated care and reimbursement based on adherence to standards of care.

“Over the past several years, more and more retirees living in the communities that United Hospital System serves have selected Medicare Advantage plans,” said Ric Schmidt, President, CEO and General Counsel of United Hospital System. “The partnership between United Hospital System and Humana will allow our outstanding team of physicians and professional healthcare workers to provide excellent patient care to the growing number of retirees who select Humana Medicare Advantage plans. This partnership is clearly in the best interest of all parties, most notably our patients.”

Kenosha County-based United Hospital System offers a wide array of services primarily through the Kenosha Medical Center Campus and the St. Catherine’s Medical Center Campus. Additionally, United Hospital System has physician clinics located at the Kenosha Medical Center Campus and the St. Catherine’s Medical Center Campus, and other off-site physician clinics located in the city of Kenosha and Village of Paddock Lake, Wisconsin as well as in Gurnee, Illinois. By providing services through these locations, United Hospital System’s facilities and physicians treat approximately 65 percent of the total patients who receive care within Kenosha County.

United Hospital System recently began construction of a new medical office building located in the Town of Somers. The three-story 31,000 square foot building is located in the Somers Market Center on the corner of Highway 31 (Green Bay Road) and Highway S (Route 142). The ground floor will house audiology and physical therapy services, including a warm water aqua therapy pool. The second floor will offer urgent care services, physician offices, and basic diagnostic services. Construction started in August 2014 and is expected to be complete in Spring/Summer 2015.

The Humana/United Hospital System agreement emphasizes quality 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. The partnership will also offer more personalized care and a broad range of population management tools like predictive analytics, chronic disease management and wellness programs.

“The Accountable Care model is changing the way we and our physician partners manage patient care and promote wellbeing,” said Bruno Piquin, Humana Senior Markets Vice President, Northern Division. “We are continuing to establish these value-based partnerships nationwide because we know they work and we’re already witnessing their impact on how health care is delivered.”

Humana has a 26-year accountable care relationship history with more than 1.2 million MA members that are cared for by 38,000 primary care physicians, in more than 900 accountable care relationships across 43 states and Puerto Rico.

About United Hospital System

United Hospital System is a comprehensive regional healthcare system that has served southeastern Wisconsin and northern Illinois communities for more than 100 years. United Hospital System provides services primarily through the Kenosha Medical Center Campus and the St. Catherine’s Medical Center Campus. At United Hospital System, we are committed to living out the healing ministries of the Judeo-Christian faiths by providing exceptional and compassionate healthcare services that promote the dignity and well-being of the people we serve; this is our Mission and our reason for being. United Hospital System strives to be accessible to all members of the communities we serve by providing emergent and urgent healthcare needs irrespective of ability to pay. This is our commitment to the fundamental components of quality, accessibility and affordability which impact the delivery of healthcare. Our Mission is the foundation for the care delivered through our multiple locations. Our locations are positioned to deliver services to people residing in Kenosha, Pleasant Prairie, western Kenosha County and northern Illinois.

A report from the Greater Milwaukee Business Foundation on Health, an independent third-party group that commissions a report that is conducted by the Milliman consulting firm, which has been updated annually since 2003 and for which the most recently available data was released on July 23, 2014 indicates that United Hospital System’s average composite payment levels are the lowest of all the hospitals and healthcare systems within the seven counties that make up Southeastern Wisconsin (Milwaukee, Kenosha, Racine Ozaukee, Washington, Walworth and Waukesha). Not only does that report show that United Hospital System’s average composite payment levels were the lowest for the most recently available period, but that United Hospital System’s average composite payment levels have been the lowest each year since the inception of the report in 2003.

Additional information about United Hospital System is available at www.uhsi.org.

About Humana

Humana Inc., headquartered in Louisville, Kentucky, 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.

More information regarding Humana is available to investors via the Investor Relations page of the company’s web site at www.humana.com, including copies of:

  • Annual reports to stockholders;
  • Securities and Exchange Commission filings;
  • Most recent investor conference presentations;
  • Quarterly earnings news releases;
  • Replays of most recent earnings release conference calls;
  • Calendar of events (including upcoming earnings conference call dates and times, as well as planned interaction with research analysts and institutional investors); and
  • Corporate Governance information.

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Humana Inc.
Cathryn Donaldson, 312-441-5346
Corporate Communications
United Hospital System
Susan Rizzo, 262-656-2100