Tag Archives: Medicare Advantage

healthcare

Humana, Iora Health partner in Arizona

Improved health and more coordinated care for Medicare Advantage members is the goal behind a new Accountable Care arrangement and population health management partnership between Humana Inc. and Iora Health.

The partnership launches Iora’s unique health care model in Arizona and Washington where Iora Health will open four new primary care practices – two in Phoenix and two in Seattle – under the Iora Primary Care brand.

The primary care practices are designed exclusively for Humana’s Medicare Advantage members and will provide members access to affordable, quality care. Building on Iora’s proven success, these practices will have integrated care teams that include doctors, nurses, health coaches, medication management, behavioral health and social services resources. Iora builds practices to meet the specific needs of the communities they serve, including hiring teams who speak their patients’ languages and who understand the local challenges patients face.

“The partnership with Humana allows Iora to help improve the lives of seniors in Phoenix and Seattle,” said Rushika Fernandopulle, M.D., M.P.P., CEO and Co-Founder of Iora Health. “Seniors deserve care matched to their specific needs. Iora’s people-first primary care operating system helps do just that. We’re thrilled to partner with Humana to continue to restore humanity to health care.”

Iora Health serves over 9,000 patients in seven primary care practices across four states. Iora has expanded the definition of primary care to include integrated health and wellness, offering behavioral health and groups like Diabetes Club and yoga. Results have shown improved patient engagement, experience and clinical outcomes. Additionally, Iora’s proprietary collaborative care technology enables Iora to treat and manage their full patient population and allows for patients to view and contribute to their medical record.

“Partnerships like the one with Iora Primary Care help Humana close the gap for our members by making access to care easier and providing coordination of care,” said Mark El-Tawil, West Division Leader for Humana’s Senior Products. “We’re excited that Iora’s unique care model will provide innovative patient-centered care for our Humana Medicare Advantage members, improving their well-being.”

The Arizona primary care practices are located at 3137 W. Indian School Road in Phoenix and 6611 W. Peoria Avenue in Glendale. The Washington primary care practices are located at 306 23rd Avenue South in Seattle and 15214 Aurora Avenue North in Shoreline.

The Arizona and Seattle primary care practices will open September 2014, and will start seeing Humana Medicare Advantage members on Oct. 1, 2014. The Shoreline, Wash., primary care practices will open October 2014, and will start seeing Humana Medicare Advantage members on Nov. 1, 2014.

Humana aims to work closely with doctors and hospitals through its Accountable Care Continuum. The continuum is a stepped approach to pay-for-value reimbursement that allows the company to implement different value-based partnerships with hospitals and doctors based on their infrastructure capabilities and risk-tolerance.

The new partnership between Humana and Iora Health includes value-based incentives tied to performance improvement and will bring better patient care coordination, more cost effective, quality care and a world-class patient experience to Humana members in Arizona and Washington. The partnership will offer more personalized care and a broad range of population management tools like predictive analytics and chronic care, disease management and wellness programs.

The Humana/Iora Health partnership emphasizes quality outcomes with a focus on care coordination and leverages measures as defined by the National Committee for Quality Assurance Healthcare Effectiveness Data and Information Set like diabetes care and treatment, breast cancer screenings, colorectal cancer screenings and high-risk medication.

Humana has a 25-year Accountable Care relationship history with more than one million members that are cared for by 33,000 primary care physicians, in more than 900 Accountable Care relationships across 40 states and Puerto Rico.

health

Humana, Dignity Health Sign Agreement

Humana Inc., one of the nation’s leading health and well-being companies, has reached an agreement that provides its members access to Dignity Health facilities in Arizona.

The new network agreement, which takes effect May 1, 2014, includes Humana’s Medicare Advantage (including PPO, HMO and Private Fee for Service plans), employer groups and individual plan members.

“This agreement provides our Arizona members with access to Dignity Health’s network of respected facilities and health care providers,” said Victoria Coley, Arizona and Nevada Market Vice President for Humana’s Employer Group segment. “Through this partnership, we’ve been able to substantially increase health care options for our members who live in the East Valley and, soon, the West Valley.”

“Humana has a strong Medicare Advantage presence in Arizona. Expanding our network to include Dignity Health will offer our members a strong provider network and is key to our continued growth in the market,” said Brendan Baker, Arizona Market President for Humana’s Senior Products.

Humana members will have in-network access to St. Joseph’s Hospital and Medical Center, including Barrow’s Neurological Institute; Chandler Regional Medical Center; Mercy Gilbert Medical Center; and the soon-to-open St. Joseph’s Westgate Medical Center. Members will also have access to Dignity Health’s network of nearly 200 physicians and its care centers in Arizona, including two specialty hospitals, six surgery centers, four urgent care centers and 30 imaging centers.

