Humana Brings Value-Based Orthopedic Specialty Care to Indiana and Kentucky

April 18, 2017

LOUISVILLE, Ky. & FORT WAYNE, Ind.–(BUSINESS WIRE)–Humana Inc. (NYSE: HUM) is teaming up with eight orthopedic specialty groups in Indiana and Kentucky on an orthopedic value-based care model for Humana Medicare Advantage members undergoing total hip or knee joint replacement procedures.

Humana’s Total Joint Replacement Episode-Based Model is designed to improve quality, outcomes and cost across a person’s entire joint replacement episode of care. Humana will provide the orthopedic practices with robust data and analytics needed to better manage all aspects of their patients’ care from diagnosis to recovery. For the patient, this is expected to deliver a more coordinated care experience and to reduce complication rates and unnecessary readmissions after surgery.

In Indiana, Humana will work with Fort Wayne Orthopedics, Ortho NorthEast, Orthopaedic Associates Inc., Tri-State Orthopaedics and Unity Healthcare LLC.

In Kentucky, Humana will work with Commonwealth Orthopaedic Centers, Kentucky Bone and Joint Surgeons and Norton Orthopedic Specialists.

Humana has 30 years of experience partnering with primary care physicians in value-based arrangements. By focusing on quality and health, Humana experienced 20 percent lower costs in total in 2015 for members who were treated by doctors and other health care professionals in a value-based reimbursement model setting versus an estimation of original fee-for-service Medicare costs using the Centers for Medicare and Medicaid Services (CMS) Limited Data Set Files. Humana is now moving to apply the approach to specialties, such as orthopedics, where highly coordinated care supported by population health data has the ability to potentially improve outcomes, lower cost and deliver a better health care experience for patients.

The participating Indiana and Kentucky orthopedic groups join the 12 orthopedic groups in Ohio and Tennessee who joined Humana’s orthopedic value-based care model in 2016.

Humana’s model is similar to the State of Tennessee’s Innovation Model (SIM) Grant through CMS for Medicaid beneficiaries.

Through the new agreements, Humana’s population health capabilities, including patient data and analytics as well as chronic disease management and wellness programs, will complement the integrated care approach that each orthopedic group will employ with Humana members.

“Through our total joint replacement model, Humana is taking value-based care to the next level – from primary care to a more involved medical procedure,” said Chip Howard, Humana’s Vice President of Payment Innovation. “Humana’s approach is to provide orthopaedic surgeons the tools they need to coordinate all aspects of their patients’ diagnosis, treatment, recovery and rehabilitation to in turn improve quality, lower cost and create a better experience for our members.”

As of Dec. 31, 2016, Humana has 1.8 million individual Medicare Advantage members and 200,000 commercial members today who are cared for by 50,400 primary care providers, in more than 900 value-based relationships across 43 states and Puerto Rico. For more information, visit or

About Humana

Humana Inc., headquartered in Louisville, Ky., is a leading health and well-being company focused on making it easy for people to achieve their best health with clinical excellence through coordinated care. The company’s strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people we serve across the country.

More information regarding Humana is available to investors via the Investor Relations page of the company’s web site at, including copies of:

  • Annual reports to stockholders
  • Securities and Exchange Commission filings
  • Most recent investor conference presentations
  • Quarterly earnings news releases and conference calls
  • Calendar of events
  • Corporate Governance information

More Information

Humana is a Medicare Advantage HMO, PPO and PFFS plan with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits may change each year. Other providers are available in our network.

Humana Inc. and its subsidiaries (“Humana”) do not discriminate on the basis of race,color, national origin, age, disability or sex.

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Humana Inc.
Corporate Communications
Marina Renneke, APR, 602-760-1758

Josh Sandberg

Josh Sandberg is the President and CEO of Ortho Spine Partners and sits on several company and industry related Boards. He also is the Creator and Editor of OrthoSpineNews.

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