Louisville, KY. – Value and outcomes-based care is making headlines recently. With so much pressure on pharmaceutical companies to defend their pricing methodologies as well as become more transparent, many are innovating with new contracts.

For example, Novartis has been in the news in the past year regarding their heart failure drug Entresto – compensating patients at a lower level if targeted reductions in hospitalizations are not achieved.  Novartis made even bigger news in 2017 for outcomes-based contracting on its $475,000 CAR-T drug, Kymriah. They are collaborating with the Centers for Medicare & Medicaid Services (CMS) “…to make an outcomes-based approach available to allow for payment only when pediatric and young adult ALL [acute lymphoblastic leukemia] patients respond to Kymriah by the end of the first month.”

And now, Humana Health Care is stepping into the arena, by announcing a new compensation model determined on patient experience, safety and outcomes. According to the article on Healthcare Finance, the health care company is attempting to reduce duplicative services, hospital readmissions and complication rates. 

"This program expands Humana's reach in value-based care as we broaden our efforts to provide a better experience for our members and help them achieve their best health," said Caraline Coats, vice president of Humana's Provider Development Center of Excellence.

You can read more about this recent announcement, here.

Why This Matters – 

Value and outcomes-based care is at the center of a couple shifting expectations we are following in 2018. As our ‘Paying For Value’ trend report states – 2018 is all about analyzing the data to understand what benefits can be gained and companies finding new and innovative ways to link innovation to impact.

What also has me interested in Humana’s new model are the behavior modifications that will happen due to compensation linked to the new measures. And, of course, the newly adopted behaviors will inevitably create better experiences for patients, their families and hopefully reduce the burden on the participating hospital systems. The latter change to be determined. Hats off to Humana for thinking outside of the box and helping create better experiences around the services they offer.

You can read these shifting expectations and many more by downloading our 2018 trend reports here.

About the Author:

As Strategist of Innovation, Drew is charged daily with championing innovative thinking and doing. Drew is part of a global team that leads new innovative ideas that attract different advocates among existing and potential brands that are shared across all agency partners. Drew is backed by over 16 years of brand, sales and marketing experience with Fortune 500 companies such as Progressive and Nationwide Insurance as well as Founder & President of his own healthcare insurance agency for 6 years. Most recently Drew was part of the agency team that launched Briviact for UCB, Foundation Medicine as well as key roles with Eli Lilly Oncology and Johnson & Johnson.