Humana dives into value-based care for maternity health

Pregnant woman getting checkup
Humana is making more moves into value-based care, following reports of a possible merger with Walmart. (Getty/byryo)

Humana is moving further into the value-based payment market with an announcement that it is contracting with physician practices for a bundled-payment model for maternity care. 

Under the episode-based model, announced on Wednesday, the Louisville, Kentucky-based insurer will coordinate with five OB-GYN practices for commercial group beneficiaries with low-moderate-risk pregnancies in an attempt to improve quality and lower costs.

The insurer said its model will make available more data and analytics to enhance patient care, reduce duplicate services, readmissions and complications. 

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“Because quality maternity care is important for many of our members and a significant focus of specialty care services in our country, we’re very pleased to launch Humana’s newest specialty-care bundled payment model,” Caraline Coats, vice president of Humana’s provider development center of excellence, said in a statement. 

The move also follows reports that big-box store Walmart might be eyeing acquisition of the insurer. This month, Humana also purchased a large physician group in Orlando, and it's finalizing a deal with Kindred Healthcare, the largest long-term care provider in the country.  

The value-based payment model is Humana's second such bundled payment model, following the start of its joint replacement model in 2016, which was intended to lower costly readmission rates. Humana recently announced it was expanding the bundle to an additional seven states. 

RELATED: Humana adds 7 new states to bundled payment portfolio

Moves by the insurer, and others, are signals of a gradual but steady change in the industry to pay for quality over quantity. But many insurers and providers are still working through the kinks of that transition. 

The Department of Health and Human Services, which is responsible for Medicare and Medicaid payment policy, has flip-flopped over the past year about how hard it wants to push providers to move into these value-based payment arrangements. Recently, however, HHS Secretary Alex Azar has emphasized the need to transition the industry toward value. 

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