Humana launches maternity bundled payment model with analytics and care coordination capabilities

Humana is teaming up with five Ob-Gyn practices to launch a  maternity bundled payment model for commercial group members with low-to-moderate-risk pregnancies.

Humana is providing the data and analytics to deliver a more coordinated patient care experience and to reduce duplicative services, readmissions, and complication rates.

Reimbursement to physicians is linked to the health outcomes.

[Also: Transforming bundled payments into episodes of care can give hospitals, payers an edge]

The maternity episode-based model will incentivize Ob-Gyns to achieve better outcomes across a member's entire perinatal episode of care from the mother's prenatal, labor and delivery to post-delivery care. 

Humana's inaugural value-based maternity bundled payment  agreements are with five voluntarily-participating practices including  Ob/Gyn Associates of Southern Indiana; Mid America Physician Services in Kansas; Seven Hills Women's Health Centers and TriHealth in Ohio; and Consultants in Women's Health in Texas.

"Because quality maternity care is important for many of our members and a significant focus of specialty care services in our country, we're very pleased to launch Humana's newest specialty-care bundled payment model," said Caraline Coats, vice president of Humana's Provider Development Center of Excellence.  

The maternity payment model is Humana's second specialty-care payment model, following its total joint replacement episode-based model for Medicare Advantage members undergoing total hip or knee joint replacement. Since its launch in 2016, that program has expanded to 40 orthopedic groups in 13 states. 

Humana, which specializes in Medicare Advantage plans, has reached its 2017 goal of having 66 percent of Humana's 2.9 million Medicare Advantage members seeing primary care physicians in value-based payment relationships.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com