Ep 10 – Transitioning to Value during Unprecedented Times, with Mike Funk

The importance of Humana’s consumer focus, care in the home, technology, and other strategic imperatives related to value-based care have been amplified by the novel coronavirus (COVID-19) pandemic. As COVID-19 presses onward, this week Race to Value presents an industry perspective from Mike Funk, Vice President for the Office of Health Affairs and Advocacy.  Mike Funk believes that the transition to value-based care is inevitable. In his role with Humana, he leads the organization’s commitment to ensure that Humana providers are well equipped for the transition to value, especially during these unprecedented times. From stabilizing physician practices, increasing access to care, creating a high-touch primary care model, improving interoperability, and more, Humana has been a leader in the race to value. In this episode Mike reveals Humana’s efforts in value, including outlining impressive partnerships with the DaVinci project, OATS, Epic, Oak Street Health, Iora Health, Kindred Health, and the University of Houston, to name a few.

Mike Funk is responsible for thought leadership at Humana in transforming the industry to value-based care, as well as serving as the voice of the provider, infusing clinical thinking and leadership across the enterprise. His prior experience includes; executive positions in hospital administration, physician practice management, managed care, insurance products, and health and wellness services. Mike most recently spent the last several years in the Provider Development Center of Excellence, where he focused on developing value-based programs, and assisting physicians with the tools, capabilities, and best practices for transitioning from fee for service to value. Mike is a fellow of the American College of Healthcare Executives and a Certified Medical Practice Executive.

References for more information:




5:45 “Unprecedented times call for unprecedented actions”

6:24 Primary focus of Humana during the pandemic has been to improve access to healthcare services

6:45 Pandemic was the catalyst for jumpstarting and mainstreaming telehealth

8:01 5-10 years of technology adoption progress happening in 2-3 months

8:30 The “genie is out of the bottle” when it comes to telehealth

9:10 Limitations with technology and telehealth access in rural areas

9:30 Older Adults Technology Services (OATS) investment by Humana Foundation to launch national digital engagement consortium for older adults

10:11 Recognition by CMS of increased need for telehealth

10:20 Mike shares a story of a practice leveraging telehealth visits in an innovative way

12:40 Lack of interoperability held back the healthcare system in navigating the pandemic crisis

13:20 Need for interoperability COVID-19 test results

13:50 Humana’s participation in the HL7 Da Vinci Project to support increased data sharing by leveraging the FHIR Standard

14:20 Humana’s work with EMR companies to advance interoperability (Epic, eCW, AthenaHealth)

17:00 Humana’s goal to ensure stabilization of physician practices

18:00 Risk-based payment models providing stability in cash flow

21:00 Humana has evolved its value-based product portfolio to include specialty bundles (e.g. joint replacement, spine, maternity care)

21:10 Humana’s omni-channel approach to create a value-based care ecosystem that is “personalized, proactive, and predictive”

21:40 Increased demand in home care services and Humana’s recent investments in Kindred and Heal

22:00 Humana’s partnership with high-touch primary care practices (e.g. Iora, Oak Street) and their own practice (Partners in Primary Care)

22:20 Moving from a health insurance company to a health company with elements of insurance

23:45 Humana’s Bold Goal initiative and other strategies to address social determinants of health and support whole-person care

24:35 CMS’ work to assess COVID-19 impact on Medicare beneficiaries

24:45 Humana’s work with MGMA to better understand the impact of diverted care during pandemic

25:05 Humana’s work to support medication adherence

27:20 Addressing racial disparities within a whole-person care model

28:15 Humana’s collaboration with local government in San Antonio to address diabetes which contributed to overall improvement in population health

29:30 Humana’s recent pilot with Oschner Health to launch a value-based program to address social determinants of health

30:10 Humana delivering meals to patients in need during pandemic

30:40 Humana’s commitment to health equity and recent investment in Humana Foundation to address racial inequities in population health

33:00 How the pandemic will rapidly shift the healthcare industry to value-based care due to mounting debt levels

36:40 The need for workforce development in preparing for value-based care and the new partnership with the University of Houston College of Medicine

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