Medicare is facing unprecedented cost and care challenges, and national policy experts have recommended myriad ways to make the program more sustainable. Those recommendations have included networks of contracted providers, integrated delivery systems, case management, new approaches to payment and delivery of services, and fee schedules that promote primary care.
But Humana’s Medicare Advantage (MA) plans are already doing those things.
According to the National Council on Aging, about 80 percent of seniors have one chronic condition, and almost 70 percent have two or more chronic conditions. Additionally, 95 percent of healthcare costs for older Americans can be attributed to chronic diseases. But Original Medicare is not a health program; it simply pays claims and monitors for fraud. In contrast, Humana’s Medicare Advantage plans make it easier for people to achieve their best health.
These things make a difference to our members in health and quality of life. Humana data shows:
|Hospitalizations for those at highest risk for frequent admissions||↓ 44%|
|Two year odds of survival||↑ 26%|
More than one million more healthy days in the home (versus hospitalization) than they would have had without intervention
Source: Humana At Home, 2014-2015
Medicare Advantage provides a better alternative to the traditional, fee-for-service part of Medicare in several key ways. Recent national, peer-reviewed studies of people with Medicare Advantage demonstrate the higher quality and value that MA plans bring to the healthcare system:
According to a 2017 analysis of health-services data by Rand and CMS, as reported in “Medicare Advantage and Fee‐for‐Service Performance on Clinical Quality and Patient Experience Measures: Comparisons from Three Large States”:
Additionally, a 2017 study from the Harvard T.H. Chan School of Public Health, titled “The Persistence of Medicare Advantage Spillovers in the Post-Affordable Care Act Era,” reports that higher Medicare Advantage market penetration rates lead to lower costs in traditional Medicare to the tune of $146 per person. The primary drivers of the reduction in spending were fewer home health visits, fewer hospital admissions and shorter inpatient stays, as well as fewer imaging events for traditional Medicare beneficiaries.
Because Humana’s integrated care model depends on strong primary care doctor-patient relationships, we have been expanding our primary care footprint. We support primary care “medical homes” in 16 states and more than 900 accountable care provider organization relationships across 43 states and Puerto Rico.
We continue to invest in wholly owned primary care clinics as well as joint ventures with physician partners, including multi-specialty centers focusing on senior populations in medically underserved areas. These centers take a holistic approach to health, with primary care doctors and specialists under one roof. Many have extended hours, offer transportation to and from the facilities, and fill prescriptions on site. The goal is to make it easy for people with Medicare to be as healthy as they can be, removing known barriers such as a lack of local access to care.
To read Humana’s policy about Medicare Advantage, check out this page.