Physicians + Humana
Physicians and other healthcare providers are dedicated to the health and well-being of their patients, and they’re finding Humana is a strong partner – working behind the scenes – on a number of important initiatives that help them improve their patients’ health.
A critical piece of moving the needle on health is helping physicians transition to value-based care. Already, Humana has partnered with more than 45,000 primary care physicians who have transitioned to value-based reimbursement models. We’re working closely with those physicians and their clinical staffs to maximize their time with their patients, identify those patients who are most in need of proactive care management and incorporate best practices seamlessly into current workflows.
To hear what physicians are saying about transitioning to value-based care, visit our Making Sense of Value-based Care site.
Transcend and Transcend Insights
We believe patients and members are best served by a healthcare system that focuses on quality health and well-being, and we want to help physicians transition from the traditional, reactive fee-for-service reimbursement model to one that is progressive, proactive and value based.
Humana’s goal is to have 75 percent of our individual Medicare Advantage members in the care of physicians using a value-based, quality-focused practice model by the end of 2017. In 2015, we took a bold step toward this goal with the launch of two new organizations: Transcend and Transcend Insights.
Transcend is a national organization that offers practice-management services to help physicians transition from fee-for-service to value-based care and reimbursement models. It can support medical practices of any size and anticipate and meet the needs of a value-based practice. Formerly known as the Humana Management Services Organization, Transcend also offers resources in care coordination; financial risk management; clinical integration; and patient engagement – all to support the physicians' efforts to improve the patient experience and care outcomes.
Transcend Insights is a population health company and a wholly owned subsidiary of Humana that helps health systems, care teams and patients transition from reactive, episodic care to planned, proactive care focused on long-term wellness.
Transcend Insights uses a sophisticated technology platform that provides a variety of measurements, dashboards and performance metrics to support physicians and their clinical staffs in their efforts to improve quality of care and patients’ health. One such application, HealthLogix Populations™, provides actionable performance measurement charts and dashboards to help health system executives and care teams quickly evaluate quality and utilization metrics and compare performance across an entire care community. Another, HealthLogix Care, a tablet and web-based application, provides physicians and care teams with a single, comprehensive view of a patient’s clinical claims and wellness data at the point of care. And finally, myHealthLogix, is a patient engagement tool that connects care teams with their patients to enable a more coordinated approach to care.
In 2015, Transcend Insights' enterprise solutions helped its partners analyze more than 7 billion clinical data points on 14.2 million patients every day and close more than 5.4 million gaps in care. In addition, the company’s enterprise solutions provide pharmacy prior authorization capabilities, support drug safety checks and clinical decision support to improve health outcomes. By providing solutions and insights that support a more proactive, person-centric approach to care, Transcend Insights is powering a better care experience, giving people the freedom to make confident decisions, and helping to enable care teams, not tools, to improve the health and long-term wellness of populations.
Provider Quality Rewards Program
As a part of Humana’s continued efforts to help transition providers from fee-for-service to value-based reimbursement models, Humana’s Provider Quality Rewards program offers financial bonuses to physicians and other providers who show outstanding improvements quality, outcomes and cost.
The program began in 2012, and in 2015, we distributed $77.2 million to participating physician groups across the United States.