Tag Archives: Population Health Management

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.

2010 Health Care Leadership Awards

2010 HCLA – Insurance Executive

Honoree: Richard Boals

Richard Boals
President and CEO
Blue Cross Blue Shield of Arizona

Richard Boals, President and CEO of Blue Cross Blue Shield of ArizonaAs president and chief executive officer of Blue Cross Blue Shield of Arizona (BCBSAZ) since 2003, Richard Boals is dedicated to ensuring that the health care needs of 1.3 million beneficiaries are met and exceeded.

He leads a team of managers and staff totaling 1,500 in Phoenix, Tucson, Flagstaff and Tempe. He joined BCBSAZ in 1971, and has served in a variety of capacities.

Among his initiatives, Boals pioneered a proactive program to provide health and wellness information to plan members, as well as the community. Under his guidance, BCBSAZ introduced a free online resource that provides access to certain HealthyBlue resources, including tools and services that can help individuals make better health decisions.

Boals’ trusted and effective leadership has established BCBSAZ as a health insurance leader in Arizona. He is committed to providing improved quality of life to Arizonans by delivering a variety of health insurance products and services to individuals, families, and small and large businesses.

In 2005, Boals introduced the Walk On! Challenge, a free, annual 28-day exercise challenge in February designed to motivate Arizona fifth-graders to include exercise in their daily routines. Participation in the program has increased each year by an average of 20 percent, with more than 45,000 participants in the 2009 Challenge. Since its inception, BCBSAZ has registered more than 130,000 students from 474 Arizona schools.

Boals regularly supports the fundraising efforts of nonprofits that provide programs and services to the military and their families.

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Finalist: Robert Beauchamp, MD

Senior Medical Director
UnitedHealthcare of Arizona

Dr. Robert Beauchamp, senior medical director for UnitedHealthcare of Arizona, is a member of the health plan’s senior leadership team and is its top clinician in Arizona. A major goal is to improve care while holding down costs. Robert Beauchamp, MD Senior Medical Director UnitedHealthcare of Arizona

His responsibilities include patient care, staff supervision and physician relations. He focuses on ensuring the appropriate use of medical services and improving clinical quality, efforts that promote positive patient outcomes and lower costs. He oversees three local medical directors and a team of nurses who serve patients in Arizona and Utah. Beauchamp makes weekly stops at three hospitals — Banner Good Samaritan, St. Joseph’s Hospital and Medical Center and John C. Lincoln North Mountain — to review patient cases and meet with nurses and physicians.

Through his efforts, he has helped to improve patient care and limit patient readmissions. This enables patients to return home as soon as they are healthy, reuniting with family and friends.

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Finalist: Robert Flores, MD

Medical Director, Population Health Management
CIGNA HealthCare of Arizona

Robert Flores, MD Medical Director, Population Health Management CIGNA HealthCare of ArizonaAs medical director of population health management for Cigna Medical Group, Dr. Robert Flores has direct oversight of CIGNA HealthCare of Arizona’s Chronic Health Improvement Program (CHIP).

Flores and his team developed CHIP in 2007, after observing that patients with chronic conditions — especially those with certain combinations — often received fragmented care, were more likely to be seen in the emergency room, and were often hospitalized. As a result of Flores’ efforts, approximately 1,000 patients currently are enrolled in CHIP. Outcomes studies show that CHIP members have reduced their hospital admissions and bed days by about 55 percent. Flores has been working in his current position since 2001, and full time in the health care industry since 1999.

At Cigna Medical Group, his department is responsible for quality initiatives across 28 locations and more than 200 practicing doctors, nurses or health care professionals.

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