Payer Roundup—Humana, Bridges Health Partners team up on value-based care 

Humana building
Humana has teamed with Bridges Health Partners to grow value-based care in western Pennsylvania, plus more insurance news. (Humana)

Humana, Bridges Health Partners team up on value-based care 

Humana announced Tuesday that it will team up with western Pennsylvania-based Bridges Health Care to advance value-based care. 

The goal of the partnership is to offer more personalized and integrated care to Humana’s Medicare Advantage members in the region. Bridges Health Care was founded by four nonprofit providers in the Pittsburgh area: Butler Health System, Excela Health System, St. Clair Hospital and Washington Health System. 

Physicians who work for these systems will be able to take advantage of technology and data from both partners, the companies said. 


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“Humana is pleased to expand our value-based care footprint for our Medicare Advantage members in western Pennsylvania,” Eric Bohannon, regional president for the insurer, said. (Announcement) (PDF)

Report: Missouri could save $1B a year if it overhauls its Medicaid rates 

A new study commissioned by Missouri officials found that the state could save $1 billion each year over the next four years by adjusting the payment rates in its Medicaid program. 

The report, which was compiled by consultants at the request of the state’s former governor, says that Missouri Medicaid should consider changes to payments to hospitals, physicians and nursing facilities as well as putting greater emphasis on home health to drive down costs in the program. 

The study does not suggest that the state should re-examine its eligibility criteria to slim down enrollment. However, it does recommend bolstering rural healthcare options, as people in those regions may choose high-cost hospital services instead of primary care, in part due to access concerns. (St. Louis Post-Dispatch

Utah governor signs plan for a more limited approach to Medicaid expansion 

Republicans in Utah have officially approved a plan to scale back voter-mandated Medicaid expansion in the state. 

Gov. Gary Herbert signed into law a plan that would set Medicaid eligibility at 100% of the poverty line, instead of 138% as set in the Affordable Care Act, cutting back the number of people who will be newly eligible for the program. 

That approach is also contingent on approval from the Centers for Medicare & Medicaid Services. Legislators acknowledge that it will be more costly upfront but say it’s the most cost-effective solution for the long term. 

“We’re doing the long-term responsible thing, which we are bound by the [state] constitution to do,” state Sen. Allen Christensen, one of the bill’s sponsors, said. (The Salt Lake Tribune)

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