Oak Street Health, Humana Expand Partnership to Bring Improved Care to Medicare Advantage Members in Illinois

CHICAGO & LOUISVILLE, Ky. — (BUSINESS WIRE) — Humana Medicare Advantage members in Illinois now have greater access to value-based care, thanks to an expanded partnership between Oak Street Health and health and well-being leader Humana Inc. (NYSE: HUM). The expanded arrangement, which was first announced last year, is designed to offer a more proactive and wellness-focused health care experience and financially reward doctors for high-quality care.

On average, current Humana Medicare Advantage members served by providers under value-based care experienced fewer ER visits and hospital admissions, higher screening rates, including those for colorectal cancer (+7 percent) and breast cancer (+6 percent), and healthier outcomes versus members who were treated by providers in standard Medicare Advantage settings.

The expanded partnership gives Humana’s Medicare Advantage members access to Oak Street Health’s six new patient care centers, for a total of 15 centers throughout Chicagoland, Northwest Indiana, Indianapolis and Rockford, Ill. Oak Street Health patients’ visits are more than twice as long as the average doctor visit, with prevention and early intervention being the cornerstones of its care model.

“Our goal at Oak Street can be summed up really simply: we aim to keep our patients happy, healthy, and out of the hospital. And we measure all three of those things so we can deliver on the promise. We have industry-leading patient satisfaction scores, elite performance on quality metrics around prevention and chronic disease management, and our patients go to the hospital far less than non-Oak Street peers,” said Dr. Griffin Myers, Founder and Chief Medical Officer of Oak Street Health. ​“We’re excited to grow our practice with Humana and to extend the Oak Street brand of personalized primary care to Humana members.”

Oak Street Health operates a network of primary care facilities in Illinois and Indiana focusing on older adults receiving Medicare benefits. Oak Street care teams consist of a physician, nurse practitioner, registered nurse, medical assistant, care manager, and clinical informatics specialist. Team members have explicit roles during and between visits, and teams have structured daily communication to help ensure the best possible care every step of the way.

Value-based care represents a significant shift from the historic model of health care known as fee-for-service, which focuses on the costly treatment of sickness instead of disease prevention and keeping people in good health. In the fee-for-service model, physicians are paid and incentivized based on volume (number of services they perform), not improved health outcomes for the patient. By contrast, transitioning to value-based payment models means that physicians are reimbursed for the health outcomes of the patients they serve, not the number of services they provide. By focusing on quality and health, Humana experienced 18 percent lower costs in total in 2014 for members who were treated by providers in a value-based reimbursement model setting versus original fee-for-service Medicare.

“We are proud to support Oak Street Health in building upon what is already a well-integrated care delivery system by providing care management support,” said Chuck Dow, Great Lakes Region President for Humana’s Senior Products. ​“Oak Street Health’s care teams are focused on coordinating care around each patient’s unique health needs. By partnering with Humana, we are helping to bolster Oak Street Health’s team-based approach to care delivery, providing useful information, and resources to help those teams operate at their very best.”

For doctors thinking about entering into a value-based care agreement, many cite having adequate resources and support as key barriers to adopting this new model. By partnering with Humana, providers have access to a number of different services to help support their transition to value-based care.

As part of the agreement, Oak Street Health and Humana will continue focusing on strategies that improve the health of Humana’s Medicare Advantage members in Illinois and Indiana, lower costs, and manage the ongoing health needs of the population. Oak Street Health will utilize Humana’s population health management tool to help identify gaps in care, manage medication adherence, follow up on patients needing PCP visits, and identifying high ER utilizers and at-risk patients so they can receive the right care before requiring serious medical attention. Patients will also benefit from wellness programs and improved screening and monitoring for chronic conditions such as diabetes and heart disease.

Nationally, Humana has nearly 30 years of accountable care experience, including approximately 1.7 million individual Medicare Advantage and 200,000 commercial members, cared for by 47,800 primary care providers in more than 900 value-based payment relationships across 43 states and Puerto Rico. Currently, approximately 61 percent of Humana individual Medicare Advantage members are in value-based payment relationships. Humana’s goal is to have 75 percent of individual Medicare Advantage members in value-based payment models by 2017. For more information, visit humana.com/accountable-care or www.humana.com/valuebasedcare.

About Oak Street Health

Oak Street Health is a network of primary-care centers for people on Medicare with an innovative model of care focused on keeping our patients healthy and out of the hospital. We build relationships between our patients and their doctors and care teams, and we invest in giving our patients better access to care. Our patients enjoy the benefits of personal managed care, transportation, and daily programming in our community rooms. Oak Street Health has 15 locations in Illinois and Indiana. More information about Oak Street Health can be found at www.oakstreethealth.com.

About Humana

Humana Inc., headquartered in Louisville, Ky., is a leading health and well-being company focused on making it easy for people to achieve their best health with clinical excellence through coordinated care. The company’s strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people we serve across the country.

More information regarding Humana is available to investors via the Investor Relations page of the company’s web site at 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
• Corporate Governance information