Humana and athenahealth Collaborate to Reward Primary Care Physicians for Better Clinical Performance

  • Further demonstrates Humana’s support of primary-care doctors who implement quality-focused programs
  • Provides financial support to doctors to assist adoption of electronic health record technology
  • Groundbreaking clinical data integration between health insurer and web-based electronic health record provider

LOUISVILLE, Ky. & WATERTOWN, Mass.--(BUSINESS WIRE)-- Humana Inc. (NYSE: HUM) and athenahealth, Inc. (NASDAQ: ATHN), today announced an alliance that connects Humana’s Primary Care Rewards Program with athenahealth’s electronic health record (EHR) service. The innovative alliance further demonstrates Humana’s commitment to primary care and physician engagement, as well as the company’s ability to align incentives that encourage and reward quality and better outcomes for its health-plan members, while advancing the overall efficiency of the health care delivery system.

The Humana-athenahealth Medical Home EHR Rewards Program marks the first time a national health plan is collaborating with a practice-management and EHR solution to jointly provide useful, actionable information to physicians in support of patient-centered care.

As part of the alliance, Humana will subsidize the implementation cost of athenahealth’s EHR service, athenaClinicalsSM, for physicians who are interested in and eligible for participation. Humana and athenahealth will jointly promote the program to approximately 20,000 family and internal medicine physicians who are part of Humana’s national provider network, with Humana subsidizing the implementation cost for 100 physician practices projected to represent 1,000 physicians, ranging from small practices to large multi-specialty groups that include primary-care physicians.

“Seamless, integrated electronic medical records are a critical necessity in patient care today, greatly reducing the chance of medical errors and duplicative treatment, facilitating a more holistic view of the patient’s care profile and improving outcomes,” said Bruce Perkins, senior vice president of Humana’s Healthcare Delivery Systems and Clinical Processes organization.

“This partnership not only makes it possible, but makes it easy and affordable for providers to capture patient-care activity into an integrated EHR,” Perkins said. “This will facilitate enhanced care coordination; serve as a patient-centric repository for specific gaps-in-care alerts; and be the centerpiece for multi-provider communication – all of which must exist to improve outcomes and reduce cost.”

To achieve EHR integration, the program will leverage Humana’s relationship with Availity, one of the industry’s leading health-information networks, to deliver information captured in the Availity® CareProfile® to athenahealth. Humana currently delivers health information and clinical messaging regarding its members through the Availity CareProfile; Availity will empower athenaClinicals with this information.

Via the Humana-athenahealth program, physician encounters will be measured in conjunction with nationally recognized HEDIS quality measures – administrative opportunities and measures designed to improve the overall efficiency of the health care delivery system, such as readmission rate, generic-drug dispensing rate, mail-order usage and health-risk-assessment completion.

Further evidence of Humana’s commitment to quality care is demonstrated by care-coordination payments made to practices in recognition of their transformation to a more patient-centered approach to care delivery. Physician practices will be provided with individualized goals and measured regularly to provide performance feedback. Physician practices may also be eligible to receive additional financial benefits through a shared-savings program, but only after the practices meet or exceed certain quality benchmarks.

In total, participating physicians could realize additional revenue of 20 percent beyond their current fee-for-service base collections from Humana. Also, athenahealth will be offering a service package to participants that will include the Company’s full, integrated suite of services. This package is specially designed to make Medical Home compliance easier on physician practices while enabling them to optimize their performance in the Program.

“Humana is committed to alleviating the burden felt by doctors as they balance patient care and the administration of their practices. This balance can be achieved by bringing more transactions online and through meaningful use of EHRs,” said Jonathan Bush, chairman and CEO of athenahealth. “Parallel to the government’s efforts to drive ‘meaningful use’ of EHRs, athenahealth and Humana are leaping ahead through the introduction of the first true private- sector solution between a payer and service provider to deliver meaningful outcomes.”

Bush continued, “We are eager to partner with Humana on one of the industry’s early efforts to close some of the gaps that exist in the health supply chain and hope other insurers will follow the collaboration’s lead.”

Based on the success of the partnership, Humana and athenahealth will explore other opportunities to drive new communications and collaborative options between Humana, its health care provider network and health-plan members.

Physicians or practices interested in participating in this program may contact Humana at [email protected] or visit www.athenahealth.com/Humana

About athenahealth

athenahealth, Inc. is a leading provider of Internet-based business services for physician practices. athenahealth’s service offerings are based on proprietary web-native practice management and electronic health record (EHR) software, a continuously updated payer knowledge-base, integrated back-office service operations, and automated and live patient communication services. For more information, please visit www.athenahealth.com or call (888) 652-8200.

About Humana

Humana Inc., headquartered in Louisville, Ky., is one of the nation’s largest publicly traded health and supplemental benefits companies, with approximately 10.3 million medical members and approximately 7.3 million specialty-benefit members. Humana is a full-service benefits solutions company, offering a wide array of health and supplemental benefit plans for employer groups, government programs and individuals.

Over its 49-year history, Humana has consistently seized opportunities to meet changing customer needs. Today, the company is a leader in consumer engagement, providing guidance that leads to lower costs and a better health plan experience throughout its diversified customer portfolio.

More information regarding Humana is available to investors via the Investor Relations page of the company’s Web site at http://www.humana.com, including copies of:

  • Annual reports to stockholders
  • Securities and Exchange Commission filings
  • Most recent investor conference presentations
  • Quarterly earnings news releases
  • Replays of most recent earnings release conference calls
  • Calendar of events (includes upcoming earnings conference call dates and times, as well as planned interaction with research analysts and institutional investors)
  • Corporate Governance Information

This press release contains forward-looking statements, which are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, including statements regarding the benefits of the contemplated offerings, the terms of those offerings, and the number of physicians who might participate. These statements are neither promises nor guarantees, and are subject to a variety of risks and uncertainties, many of which are beyond our control, which could cause actual results to differ materially from those contemplated in these forward-looking statements. In particular, the risks and uncertainties include, among other things: the risk that our service offerings will not operate in the manner that we expect, due to design flaws, security breaches, or otherwise; potential interruptions or delays in our internet-based service offerings; our reliance upon third parties, such as computer hardware, software, data-hosting, and internet infrastructure providers, which reliance may result in failures or disruptions in our service offerings; errors or omissions included in our payer and clinical intelligence rules engine and database; and the evolving and complex government regulatory compliance environment in which we and our clients operate. Existing and prospective investors are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date hereof. athenahealth undertakes no obligation to update or revise the information contained in this press release, whether as a result of new information, future events or circumstances, or otherwise. For additional disclosure regarding these and other risks faced by athenahealth, please see the disclosure contained in our public filings with the Securities and Exchange Commission, available on the Investors section of our website at http://www.athenahealth.com and on the SEC’s website at http://www.sec.gov.

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CONTACT:

Humana Inc.
Jim Turner, 502-580-3221
[email protected]
or
athenahealth, Inc.
John Hallock, 617-402-1428
[email protected]

KEYWORDS:   United States  North America  Kentucky  Massachusetts

INDUSTRY KEYWORDS:   Technology  Data Management  Software  Practice Management  Health  Hospitals  General Health

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