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Moving to value-based care (VBC)

Read Humana’s 2022 Value-based Care Report to learn how value-based care helps strengthen the healthcare system through increased prevention efforts, improved outcomes and an enhanced patient experience.

A doctor and a patient speak in an exam room.

What value-based care means for providers

Value-based care is a form of reimbursement that ties payments for care delivery to the quality of care provided rather than quantity. This form of reimbursement has emerged as an alternative for fee-for-service.

Humana’s value-based primary care continuum provides programs that offer financial rewards to primary care physicians for improvements in quality, outcomes and costs.

See our evolving primary care payment models, PDF and how value-based practices include a greater share of Humana MA members.

Infographic with text depicting the significant member growth of value-based care physicians from 2017 through 2021.
Value-based care physicians have seen significant member growth year over year. 1,193,291 value-based individual members were gained between Jan. 1, 2017 and Dec. 31, 2021.

Benefits of a value-based healthcare practice

Better patient engagement

According to Healthcare Effectiveness Data and Information Set (HEDIS), value-based providers screenings were 6-19% higher in 2021.

Higher Stars ratings

A full-Star difference and a 35% difference in the HEDIS average. The combined average Stars ratings for preventive screenings and patient safety: 4.0 for value-based vs. 2.92 for non-value-based.

Agile care model

At the height of COVID-19 disruptions, healthcare providers in value-based agreements reported being able to pivot quickly because of their focus on patient outcomes rather than on volume of services.3

Real-time patient data

Humana contracted value-based physicians use intelligence to proactively address patient needs within the native electronic health record (EHR) workflows, closing gaps and helping patients stay on track with their health.4

What I have found with value-based care is that you really get a chance to focus on prevention and disease management.  I feel like I am able to teach my patients ways to prevent illness.  This allows the patient to feel like they have control over their health. You can’t get this in a fee-for-service world.

Dr. Stephanie Phillips
CenterWell Primary Care

Sources

  1. “Value-Based Care Report,” Humana, last accessed November 1, 2022, https://www.humana.com/provider/news/value-based-care/value-based-care-report.
  2. “Value-Based Care Report.”
  3. “Value-Based Care Report.”
  4. “athenahealth and Humana Collaborate to Improve Healthcare Outcomes for its Members,” athenahealth, last accessed October 21, 2021, https://www.athenahealth.com/press-releases/athenahealth-and-humana-collaborate-to-improve-healthcare-outcomes-for-its-members.

Take the next step toward value-based care

Read our VBC report

See prevention, outcomes and utilization, costs and payments data for physicians in value-based agreements.

Download a copy of the report, PDF

Connect with colleagues

Explore value-based care with a representative in your area and learn how to get started.

Explore VBC episode-based models

Humana has devolped episode-based models for certain episodes of care.