Humana offers analytics to improve care for cancer

By | April 19, 2019

Humana is starting a program to improve patient experiences and outcomes in cancer care, offering analytics and other incentives to providers.

The Louisville, Ky.-based insurer has set the program in motion, making it the fourth specialty care payment program it has launched, intended to offer support to providers in making the transition to value-based care.

The programs enable personalization of care, better access to care, outcomes-based reimbursement to physicians and the ability to leverage technologies, such as analytics, which connect physicians and help them work as a team to coordinate care around the patient.

In the latest iteration, Humana is contracting with physician groups around the country intended to provide more integrated cancer care for Humana Medicare Advantage beneficiaries, as well as members covered by its commercial insurance lines.

Humana’s Oncology Model of Care (OMC) program will focus on patients who have new or recurrent cancer diagnoses.

The program will offer analytics to support providers, and will provide compensation for enhanced care navigation based on incremental evaluation of quality and cost within several key care components—these are expected to include inpatient admissions; emergency department visits; medical and pharmacy drugs; laboratory and pathology services; and radiology. These evaluations will be based on metrics that address access to care, clinical status assessments and patient education.

“The field of oncology is rapidly evolving,” says Bryan Loy, MD, corporate medical director of Humana’s oncology, laboratory and personalized medicine strategies Group. “Humana is committed to providing physician support and working together to improve coordination across the continuum of care.”

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Some 16 practices in about a dozen states will participate in the inaugural phase of the rollout, Humana says.

Humana’s other specialty-care payment models include programs for Humana Medicare Advantage members undergoing total hip or knee joint replacement or spinal fusion procedures; and its maternity episode-of-care bundled payment program for Humana commercial plan members.

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