Overview
Discussion: This week’s lessons discuss both the value of non-financial metrics and the metrics that are appropriate or expected for various business sectors. As we saw last week, often the numbers only offer part of the story.
- Describe for everyone the three greatest risks faced by your organization. They may be competitive, environmental, financial, legal, political or global.
- How do the metrics currently used by your organization address those risks? Be specific. Provide the numbers if you can.
- Are there any policy-based limitations or strategic limitations in implementing the more holistic metrics we've been talking about in the course to date?
Assignment: In late 2023, CEO Bruce Broussard reviewed health insurer Humana's transformation into a value-based care ecosystem. Under its CenterWell brand, the several millions of members in Humana Medicare Advantage plans now had access to Humana-provided primary care, home care, behavioral health, and mail order pharmacy services. Innovative partnerships with private equity firms had helped finance the acquisition and operations of key CenterWell assets. Broussard and his top team now convened to review the merits of a potential acquisition of a large group of primary care clinics. The discussion centered on how best to build further on and integrate Humana's successes to date in value-based care delivery.
You may want to review the following articles to help with your analysis. The articles are available at the Champlain Library.
- How to Pay for Health CareLinks to an external site. - Porter and Kaplan
- 3 Keys to Shifting How We Pay For HealthcareLinks to an external site. - Rothenhaus and Fox
Read the case, Humana Commits to Value Based Care, in your Harvard Coursepack. Prepare a PowerPoint presentation that addresses the following issues raised in the case:
- How an integrated payor plus provider model rewards and enables a different approach to care than a traditional, fee-for-service clinic setting. Speak directly to CenterWell’s approach.
- The process/plans to ensure acceptance of value based care.
- What safeguards Medicare Advantage introduces to ensure companies like Humana are accountable to give patients high quality care while accepting a flat membership fee.
- The expected impact on the bottom line for Humana.