Humana Military Names Alefiyah Mesiwala, M.D., Chief Medical Officer - Seite 2

The Defense Health Agency has stated the importance of integrating value-based care programs and alternative payment models (APMs) into the TRICARE 5^th generation (T5) contracts through recent draft requests for proposal. Humana is one of the nation’s leading companies for entering into value-based agreements with physician groups to serve its Medicare Advantage members. In 2019, 2.41 million Humana individual Medicare Advantage beneficiaries receiving care from primary care physicians in value-based payment models experienced, on average, better health outcomes, lower costs and more preventive care, as opposed to fee-for-service models.

“Humana Military has done an outstanding job working with the Defense Health Agency through TRICARE to serve the health needs of its beneficiaries,” said Dr. Mesiwala. “My expertise in clinical payment innovation and my on-the-ground experiences working closely with providers in value-based care will support the Humana Military team as we partner with DHA to transform the care for the TRICARE population towards the Quadruple Aim. The military members who defend our nation and their families deserve the best health care possible and it is my honor to serve them.”

Dr. Mesiwala joins Humana Military from the University of Pittsburgh Medical Center (UPMC) Health Plan, where she has served since 2017 as Senior Medical Director for Value-based Care and Innovation for UPMC Health Plan. At UPMC Health Plan, Dr. Mesiwala led the clinical design and implementation of primary care and specialty-focused alternative payment models. Additionally, she led programs to support providers and physicians across the network in practice transformation and clinical quality improvement.

From 2015 until 2017, Dr. Mesiwala served as Senior Policy Advisor in Healthcare to former President Barack Obama at the White House, where she was responsible for furthering the Administration’s progress in health care policy. As the health care lead for the White House National Economic Council, Dr. Mesiwala launched a multi-stakeholder public-private partnership to further kidney care and organ transplantation and also launched a national provider-focused collaborative to collectively address workforce challenges in health care. From 2011 to 2015, Dr. Mesiwala worked at the Center for Medicare and Medicaid Innovation (CMMI), where she served as a Medical Officer and Senior Advisor to the CMMI Director. In this capacity, Dr. Mesiwala led the development and implementation of new models including specialty-focused accountable care organization and the CMS healthcare innovation awards program.