Better Patient Experience for Humana Medicare Advantage Members Image

Better Patient Experience for Humana Medicare Advantage Members

Wednesday, October 3, 2018

(BUSINESS WIRE)–Humana Inc. (NYSE: HUM), a leading health and well-being company, today announced it has collaborated with Heritage Provider Network (HPN), one of the nation’s most experienced and effective physician-led value-based care organizations, on a value-based agreement designed to offer a coordinated, patient-centered experience to help Humana Medicare Advantage members in Southern and Central California achieve better health.

“Working with Humana brings together two highly respected, experienced organizations committed to providing better care, better health and lower costs”

Humana’s Medicare Advantage HMO plan members in Kern, Los Angeles, Orange, Riverside, San Bernardino, and Ventura counties, as well as Dual Eligible Special Needs Plan (for patients qualifying for both Medicare and Medicaid) members in Kern and Ventura counties, will have in-network access to HPN’s vast number of physicians and facilities throughout Southern and Central California.

The agreement with HPN is part of Humana’s longstanding commitment to value-based care, which emphasizes:

  • More personal time with health professionals and personalized care that is tailored to each person’s unique health situation;
  • Access to proactive health screenings and programs that are focused on preventing illness;
  • Improved care for people living with chronic conditions with a focus on avoiding health complications;
  • Leveraging technologies, such as data analytics, that connect physicians and help them work as a team to coordinate care around the patient; and
  • Reimbursement to physicians linked to the health outcomes of their patients rather than based solely on the quantity of services they provide (fee-for-service). (Watch video of Humana and AAFP’s Value-Based Payment Study Congressional Briefing).

HPN is one of the largest, physician-owned and operated integrated delivery systems in the United States with more than 50 related healthcare companies encompassing numerous hospital, pharmacy, urgent and primary care and surgical center collaborations. HPN, and its affiliates, have more than 3,600 primary care physicians and 10,000 specialists to provide coordinated, patient-doctor centric, integrated health care systems that represent the future of healthcare in the United States. HPN brings a 40-year successful track record of coordinated, managed care – a proven clinical and business model to improve healthcare outcomes – to its relationship with Humana.

  • HPN’s physician practices in Southern and Central California include:
  • Bakersfield Family Medical Center
  • Coastal Communities Physician Network
  • Desert Oasis Health Care
  • High Desert Medical Group
  • Heritage Victor Valley Medical Group
  • Lakeside Medical Group
  • Regal Medical Group
  • Heritage Sierra Medical Group
  • Affiliated Doctors of Orange County
  • Under this new agreement, Heritage Provider Network’s physicians will also benefit by having access to new tools, real-time data and care support offered by Humana, which will maximize the time HPN physicians spent with their patients covered by Humana Medicare Advantage.

“Working with Humana brings together two highly respected, experienced organizations committed to providing better care, better health and lower costs,” said Dr. Richard Merkin, President and CEO of HPN. “We will be able to coordinate care needs across our entire system and tailor healthcare services proactively that will bring added value to Humana Medicare Advantage members by increasing their access to healthcare services in all of our medical provider groups throughout Southern and Central California, creating a robust care network.”

HPN’s extensive California Medicare Advantage presence will further strengthen Humana’s growth and market share in California, and the two entities look forward to further expansion.

“We are excited to offer our southern California Medicare Advantage members additional access to value-based care through our new relationship with Heritage,” said Rick Beavin, California Medicare President for Humana. “By working together with Heritage, we are able to better serve Humana Medicare Advantage members and offer them high-quality care with the goal of improving their health and well-being.”

Humana has an extensive and growing value-based care presence. As of June 30, 2018, Humana has approximately two million individual Medicare Advantage members and approximately 130,000 Group members who are cared for by more than 52,000 primary care physicians in more than 1,000 value-based relationships across 43 states and Puerto Rico. Humana’s total Medicare Advantage membership is more than 3.5 million members, which includes members affiliated with providers in value-based and standard Medicare Advantage settings. For more information, visit