Relationship provides continuing value-based primary care from Aledade-empowered physicians for Humana’s Medicare Advantage members
Aledade, the nation’s largest network of independent primary care, and Humana Inc. (NYSE: HUM), leading health insurer and health care services company, have announced a 10-year collaboration to provide value-based primary care for Humana’s Medicare Advantage members from in-network Aledade-enabled physicians.
The two companies have been working together since 2019 in a limited number of markets, where they were able to increase primary care visits and bring impressive results, reducing inpatient hospitalizations by 5% and reducing readmissions by 12%, according to shared company data. By the end of 2022, more than 100,000 patients in Humana’s network received care under a value-based agreement with an Aledade-enabled physician practice.
Building on their existing relationship, the two companies plan to phase in the 10-year term for current and new state-wide agreements, which include a pathway to full risk. The collaboration with Humana will continue to grow as new practices and prospective markets join Aledade’s nationwide network.
“Through this value-based relationship, Aledade and Humana are making a decade-long commitment to bringing better care to patients, better support to community-based primary care, and lower costs for society,” said Dr. Farzad Mostashari, co-founder and CEO of Aledade. “Making a lasting change in our health care system requires a long-term commitment, and that’s exactly what Humana and Aledade are doing for patients all across the country.”
Aledade, a public benefit corporation, helps independent primary care practices succeed and thrive in value-based care arrangements by giving them the technology and tools to deliver more proactive and preventive care, reducing costly and invasive care for patients. The company works with more than 1,500 primary care practices and health centers around the country, empowering these community-based primary care practices with cutting-edge data analytics; user-friendly care management; patient outreach tools and regulatory expertise; and local, hands-on support. Over the past eight years, the company has generated more than $1.2 billion in health care cost savings by helping primary care clinicians give their patients better care.
“Humana and Aledade both have a longstanding commitment to value-based care, which focuses on more time with patients for personalized care tailored to the individual’s unique health needs,” said George Renaudin, Humana’s President of Medicare and Medicaid. “Aledade was one of the largest value-based care providers for Humana in 2022, and our relationship will continue our goal to improve access to proactive screenings to identify and treat illnesses early. With an increased focus on value-based care, our entire health care system can see the results through higher-quality care and lower health care costs.”
Humana’s ninth annual value-based care report demonstrates how members affiliated with physicians in value-based agreements on average receive more preventive screenings, spend less time in the hospital, and pay less out-of-pocket than those affiliated with non-value-based physicians.
- Fewer admissions: Humana Medicare Advantage value-based physicians saw their patients admitted to a hospital on average 6% less than non-value-based physicians.
- Better patient engagement: About 86% of members affiliated with value-based physicians visited their primary care physicians at least once in 2021.
- Fewer ER visits: Value-based physicians saw their patients visit an emergency room on average 9% less than non-value-based care.
- Financial savings: Humana Medicare Advantage members received took advantage of an average of $500 more in annual additional health plan benefits, such as home care, prescription delivery and healthy food cards, when associated with a value-based physician.
Humana has served Medicare beneficiaries for nearly 40 years, with about 8.6 million Medicare members in all 50 states, Washington, D.C., and Puerto Rico, as of January 2023. Approximately 5.6 million of those members are enrolled in a Medicare Advantage plan, which includes members affiliated with providers in value-based and standard Medicare Advantage settings. Humana has an extensive and growing value-based care presence with more than 1,000 value-based relationships across 43 states and Puerto Rico, as of Dec. 31, 2022, including its own 235 CenterWell- and Conviva-branded senior-focused primary care facilities.
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