Health insurer Humana has created two companies intended to help providers make the transition to new forms of contracts as reimbursement models shift away from fee for service.
The companies are Transcend and Transcend Insights. The parent organization said it was making the move with the goal of providing resources and information technology to support providers in making the transition to population health models.
Formerly known as the Humana Management Services Organization, Transcend collaborates with physicians, medical groups and integrated delivery systems to support their transition to value-based care.
Transcend will leverage Humanas Metcare model to offer resources to providers in care coordination, financial risk management, clinical integration and patient engagement helping physicians improve patient experiences and outcomes. Many industry observers believe that smaller provider organizations will struggle to provide these types of services under population health contracts, which reimburse providers for covering all the healthcare needs of a set group of patients, rather than paying them for services for individual patients as they receive them.
Transcend Insights was formed through the merging of three Humana subsidiaries Certify Data Systems, Anvita Health and nliven Systems to provide information technology resources that facilitate care coordination among diverse providers that have entered population health contracts.
The new company provides integrated health care systems, physicians and care teams with advanced community-wide interoperability, real-time health care analytics and intuitive care tools to simplify the complexities of population health, Humana said. Its technology connects more than 17,000 physicians and 590 hospitals, it added.
Humana is shifting its focus as an insurer to population health-based contracts with providers, with an announced goal of having 75 percent of its individual Medicare Advantage members covered under value-based relationships by 2017. The company says its approaches in this area have produced positive results in the form of stronger clinical models, enhanced brands focused on health, a consumer-centric approach and industry-leading provider risk relationships.
Moving more physicians towards value-based payment models is a proven strategy that increases clinical quality and patient satisfaction, and reduces medical costs, said Patrick Adams, president of Transcend.
Transcend Insights has experience pulling together data from disparate information systems and providing actionable data to improve patient care, said Marc Willard, president of Transcend Insights and the former top executive of Certify. Health care systems are often challenged to integrate both interoperability and analytics components into their population health management strategies. The sophisticated data analysis capabilities of Transcend Insights, combined with its experience in connecting widely disparate electronic health record systems, support physicians and care teams with the real-time clinical insights necessary to simplify population health and improve health outcomes.
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