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North Shore-LIJ, Humana to Offer Integrated, Value-Based Health Care to 1,000+ Medicare Advantage Members

New agreement designed to help improve the health and well-being of Humana members in NYC, Long Island


Wednesday, September 9, 2015 10:32 am EDT



Public Company Information:

"Humana has a strong history of working alongside providers to deliver high-quality and high-value care. We look forward to helping Humana grow in our market through coordinated and respectful engagements with patients and clinicians."

GREAT NECK, N.Y.--(BUSINESS WIRE)--The North Shore-LIJ Health System and Humana Inc. (NYSE: HUM) today announced a joint agreement to advance their engagement to cover more than 1,000 Medicare Advantage members in New York City and Long Island in a value-based collaboration designed to coordinate patient care, improve quality and reduce healthcare costs.

North Shore-LIJ and Humana have worked together since January 2014 on a fee-for-service basis. Building on both organizations’ success to transform health care, they will transition to a value-based care plan effective January 1, 2016.

Under the latest agreement, North Shore-LIJ will coordinate Humana members’ care through North Shore-LIJ Premium, an integrated network of over 5,500 primary care and specialty physicians as well as other health care professionals in the New York metropolitan area. Members can continue to access North Shore-LIJ’s network of 19 hospitals, more than 400 outpatient practices and a full continuum of long-term care, rehabilitation, homecare, hospice and other services on Long Island, in New York City and in Westchester County.

“We are proud to collaborate with Humana in the New York market, further increasing our value-based contracting,” said Howard Gold, Executive Vice President and Chief Managed Care Business Officer at North Shore-LIJ. “North Shore-LIJ and Humana are both committed to serving the Medicare population with exceptional care and service. The value-based plan allows us to focus on measurable patient outcomes, care coordination and aligning quality with payment incentives.”

The value-based agreement reflects a shift away from the current episodic health care model to a value-based model that emphasizes quality and patient care experiences. The accountable care approach also aligns North Shore-LIJ and Humana’s complementary population health capabilities, including predictive analytics, chronic disease management and wellness programs.

“We’re delighted to deepen our relationship with North Shore-LIJ to focus on our mutual desire to help people on Medicare achieve their best health by focusing on patient-centered, integrated care that emphasizes prevention, chronic care and improved quality outcomes,” said Alexander Clague, Humana’s President for Senior Products in the Northeast Region. “We are excited to share our data to support North Shore-LIJ’s holistic focus on population health across all levels of care.”

“The North Shore-LIJ Premium Network and North Shore-LIJ Care Solutions, the health system’s care management organization, are the engines that will engage physicians to manage high-risk patients covered under this program,” Mr. Gold said.

Humana has nearly 30 years of accountable care experience, reflected in results from approximately one million Medicare Advantage members who showed significant improvements in quality, outcomes and costs in 2013.

Kristofer Smith, MD, Vice President and Medical Director of Care Solutions at North Shore-LIJ, said, “Humana has a strong history of working alongside providers to deliver high-quality and high-value care. We look forward to helping Humana grow in our market through coordinated and respectful engagements with patients and clinicians.”

About North Shore-LIJ Health System

One of the nation's largest health systems, North Shore-LIJ delivers world-class clinical care throughout the New York metropolitan area, pioneering research at The Feinstein Institute for Medical Research, a visionary approach to medical education highlighted by the Hofstra North Shore-LIJ School of Medicine, and healthcare coverage to individuals, families and businesses through the CareConnect Insurance Co. Inc. North Shore-LIJ cares for people at every stage of life at 21 hospitals and about 450 outpatient physician practices throughout the region. North Shore-LIJ’s owned hospitals and long-term care facilities house more than 6,600 beds, employ more than 13,300 nurses and have affiliations with about 10,300 physicians. With a workforce of more than 61,000, North Shore-LIJ is the largest private employer in New York State. For more information, go to www.northshorelij.com.

About Humana

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.

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; and
  • Corporate Governance information.

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North Shore-LIJ
Betty Olt, 516-465-2645
Terry Lynam, 516-465-2640
Humana Media Relations
Nancy A. Hanewinckel, 941-585-4763