Humana and athenahealth team up to reward clinical performance

Humana, Inc., a health and supplemental benefits company, and athenahealth, a provider of Web-based practice management and electronic health record software, have announced an alliance with the aim of combining Humana's Primary Care Rewards Program with athenahealth's EHR service.

"Parallel to the government's efforts to drive meaningful use of EHRs, athenahealth and Humana are leaping ahead through the introduction of the first true private-sector solution between a payer and service provider to deliver meaningful outcomes," said Jonathan Bush, chairman and CEO of Watertown, Mass.-based athenahealth. 

The alliance combines a national health plan with EHRs designed to provide physicians useful, applicable information about their patients. The cost of athenahealth's EHR service, athenaClinicals, will be subsidized by Humana for the benefit of physicians who wish to participate in the program.

"Seamless, integrated electronic medical records are a critical necessity in patient care today, greatly reducing the chance of medical errors and duplicative treatment, facilitating a more holistic view of the patient's care profile and improving outcomes," said Bruce Perkins, senior vice president of Louisville, Ky.-based Humana's healthcare delivery systems and clinical processes organization.

Humana and athenahealth will both promote the program to approximately 20,000 family and internal medicine physicians who are part of Humana's national provider network. For 100 physician practices – including small practices and large, multi-specialty groups – projected to represent 1,000 physicians, Humana will subsidize implementation costs. Each practice will be provided with individual goals and measured regularly to provide performance feedbacks, and may also be eligible to receive additional financial benefits through a shared-savings program should they meet or exceed certain quality standards

"This partnership not only makes it possible, but makes it easy and affordable for providers to capture patient-care activity into an integrated EHR," Perkins said. "This will facilitate enhanced care coordination, serve as a patient-centric repository for specific gaps-in-care alerts and be the centerpiece for multi-provider communication – all of which must exist to improve outcomes and reduce cost."

Humana will provide health information and clinical messaging to athenahealth's athenaClinicals solution through CareProfile, part of the company's Availity health-information network. Physician encounters will be measured using nationally recognized HEDIS quality measures – standards designed to improve the efficiency of healthcare delivery.

Human officials say participating physicians could possibly accrue 20 percent in additional revenue beyond current fee-for-service base collections.

"We are eager to partner with Humana on one of the industry's early efforts to close some of the gaps that exist in the health supply chain and hope other insurers will follow the collaboration's lead," said Bush.