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Humana Launches CMS’ New Comprehensive Primary Care Initiative

Humana implements program in three areas

Category:

Wednesday, August 22, 2012 11:10 am EDT

Dateline:

LOUISVILLE, Ky.

Public Company Information:

NYSE:
HUM
US4448591028
"We believe the innovative partnership with the Centers for Medicare and Medicaid Services is an opportunity for us to help primary care practices leverage a framework that can help drive coordinated care"

LOUISVILLE, Ky.--(BUSINESS WIRE)--As the Centers for Medicare and Medicaid Services (CMS) officially kicks off its Comprehensive Primary Care initiative, Humana Inc. (NYSE: HUM), one of the nation’s leading health and well-being companies, announced today that it is now implementing its previously announced participation in this CMS initiative across three areas. The four-year, multi-payer agreement with CMS is designed to provide more Americans with affordable, high quality health care.

Under the Comprehensive Primary Care initiative, CMS will pay primary care practices a care management fee, initially set at an average of $20 per beneficiary per month, to support enhanced, coordinated services on behalf of Medicare fee-for-service beneficiaries. Simultaneously, participating commercial, state, and other federal insurance plans are also offering enhanced payment to primary care practices that are designed to support them in providing high-quality primary care on behalf of their members.

“Primary care practices play a vital role in our health care system and we are looking at ways to better support them in their efforts to coordinate care for their patients,” said Acting CMS Administrator Marilyn Tavenner. “By engaging in this unprecedented and innovative public-private partnership we aim to create a payment model that allows our primary care practices to take a lead role in delivering improved overall coordinated care for their patients. Our goal is to see healthier families across our nation and to generate savings for providers, insurers and taxpayers.”

“We believe the innovative partnership with the Centers for Medicare and Medicaid Services is an opportunity for us to help primary care practices leverage a framework that can help drive coordinated care,” said Renee Buckingham, Vice President of Provider Engagement for Humana. “By collecting data that pertains to cost, quality and member satisfaction, the Comprehensive Primary Care initiative enables Humana to identify and drive greater efficiencies while delivering quality, affordable health care to our members in their quest to achieve well-being.”

Humana previously announced the company will cover three areas for the Comprehensive Primary Care initiative: Arkansas, Colorado and southern Ohio/northern Kentucky. Members of Humana’s Medicare Advantage Preferred Provider Organization (PPO) and Private-Fee-For-Service (PFFS) as well as Commercial ASO and Fully Insured will have access to health care services at approximately 75 practices across each of these three geographic areas under the Comprehensive Primary Care initiative. These practices were selected for each of the regions and each will receive aggregate and member level data on cost and utilization at regular intervals from Humana.

In conjunction with CMS, Humana will specifically focus on:

  • Aligning quality, practice improvement and patient experience measures
  • Conducting systematic data sharing on cost and utilization
  • Building multi-payer alignment around processes and reporting

Humana’s national network -- one of the largest in the country -- includes more than 600,000 hospitals and physicians.

About Humana

Humana Inc., headquartered in Louisville, Ky., is a leading health-care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

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)
  • Corporate Governance information

Contact:

Humana Corporate Communications
Alex Kepnes, 502-580-2990
akepnes@humana.com