Humana collaborates with orthopedic groups in joint replacement model

Humana's headquarters in Louisville, Kentucky.

Humana is collaborating with eight orthopedic specialty groups in Indiana and Kentucky on a value-based care model for Medicare Advantage members undergoing total hip or knee joint replacement procedures.

Humana will provide the analytics needed to manage patient care from diagnosis to recovery, to deliver coordinated services for the patient, reduce complications and unnecessary readmissions after surgery.

Humana offers population health capabilities, chronic disease management and wellness programs to complement the integrated care approach for the orthopedic groups.

"Through our total joint replacement model, Humana is taking value-based care to the next level – from primary care to a more involved medical procedure," said Chip Howard, Humana's vice president of Payment Innovation. "Humana's approach is to provide orthopedic surgeons the tools they need to coordinate all aspects of their patients' diagnosis, treatment, recovery and rehabilitation to in turn improve quality, lower cost and create a better experience for our members."

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For over 30 years, Humana has partnered with primary care physicians in value-based arrangements. In 2015, this lowered costs by 20 percent, the insurer said.

Humana's model in Indiana and Kentucky is similar to the State of Tennessee's Innovation Model Grant through the Centers for Medicare and Medicaid Services for Medicaid beneficiaries.

The model is intended to improve quality, outcomes and costs across a person's entire episode of joint replacement care.

The participating Indiana and Kentucky orthopedic groups join the 12 orthopedic groups in Ohio and Tennessee which joined Humana's orthopedic value-based care model in 2016.

In Indiana, Humana will work with Fort Wayne Orthopedics, Ortho NorthEast, Orthopaedic Associates Inc., Tri-State Orthopaedics and Unity Healthcare LLC.

In Kentucky, Humana will work with Commonwealth Orthopaedic Centers, Kentucky Bone and Joint Surgeons and Norton Orthopedic Specialists.

Twitter: @SusanJMorse