Humana and Heritage Provider Network expand in-network Medicare Advantage coverage
The value-based agreement will reimburse physicians based on patient outcomes.
Humana has collaborated with the Heritage Provider Network on a value-based plan to reimburse physicians based on outcomes and to give expanded in-network access to its Medicare Advantage members in California.
Humana's Medicare Advantage HMO plan members in Kern, Los Angeles, Orange, Riverside, San Bernardino, and Ventura counties, as well as dual eligible special needs plan members in Kern and Ventura counties, will have in-network access to Heritage's physicians and facilities throughout Southern and Central California.
WHY IT MATTERS
Collaborations such as this have expanded value-based care between providers, and between providers and payers.
This week, two Tennessee health systems collaborated to create an independent, statewide system of in-network physicians, hospitals and quick care centers.
THE TREND
In the Humana and HPN agreement, the insurer gets an expanded network in California. HPN is a physician-owned and operated integrated delivery system of over 50-related hospital, pharmacy, urgent and primary care and surgical center collaborations.
Heritage gets access to new tools, real-time data and care support offered by Humana. Data analytics connect physicians and help them work as a team to coordinate care.
Patients get more personalized care; access to proactive health screenings and programs focused on preventing illness; and improved care for chronic conditions, Humana said.
ON THE RECORD
"Working with Humana brings together two highly respected, experienced organizations committed to providing better care, better health and lower costs," said Dr. Richard Merkin, president and CEO of HPN. "We will be able to coordinate care needs across our entire system and tailor healthcare services proactively that will bring added value to Humana Medicare Advantage members by increasing their access to healthcare services in all of our medical provider groups throughout Southern and Central California, creating a robust care network."
Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com