“We have always been dedicated to high-quality patient care and to making the entire health system work better for patients and their families,” said Carolyn Pace, Vice President of Managed Care at Dignity Health in Arizona. “We are pleased to be able to respond to the health care needs of Humana members at our numerous care centers.”

aetna - save money on insurance at Costco

SCAN Health Plan Arizona Gets New VP

SCAN Health Plan Arizona has appointed Wendy Karsten vice president and general manager, effective immediately. For the past year Karsten has been serving as vice president of healthcare operations for SCAN in Arizona.

“Over the past year Wendy has made a significant contribution to SCAN and our members in a variety of areas, including overseeing our home-visit program,” said Chris Wing, president and CEO of SCAN Health Plan. “We know that in this newly created role she will continue to find new ways to help our SCAN members maintain their health and independence.”

As vice president and general manager for SCAN Health Plan Arizona, Karsten is now responsible for the health plan’s overall performance in Maricopa and Pima counties, providing strategic, operational and financial direction. To that task she brings more than 25 years of experience in healthcare leadership. Immediately prior to joining SCAN, Karsten served as CEO for Huntington Medical Foundation in Pasadena, California, where under her leadership the large multi-site medical group implemented an electronic health record system, opened an urgent care center, formed a local partnership to provide care to uninsured children in the community, and acquired 14 area medical practices.

Karsten holds a Master of Arts degree in education from California State University Los Angeles and a Bachelor of Science in finance and accounting from Eastern Oregon University in La Grande, OR.

SCAN Health Plan, one of the largest not-for-profit Medicare Advantage plans in the United States, currently has nearly 145,000 members in California and Arizona. Further information may be obtained at scanhealthplan.com or on Facebook at facebook.com/scanhealthplanarizona.

health care leadership awards - AZ Business Magazine Mar/Apr 2011

HCLA 2011- Institutional Or Education Program

Honoree: Home-Based Care Program, Cigna Medical Group

IHome-based Care Program, CIGNA Medical Group, 2011 Health Care Leadership Awardsn response to investigations concerning why some patients under a Medicare Advantage plan weren’t returning to their doctors, Cigna Medical Group established the Home-Based Care Program in 2004.

The program was created to assist these home-bound patients and to treat those who had recently experienced a severe health event and were about to face gaps in care.

The program has a team of physicians, physician assistants, registered nurses, practical nurses and social workers who visit patients in their homes to provide medical care. They monitor vital signs, provide treatment, review prescriptions, help patients take medications correctly, evaluate nutritional needs and coordinate with others to arrange community services.These interactions are recorded in an electronic health record and are shared with the patient’s primary care physician.

Patients in the program are maintaining, and in some cases improving, their health. There has been a 30 percent decrease in acute hospital admissions since the program began, due in large part to an improved ability to prevent life-threatening or severe changes in home-bound patients’ conditions.

[stextbox id="grey" image="http://www.cigna.com"]www.cigna.com[/stextbox]


Mark Smith, System Director of Simulation/Innovation, Banner HealthFinalist: Mark Smith, M.D., System Director of Simulation/Innovation, Banner Health

In 2005, Dr. Mark Smith conceptualized and developed the first of Banner Health’s simulation centers at Banner Good Samaritan Medical Center. He currently serves as the system director of simulation and innovation for Banner.

Banner Health, one of the nation’s largest not-for-profit health systems, hopes to reduce medical errors and improve patient care by using high-tech mannequins that help simulate a variety of medical conditions and emergencies in its educational training centers. In 2009, Banner opened a second medical simulation training center in Mesa with more than 70 mannequins and a full-size emergency department, intensive care unit, pediatric/neonatal ICU and operating room.

[stextbox id="grey" image="http://www.bannerhealth.com"]www.bannerhealth.com[/stextbox]

Finalist: Water Watchers Program, Phoenix Children’s Hospital

Water Watchers Program, Phoenix Children's HospitalArizona has the country’s second-highest number of child drownings. This devastating statistic is why the Injury Prevention Center at Phoenix Children’s Hospital created the Water Watchers program.
Water Watchers raises awareness about water safety, provides information about child drowning risks and teaches drowning prevention through a variety of outreach events throughout the year.

Water Watchers was co-founded by Druann Letter and Carol Achs, the mother and grandmother of Weston Letter, who drowned in 1998 at the age of three. The program has been recognized by the National Drowning Prevention Alliance, as well as the National Water Safety Congress.

[stextbox id="grey" image="http://www.phoenixchildrens.com/"]www.phoenixchildrens.com[/stextbox]