Humana medical home program - Metro Health PHO

Program Location: 
Wyoming, MI
Payer Type: 
Commercial
Payers: 
Humana
Medicare

Reported Outcomes

Description: 

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice. This program offers a care coordination fee to address the cost of infrastructure development and PCMH certification.  

Payment Model: 

This program offers a care coordination fee to address the cost of infrastructure development and PCMH certification.

Fewer ED / Hospital Visits: 
  • 7% fewer emergency department visits*
  • 6% fewer hospital inpatient admissions*
Improved Health: 
  • 7% more blood pressure control*
  • 7% greater diabetes patients with blood sugar¬†controlled*
  • 2% greate diabetes patients renal disease controlled*
Cost Savings: 
  • Total health care costs were 15% lower vs. original fee-for-service Medicare*
  • Total health care costs were 4% lower vs. Humana standard Medicare Advantage settings*
Increased Preventive Services: 
  • 13% increase on colorectal cancer screenings*
  • 8% increase in breast cancer screenings*
Other Outcomes: 

*Based on overall Humana value-based care data, not program-specific

Last updated March 2019
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