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The American Journal of Managed Care October 2015
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The Path to Value Through the Use of Holistic Care
Roy A. Beveridge, MD, Chief Medical Officer, Humana
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The Path to Value Through the Use of Holistic Care

Roy A. Beveridge, MD, Chief Medical Officer, Humana
An analysis of the healthcare industry shift from fee-for-service to value-based reimbursement and how this change creates a more holistic approach to patient care.
The Holistic Approach
This holistic approach can only be achieved through personalized care, effective provider partnerships and a high level of member engagement. Data analytics is a critical element; in the past, health plans have been criticized as an obstruction to the physician–patient relationship. Now, health plans not only have the necessary data that primary care physicians need for the holistic approach, but also the data analytics necessary to work together to help close gaps in care.
 
In our experience with 43,000 providers and physicians in value-based MA relationships, we’ve found that when physicians use a holistic approach to care and are reimbursed for value, the results are better health outcomes and higher quality, with improvements in costs for us all.
 
The Future Is Bright
Helping people become healthier is not a slogan; it’s the best business model. The healthier our population becomes, the more healthcare costs reduce, and that is great for society.
 
At Humana, we’re working to improve the health of the communities we serve by 20% by 2020. As a physician, this goal appeals to me personally because physicians would rather spend their time keeping patients healthy than on administrative matters.
 
Providers and physicians have gone to medical school, nursing school, and pharmaceutical school to learn how to take care of patients, so we need to enable our clinicians to focus on what they do best: using their clinical acumen to render high-quality care. Building out the clinical capabilities they need to deliver the holistic approach to care that’s necessary in a value-based model will achieve critical alignment among health plans, providers, physicians, and patients.
 
Twenty years ago, AJMC took the first steps by shedding light on the importance of the value-based model. The time has come for us to band together to show the rest of the country the future of healthcare in the new century.


Author Affiliation: Chief Medical Officer, Humana, Louisville, KY.

Source of Funding: None.

Author Disclosures: Dr Beveridge is an employee and stockholder of Humana.

Authorship Information: Concept and design; drafting of the manuscript; critical revision of the manuscript for important intellectual content; administrative, technological, or logistical support; supervision.

Address correspondence to: Roy A. Beveridge, MD, Chief Medical Officer, Humana, 500 W Main St, Louisville, KY 40202. E-mail: rbeveridge@humana.com. 
REFERENCES
 
1. Rising health care costs are unsustainable. CDC website. http://www.cdc.gov/workplacehealthpromotion/businesscase/reasons/rising.html. Updated October 23, 2013. Accessed September 7, 2015.

2. Better, smarter, healthier: in historic announcement, HHS sets clear goals and timeline for shifting Medicare reimbursements from volume to value [press release]. Washington, DC: HHS; January 26, 2015. http://www.hhs.gov/news/press/2015pres/01/20150126a.html. Accessed September 7, 2015.

3. Accountable care supports improved population health, results for Humana Medicare Advantage members [press release]. Louisville, KY: Humana; December 9, 2014. http://press.humana.com/press-release/accountable-care-supports-improved-population-health-results-humana-medicare-advantage. Accessed September 7, 2015.

4. Humana distributes more than $76 million in quality awards to physicians nationwide [press release]. Louisville, KY: Humana; October 23, 2014. http://press.humana.com/press-release/humana-distributes-more-76-million-quality-awards-physicians-nationwide. Accessed September 7, 2015. 
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