Humana and agilon health Expand Relationship, Announce Value-Based Agreements with Physician Groups
Working Together to Help Independent Practices Transition from Fee-for-Service
LOUISVILLE, Ky. & LONG BEACH, Calif. – November 20, 2019 –Humana Inc. (NYSE: HUM), one of the nation’s leading health and well-being companies, announced today that it has signed value-based care agreements with agilon health, which helps physicians and medical groups manage the transition from fee-for-service reimbursement, on behalf of three independent physician practices located in Ohio and Texas.
Effective January 1, 2020, the contracts are designed to improve health outcomes and the patient experience for Humana Medicare Advantage Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) members seeking care from physicians and other clinicians at Physicians Group of Southeastern Ohio (PGSEO) in southeast Ohio, PriMed Physicians in southwest Ohio, and Capital Medical Clinic in central Texas. Clinicians participating in Humana’s Medicare Advantage network will be able to utilize tools and resources from both agilon health and Humana in delivering value-based care.
These agreements supplement existing value-based contracts between Humana and agilon health for MDX Hawai‘i in Hawaii, Central Ohio Primary Care (COPC) and Pioneer Physicians Network in Ohio, and Austin Regional Clinic (ARC) and Premier Family Physicians in Texas, for a total collaboration involving more than 1,800 independent primary care clinicians.
“We’re proud to deepen our work with Humana in support of independent physician groups as they care for their patients,” said Ron Kuerbitz, CEO of agilon health. “We’re pleased that through our expanding network of physician partners, and in collaboration with Humana, we can help additional communities become healthier, and enable a growing number of primary care physicians to spend more time with patients toward improving their care.”
Agilon health partners with primary care physician groups, and provides the tools – the data, technology, capital, and workflow – so doctors are free to be the doctors they trained to be and ready to take on the responsibility for quality care of their patients.
“Through our work with agilon health, Humana is pleased to expand our ability to support independent physicians interested in moving to a value-based care model,” said Oraida Roman, Vice President, Value Based Strategies at Humana. “We look forward to sharing data and analytics with these physicians, and improving health outcomes and the patient experience for our Medicare Advantage members in Ohio and Texas.”
The value-based agreements with agilon health are in keeping with Humana’s longstanding commitment to value-based care, which emphasizes:
- More personal time with health professionals and personalized care that is tailored to each person’s unique health situation;
- Access to proactive health screenings and programs that are focused on preventing illness;
- Improved care for people living with chronic conditions with a focus on avoiding health complications;
- Leveraging technologies, such as data analytics, that connect physicians and help them work as a team to coordinate care around the patient; and
- Reimbursement to physicians linked to the health outcomes of their patients rather than based solely on the quantity of services they provide (fee-for-service).
Humana has an extensive and growing value-based care presence. As of Sept. 30, 2019, Humana has more than 2.3 million individual Medicare Advantage members and approximately 115,000 commercial members who are cared for by more than 60,000 primary care physicians in more than 1,000 value-based relationships across 43 states and Puerto Rico. Humana’s total Medicare Advantage membership is more than four million members, which includes members affiliated with providers in value-based and standard Medicare Advantage settings.
Terms of the agreements were not disclosed.
About agilon health
agilon health of Long Beach, California, a company founded in 2016 by world-class health care leaders, is helping U.S. physicians manage the leap from fee for service to global risk-based health care. Recognizing the increasing pressure on physicians caused by the existing healthcare system, agilon health has created a complete operating platform for managing global risk-based health care that brings people, processes and proprietary technology together in partnership with physicians to take responsibility for total healthcare spend. The company has now expanded its operations to leading positions in nine U.S. markets. For more information visit www.agilonhealth.com.
Humana Inc. is committed to helping our millions of medical and specialty members achieve their best health. Our successful history in care delivery and health plan administration is helping us create a new kind of integrated care with the power to improve health and well-being and lower costs. Our efforts are leading to a better quality of life for people with Medicare, families, individuals, military service personnel, and communities at large.
To accomplish that, we support physicians and other health care professionals as they work to deliver the right care in the right place for their patients, our members. Our range of clinical capabilities, resources and tools – such as in-home care, behavioral health, pharmacy services, data analytics and wellness solutions – combine to produce a simplified experience that makes health care easier to navigate and more effective.
More information regarding Humana is available to investors via the Investor Relations page of the company’s web site at www.humana.com, including copies of:
- Annual reports to stockholders
- Securities and Exchange Commission filings
- Most recent investor conference presentations
- Quarterly earnings news releases and conference calls
- Calendar of events
- Corporate Governance information
Humana is a Medicare Advantage HMO and PPO organization with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. Other providers are available in our network. The provider may contract with other Plans.