Lancaster General Health and health and well-being company Humana have partnered on a new accountable care arrangement.
The arrangement is designed to improve the wellness and care experience for a growing population of more than 3,000 Medicare Advantage members in Lancaster County.
The agreement became effective April 1, 2015, and reflects a shift in the health care system away from the current episodic model to place greater emphasis on health outcomes, preventive care and patient care experiences.
The LG Health/Humana partnership has established focused quality and cost goals that, if attained, will generate savings for individuals and employers.
The accountable care arrangement with Humana is being undertaken specifically by LG Health’s accountable care organization, the LG Health Community Care Collaborative, which launched in 2014.
“Innovative partnerships like this will enhance care coordination, improve health outcomes and eliminate unnecessary spending,” said Tom Beeman, president and chief executive officer of Lancaster General Health. “This approach will encourage clinicians to provide the highest-quality care as efficiently as possible, while stabilizing costs for both patients and employers.”
Humana’s Medicare Advantage members will have access to LG Health’s growing network in the greater Lancaster County region, which includes three hospitals, 300 family physicians and specialists and more than 40 offices.
“The value-based healthcare delivery and payment model is a critical evolution in how our health system works, and a much-needed one,” explained Rich Vollmer, Humana’s senior markets president for Pennsylvania. “This new pay-for-value model, which is in its early stages and quickly growing, fosters quality care, lower costs and a more patient-centric healthcare system.”
The new Humana-LG Health accountable care agreement includes value-based incentives tied to performance improvement and quality outcomes, emphasizing standard measures defined by the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS), including Breast Cancer Screening, Colorectal Screening, Comprehensive Diabetes Care and High-Risk Medications.
Lancaster General Health, Humana, US, Medicare