Humana Expands Medicare Advantage Value-Based Contract in Minnesota

November 24, 2021  by  Allzone MS   102

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The payer will expand its partnership with Allina Health to cover more members under Medicare Advantage value-based contracts.

“This value-based agreement for Humana Medicare Advantage members is an important part of helping our members achieve their best health,” Chuck Dow, vice president and Medicare regional president for Minnesota at Humana. “We’re excited to share with Allina Health a strong commitment to providing quality care while improving patient health outcomes in Minnesota.”

The agreement forms a value-based contract with Allina Health, a non-profit healthcare system in parts of Wisconsin and Minnesota with which Humana had an existing partnership. Starting on January 1, 2022, the partners will expand their value-based care approach in the Medicare Advantage community.

Humana’s plans in Minnesota include both health maintenance organization-point of service (HMO-POS) and preferred provider organization (PPO) plans. They also encompass zero-dollar premium plans, which have become increasingly popular among Medicare Advantage beneficiaries over the years.

The press release noted five areas of focus for the agreement that align with Humana’s traditional value-based care goals.

First, the partners shared that members will be able to have longer visits with their healthcare professionals. Additionally, members will have access to health screenings and preventive care services. They will also receive better chronic disease management support.

Fourth, Humana and Allina Health will incorporate data analytics technologies to bolster coordinated care efforts between providers. And lastly, reimbursement will be attached to the quality of services performed, not the quantity.

A month before Humana announced the Allina Health value-based contract, the payer finalized several Medicare Advantage expansions in Tennessee. The expansions included a new dual special needs plan, a zero-dollar premium preferred provider organization plan, and enhancements to the payer’s Humana Honor Plan for veterans.

With over 90 clinics, 11 hospitals, along with retail pharmacies, specialty care centers, and specialty medical services, Allina Health is no stranger to value-based contracting either.

The healthcare provider has an ongoing partnership with Aetna, delivering value-based care to Aetna’s Medicare Advantage members.

Additionally, the provider established a six-year value-based contract with Blue Cross and Blue Shield of Minnesota (Blue Cross) with the goal of reducing members’ healthcare spending by five percent over the course of the next decade. Under this contract, if Allina Health attains the target outcomes, its providers will earn five to ten times the normal reimbursement amount.

The announcement regarding Humana and Allina Health’s value-based Medicare Advantage expansion in Minnesota comes on the heels of Humana’s 2020 Medicare Advantage value-based care report. The report found that two-thirds of Humana Medicare Advantage members were covered under a value-based contract in 2020.

In addition to shedding light on the prevalence of value-based care in the payer’s Medicare Advantage community, the report included demographic data on Humana’s Medicare Advantage population.

For example, nearly nine out of ten members in a Humana Medicare Advantage plan had one or more chronic conditions. The most common chronic conditions among Humana members were hypertension, type 2 diabetes, coronary artery disease, and chronic kidney disease.

The report also found that members’ hospitalizations and emergency room visits dropped during the coronavirus pandemic when compared to members who were covered under fee-for-service reimbursement models.

With the expanded contract in Minnesota, the payer will extend its value-based care strategy to more Medicare Advantage members in the new year.

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