Humana Expands Value-Based Bundled Payment Programs

On March 12, 2019, Humana, Inc. announced it launched a Medicare Advantage bundled payment model for spinal fusion surgeries. At the same time, Humana also said it expanded the reach of its Total Joint Replacement Episode-Based Model (EBM) for total hip or knee joint replacement procedures. Both programs are focused on Humana’s Medicare Advantage members.

The new Spinal Fusion Episode-Based Model (EBM) offers participating physicians and clinicians additional payment for improved health outcomes and lower cost across a member's entire spinal surgery episode-of-care. This EBM measures improvement based on readmission rates, and the rate . . .