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Health4, Humana Announce Accountable Care Agreement

Accountable care contract aligns reimbursement with goal of improved health and well-being for Humana members in Central Ohio

Monday, March 24, 2014 11:42 am EDT



Public Company Information:

"With sophisticated integration among its broad geographic array of hospitals, physician offices and ancillary care delivery settings, Health4 is the ideal partner in central Ohio as we reshape the health care system to deliver a more patient-centered experience"

COLUMBUS, Ohio--(BUSINESS WIRE)--Health4, 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.

Health4 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 Health4-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.

“Health4 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 Health4 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 Health4’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, Health4 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.

About The Medical Group of Ohio

The Medical Group of Ohio is an independent, physician-owned and operated company comprised of approximately 2,300 physicians practicing in 36 counties across Ohio. MGO works together, as a business, to improve the process of delivering health care and to enhance the professional satisfaction of its members. Please visit MGO’s web site at www.theMGO.com.

About OhioHealth

OhioHealth is a nationally recognized, not-for-profit, charitable, healthcare organization with Methodist roots. Based in Columbus, Ohio, OhioHealth is currently recognized as one of the top five large health systems in America by Truven Health Analytics. It is also recognized by FORTUNE Magazine as one of the “100 Best Companies to Work For” and has been for eight years in a row, 2007-2014.

Serving its communities since 1891, it is a family of 28,000 associates, physicians and volunteers, and a network of 12 member hospitals, 25+ health and surgery centers, hospice, home-health, medical equipment and other health services spanning a 40-county area.

OhioHealth member hospitals include OhioHealth Riverside Methodist Hospital, OhioHealth Grant Medical Center, OhioHealth Doctors Hospital-Columbus, OhioHealth Grady Memorial Hospital, OhioHealth Dublin Methodist Hospital, OhioHealth Doctors Hospital-Nelsonville, OhioHealth Hardin Memorial Hospital, OhioHealth Marion General Hospital, OhioHealth O’Bleness Hospital, OhioHealth MedCentral Mansfield, OhioHealth MedCentral Shelby and OhioHealth Rehabilitation Hospital. For more information, please visit our website at www.ohiohealth.com.

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

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Humana Corporate Communications
Jeff Blunt, 513-826-7094
Jennifer Bethel, 614-566-0043

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