Amid a planned acquisition by Aetna, Humana is still going forward with new models, including an expanded deal with one of several promising primary care ventures.
After an accountable care and population health contract last year, Humana is rolling out another partnership with the new clinic network Iora Health, helping to open seven new primary care practices in Arizona, Colorado and Washington.
Those Iora Primary Care practices, offering team-based integrated primary, behavioral and social services, will be exclusively for Humana's Medicare Advantage members in Denver, Phoenix, Tucson and Seattle, according to an announcement.
"Our mission is to restore humanity to healthcare. We do this by changing everything, delivering a care experience for older adults that starts with spending the time necessary to listen," said Rushika Fernandopulle, MD, CEO and co-founder of Iora Health, headquartered in Cambridge, Massachusetts. "Partnering with a progressive company like Humana has enabled us to deliver the Iora care model across two markets and we're looking forward to improving the lives of even more patients across Arizona, Colorado and Washington this year."
Founded in 2011, Iora Health has served over 10,000 patients in twelve primary care practices across seven states, and has tried to "expand the definition of primary care to include integrated health and wellness, offering behavioral health and groups like Diabetes Club and yoga, based on their patients' needs."
The company maintains that its model can bring one of most sought-after changes in healthcare, a reduced need for hospitalizations and acute care, based on trusting relationships and engagement with at-risk patients. It's one of the reasons why Humana has turned to Iora for Medicare Advantage patients, and why other insurers are inking similar deals with similar direct primary care companies like Qliance.
"As we venture into our bold goal, to improve the health of the communities we serve 20 percent by 2020 by making it easy for people to achieve their best health, it's partnerships like the one with Iora Health that will help Humana be successful," said Mark El-Tawil, west division leader for Humana's senior products.
El-Tawii said that Humana already has about 1.5 million individual Medicare Advantage and 230,000 commercial members cared for by about 45,500 primary care physicians in more than 900 accountable care relationships across 43 states.
"Iora's unique care model is already making a difference for our members in Phoenix and Seattle, so we are excited that the expansion of this partnership will provide innovative patient-centered care for our Humana Medicare Advantage members in Tucson and Denver, improving their well-being."
The Humana-Iora Health partnership includes "value-based incentives" tied to performance improvement and a "world-class patient experience for Humana members and Iora patients." The value-based outcomes use 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, A1c control and high-risk medications.