Humana expands Medicare Advantage bundled payment model to 7 states: 4 things to know

Written by Shayna Korol | April 13, 2018 | Print  |

Louisville, Ky.-based health plan Humana is partnering with orthopedic specialty groups in seven states to expand its value-based care bundled payment model for Humana Medicare Advantage members undergoing total hip or knee joint replacement.

Here are five things to know.

1. Humana has more than doubled the number of states in which it offers its Total Joint Replacement Episode-Based Model with these agreements.

2. The model was initially launched in 2016 with Ohio and Tennessee orthopedic groups and expanded into Indiana, Kentucky, North Carolina and Virginia in 2017.

3. The program will expand to the following seven states:

  • Alabama
  • Florida
  • Georgia
  • Illinois
  • Louisiana
  • Mississippi
  • Texas

With these expansions, the program will operate in approximately 40 provider locations in 13 states across the nation.

4. The newest provider agreements are with:

  • Alabama Orthopaedic Clinic in Mobile
  • OrthoAtlanta Orthopedic and Sports Medicine Specialists, Peachtree Orthopedics in Atlanta, and Atlanta-based Resurgens Orthopaedics
  • Illinois Bone & Joint Institute and OrthoIllinois, various locations
  • Bone & Joint Clinic of Baton Rouge in Louisiana
  • Miss.-based Bienville Orthopaedic Specialists and Mississippi Sports Medicine and Orthopaedic Center in Jackson
  • TSAOG Orthopaedics in San Antonio, Texas

Humana also made agreements with:

  • Indiana-based Ascendant Orthopedic Alliance
  • Chattanooga, Tennessee-based Center for Sports Medicine & Orthopaedics
  • Atlantic Orthopaedic Specialists, OrthoVirginia, and Riverside Medical Group in Virginia

5. Humana has 1.9 million Medicare Advantage members.

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Twin Cities Orthopedics opens new clinic beside Vikings HQ — 5 insights

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