Humana adds 7 new states to bundled payment portfolio

HumanaThe Louisville-based Humana is expanding a value-based payment model into seven additional states, while the Medicare agency has yet to set a clear course for how to handle such models.

Humana announced last week it would start offering its bundled payment model for hip and knee replacements under Medicare Advantage plans to members in Alabama, Florida, Georgia, Illinois, Louisiana, Mississippi and Texas.

The bundle, which intends to reduce costly hospital readmissions, was originally launched in 2016 in Ohio and Tennessee but was expanded to Indiana, Kentucky, North Carolina, and Virginia last year. Under Humana’s most recent expansion, the model will be available to more than one-quarter of the country.

Hip and knee replacements total about one million a year, according to the Journal of Bone and Joint Surgery, and the number of surgeries is projected to increase.

The expansion by the private payer comes months after the Medicare agency rolled back a mandatory bundled payment expansion for hip fractures and cardiac care, which some have said would slow the industry’s transition to value-based care.

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