Puget Sound-area insurer Humana, which covers about 850,000 Washington state residents, is partnering with MultiCare Health System to create an accountable care network for Medicare Advantage members in South King County and Pierce County, the company announced. The move is the latest in a broad trend to great these partner networks across the country.
Available to Humana’s Medicare HMO and Medicare supplemental policy holders, the new network with the five-hospital MultiCare Health System hopes to emphasize prevention and care coordination across primary, acute and speciality services.
“Most traditional health care systems revolve around sick care and paying for services rather than paying for healthier patient outcomes,” said Catherine Field, market director of senior products for Humana in Washington, in a statement. “Humana is transitioning to a fully-accountable, value-based model that aligns incentives to health systems, like Multicare, for improving the health and well-being of our members.”
MultiCare, a Tacoma-based nonprofit, includes Allenmore Hospital, Auburn Medical Center, Good Samaritan Hospital, Mary Bridge Children's and Tacoma General Hospital (pictured below), along with a variety of outpatient specialty centers, primary care and urgent care clinics.
In Washington State and elsewhere, Humana has been active in setting up a network of accountable care organizations, or a continuum, with about 1.2 million of its 11 million members covered in 900 ACOs.
The continuum, Field said, is a “stepped approach to pay-for-value reimbursement that allows the company to implement different value-based partnerships with hospitals and doctors based on their infrastructure and value-based reimbursement capabilities.”
The arrangement with MultiCare, Humana said, will bring its Medicare members in greater Tacoma “personalized care and a broad range of population management tools like predictive analytics and chronic care, disease management and wellness programs,” targeting areas such as diabetes control, colorectal cancer screenings and high-risk medication.
In September, Humana launched an accountable care venture for Medicare Advantage members in greater Seattle focused on primary care, in a deal with Cambridge, Massachusetts-based primary care clinic startup Iora Health. With Humana’s support, Iora Health opened two new primary care clinics — one in Seattle and one in the northern suburb of Shoreline — with the goal of bringing Medicare Advantage beneficiaries more personalized primary care, with one-on-one coaching and support for chronic conditions.