Humana Launches Value-Based Orthopedic Specialty Care Model in Ohio

Program, based on Ohio State Innovation Model Grants, brings payment
bundling to five practices across state

(NYSE: HUM) is partnering with five leading orthopedic
specialty groups in Ohio to launch a value-based bundled payment care
model for Humana Medicare Advantage members undergoing total hip or knee
joint replacement procedures.

The new care model is designed to improve quality, outcomes and cost
across a person’s entire joint replacement episode of care, and it
financially rewards orthopedic surgeons for better outcomes. Humana will
also provide the orthopedic practices with robust data and analytics
needed to better manage all aspects of their patients’ care, from
diagnosis to recovery. For the patient, this is expected to deliver a
more coordinated care experience and reductions in readmission and
complication rates.

The program is based upon the model of care standards developed for
total joint replacement as part of the State of Ohio’s State Innovation
Model (SIM) Grant through the Centers for Medicare and Medicaid Services
(CMS). The grants provide funding and guidance to help transform the
health care system from a fee-for-service model to a value-based system,
which aligns health care provider incentives with quality measures and
rewards better outcomes.

Humana will be working with Beacon
Orthopaedics & Sports Medicine
and Reconstructive
Orthopaedics and Sports Medicine
in Cincinnati; Orthopaedic
Institute of Dayton
, Ohio; Orthopaedic
Associates of Zanesville
, Ohio; and Wooster
Orthopaedic & Sports Medicine Center
in Wooster, Ohio.

Humana’s population health capabilities, including patient data and
analytics as well as chronic disease-management and wellness programs,
will complement the integrated care approach that each of the selected
orthopedic specialists will employ with Humana members. The goal,
according to Humana Vice President of Payment Innovation Chip Howard, is
to place the orthopedic surgeon in the quarterback role of total hip or
knee replacement procedures.

“The orthopedic surgeon is the key to creating more effective health
care for patients undergoing total hip or knee replacement,” explained
Howard. “Value-based care allows physicians to spend more time with
patients, arms them with the tools they need to truly manage their
patients’ health, and aligns the health care system to be more
responsive to the people it serves.”

Howard says Humana will evaluate results from the Ohio program and plans
to expand to other states if the new model generates the expected
outcomes improvement, coordinated member experience and cost savings.

Humana has 30 years of experience partnering with primary care
physicians in value-based/accountable care arrangements. In November
2015, the company released value-based
care data
indicating that patients cared for through value-based
models experienced healthier outcomes and lower costs. Humana is now
moving to apply the approach to specialties, such as orthopedics, where
highly coordinated care supported by population health data has the
ability to improve outcomes, lower cost and deliver a better health care
experience for patients.

Humana has 1.6 million individual Medicare Advantage members and 200,000
commercial members today who are cared for by more than 45,000 primary
care physicians, in more than 900 value-based relationships across 43
states and Puerto Rico. For more information, visit

About Humana

Humana Inc., headquartered in Louisville, Ky., is a leading health and
well-being company focused on making it easy for people to achieve their
best health with clinical excellence through coordinated care. The
company’s strategy integrates care delivery, the member experience, and
clinical and consumer insights to encourage engagement, behavior change,
proactive clinical outreach and wellness for the millions of people we
serve across the country.

More information regarding Humana is available to investors via the
Investor Relations page of the company’s web site at,
including copies of:

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Humana Inc.
Jeff Blunt, 513-826-7094
Corporate Communications