Humana CMO: Think like a provider for high-value care

Humana recognizes paying for value is central to solving industry problems, especially in a changing healthcare environment. "We're pushing for value and we're pushing for outcomes," Humana Chief Medical Officer Roy A. Beveridge, M.D., told Hospital & Health Networks Daily in a video interview.

He said it's physicians, caregivers and clinicians up-to-date on evidence-based medicine who know best how to bring value to patients.

That helps make hospitals necessary partners for payers. "I don't ever see that it's an us or them," Beveridge told H&HN Daily. "We all have critical roles to play within this complicated orchestra, this complicated symphony that is the care of our patients."

So Humana is moving away from being the kind of insurer that only writes checks to providers and hospitals for a service to a company that thinks like and works with providers, H&HN Daily noted.

"We have pivoted at this point to being an organization that is working with providers, physicians, hospitals, nursing homes so we have this vast exchange of data that were transparent in what our members want and that we're working together in this."

Humana joins Highmark and other insurers showing more interest in crossing over to the provider side of the industry to help diversify their business, better manage risk, control costs and meet quality measures, FierceHealthPayer previously reported.

Beveridge expects more organizations to focus on the health and wellness of their members and take an active role in managing their care when members get sick.

For instance, Aetna already has launched marketing and outreach campaigns about wellness. "It's not only about healthcare and hospitals and doctors and tests and procedures, it's about wellness, it's about physical, mental and spiritual wellness," Robert Mead, Aetna's senior vice president of marketing and communications, said last month in an interview with Forbes.

To learn more:
- listen to the H&HN Daily piece (audio)

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