Humana (NYSE: HUM) is forming an accountable care organization (ACO new) with Norton Healthcare, which runs five hospitals and 12 clinics in the Louisville, Ky., area, according to the National Underwriter.
The accountable care model establishes spending targets to reflect the expected costs of caring for the patients. Those that improve quality of care and slow spending growth receive a portion of any savings, the Louisville Courier-Journal reports.
Part of Humana's role in the ACO is to provide information, including reports on particular doctors' patient populations and benchmarks to which those doctors can compare their data. Humana is also designing some of the billing structure.
The Humana-Norton ACO expects to emphasize preventive screenings and tests such as mammograms, along with vaccinations, and managing chronic illness such as heart disease. It also will examine how people pay for healthcare, hoping to create a model that could go nationwide, reports Fox 41. Another important focus is to ensure the appropriate use of generic drugs and provide better access to the right level of care, such as primary care for routine problems rather than the emergency department, according to the Courier-Journal.
Although the program is still in the early stages, Dr. Tom James, corporate medical director at Humana, said patients can ultimately expect better care, more coordination and more help navigating the health care system. "We are excited to participate in the development of new processes that encourage continuous improvement in quality while finding greater efficiencies in the delivery of care," he said in a statement.
Humana plans to continue developing more ACO models by partnering with providers in multiple regions.