Doctor with patient

Care services and support

Supporting your patients’ care

At Humana, we are patients, mothers, fathers, aunts, uncles, sons and daughters and, yes, even physicians and nurses. Because we can relate, we are continuously striving to make sure the programs we offer support your patient care. Below you’ll find a list of programs, services and capabilities to help support physicians who are transitioning to or currently participating in a value-based care model. We support you in your care decisions and, should you decide to enter a value-based care contract with Humana, we will be with you every step of the way. The programs, services and capabilities you see here are just one part of our commitment to you and your practice.

Please note that this list is not exhaustive of all Humana programs and services, and availability of the patient programs and services listed below varies by benefit plan. Not all patient programs and services are available under all benefit plans.

Acute, episodic events

Health Planning and Support

  • Determines which program or service is available to help the patient
  • Provides non-urgent nurse advice, guidance to in-network providers and preventive screening reminders; available 8:30 a.m. to 5 p.m. local time

Humana At Home Transitions Program

  • Provides in-home care management support for patients transitioning from an acute hospital admission to the home setting
    • Employs care managers who collaborate with physicians/clinicians to enable patients to continue living at home safely while addressing their physical, behavioral, cognitive, social and financial needs
    • Reinforces care plans prescribed by patients’ physicians
    • Transitions to Humana At Home Chronic Care Program within 30 days

HumanaFirst (administered by Citra Health)

  • Offers access 24 hours a day, seven days a week to nurse advice for immediate medical concerns
  • Helps patients pursue appropriate care options when physician is unavailable

Case Management

  • Performs short-term care management (less than 90 days) for acute members
    • Provides post-discharge care coordination to decrease risk of avoidable, unplanned readmissions
    • Makes referrals to other clinical programs, such as complex case management and disease management

Telemedicine

  • Enables video telemedicine visits
  • Serves as a resource for patients and provides alternative care options when their physicians are unavailable

Well Dine®

  • Delivers meals cost-free to patients at home after hospitalization, with goal of improving nutrition to reduce readmission
    • Provides added meal support for patients with certain chronic conditions (including diabetes, congestive heart failure, coronary artery disease)
    • Follows up telephonically within 48 hours of meal delivery

Long-term health

End-stage renal disease and chronic kidney disease management (administered by VillageHealth®)

  • Offers individual care guidance, patient education and coordination of care for patients with end-stage renal disease (ESRD) and late-stage chronic kidney disease (CKD)
    • Facilitates compliance with the physician’s treatment goals and communicates with the physician as a liaison and advocate for the patient and his or her family
    • Coordinates with network dialysis centers

Humana At Home Chronic Care Program

  • Offers in-home and telephonic nurse support for patients with multiple chronic conditions and functional limitations
    • Employs care managers who collaborate with physicians/clinicians so that patients can continue living at home safely while addressing patient physical, behavioral, cognitive, social and financial needs
    • Uses a database of community resources to which care managers can refer patients
    • Works to lower risk of frequent hospitalizations

Humana Behavioral Health

  • Reaches out proactively and engages with patients experiencing coexisting medical and behavioral issues
  • Combines medical and behavioral support to improve behavioral health issues that could hinder progress to better physical health
    • May improve patients’ adherence to physicians’ treatment plans by addressing underlying behavioral concerns
    • Includes case management and utilization management of inpatient and outpatient behavioral healthcare services

Across all health levels

Humana Health Alerts

  • Reaches out proactively via multiple channels when opportunities to improve health outcomes are identified in these categories: preventive care, condition-specific best practices, drug-to-drug and drug-to-disease interactions
    • Uses Member Summary to reach physicians at the point of care (summaries accessible Availity.com)

Humana Pharmacy® Mail Delivery

  • Is the preferred cost-sharing mail-delivery pharmacy for Humana Medicare Advantage plans (excluding Puerto Rico)
    • Offers patients the lowest comparable cost-shares available through their plan
    • Includes a 90-day supply of maintenance medications shipped to the patient’s chosen location

Humana Pharmacy Solutions®

  • Is Humana’s pharmacy benefits manager (PBM), offering patients programs designed to improve their safety and adherence and reduce medication-related complications
    • Includes medication therapy management, which addresses therapeutic duplication, disease/drug contraindications, drug allergies and misuse or abuse

Humana Specialty Pharmacy

  • Is Humana’s specialty prescription mail-delivery pharmacy offering high-touch clinical programs and services to patients on specialty medicines
    • Includes a clinical team of registered nurses, pharmacists and pharmacy technicians to help manage side effects and secure financial assistance to help patients stay compliant with medication plans

Predictive modeling

  • Identifies disease and health risk indicators early on, leading to earlier intervention and helping avoid or mitigate future health issues
    • Enables cost savings and optimal health outcomes associated with earlier identification and engagement

Transportation assistance

  • Coordinates transportation to help patients get to routine healthcare visits (e.g., medical appointments; ongoing care appointments, such as dialysis)
    • Helps remove a barrier to prescribed care

Capabilities for your practice

Transcend Insights

  • Simplifies the complexities of population health through advanced community-wide interoperability, real-time healthcare analytics and intuitive care tools
    • Uses the company’s HealthLogix™ platform to provide healthcare systems, physicians and care teams with valuable clinical insights that enable more informed decisions at the point of care while enhancing the patient experience and reducing costs