DeKalb Physician Hospital Organization (DPHO) and Humana announced an expanded relationship by adding value-based provisions to their agreement for Humana’s commercial members. DPHO also has an agreement in place for Humana’s Medicare Advantage members in Atlanta. Decatur, Ga.-based DPHO, a DeKalb Medical affiliate, is a clinically integrated network including 500 physicians and three hospitals. Humana has 1.6 million Medicare Advantage members and 200,000 commercial members in more than 900 value-based arrangements in 43 states and PuertoRico.

“DeKalb Medical and DPHO physicians are highly respected members of the local medical community,” said Alan Stewart, Regional Vice President of Market Development for Humana. “We are pleased to build on our long-term relationship with DeKalb to focus on helping our members achieve their best health by including provider rewards for increased attention to preventive measures such as breast cancer screenings and diabetes testing.”

Blue Cross Blue Shield of Rhode Island, Coastal Medical and Lifespan announced an accountable care agreement for 45,000 BCBRI members. Initially the agreement includes expansion of Coastal’s existing condition-specific initiatives for COPD, diabetes and heart failure by integrating these programs into Lifespan’s existing systems of care. The agreement calls for improved coordination of primary, speciality and hospital care among Coastal snd Lifespan “to create a more seamless experience of care specifically tailored to each patient's medical condition and personal preferences.”

"Coastal Medical's primary care offices have been recognized nationally for their success in delivering high-quality care that emphasizes coordination of the services each patient receives beyond the walls of the primary care office" said Al Kurose, M.D., president and CEO of Coastal.  "Under this new agreement, Coastal and Lifespan and Blue Cross will be able to take care coordination to the next level and provide a more seamless experience of care for patients, especially those with complex needs."

Leave a comment