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Humana’s 2014 accountable care results

For the 2014 results, Humana compared quality and outcomes for approximately 1 million Medicare Advantage members who were treated by physicians in value-based reimbursement model agreements with Humana versus members who were treated by physicians in standard Medicare Advantage settings. Humana also experienced 18 percent lower costs in total for this same member population treated by physicians in value-based reimbursement model settings versus original fee-for-service Medicare.

For Humana’s Medicare Advantage members treated by providers in value-based reimbursement (VBR) model relationships, results show:

Providers Deliver Better Quality

21%

Higher Healthcare Effectiveness Data and Information Set (HEDIS®) Centers for Medicare & Medicaid Services (CMS) Star scores

Members Experienced Healthier Outcomes

7%

Fewer inpatient admissions per thousand

Humana had Lower Costs

18%

Lower costs in total in 2014

Fewer Emergency Room Visits

6%

Fewer emergency room visits per thousand

Better Chronic Condition Management

For diabetes and osteoporosis compliance, higher numbers of screenings for each of the following:

+9% Eye exams (diabetes care)

+12% Blood sugar control (diabetes care)

+13% Osteoporosis management

Population Care for Special Needs

Better management for older adults in vulnerable populations, including higher assessment rates for the following:

+15% Functional status assessment

+11% Medication review

+12% Pain screening

Shift to Value-based Reimbursement

Of Humana individual Medicare Advantage members are currently in VBR relationships

Is Humana’s goal for Medicare Advantage members to be in VBR relationships by 2017

Humana’s Medicare Advantage Members

Today, Humana has approximately:

3.2 million individual Medicare Advantage members

1.6 million individual Medicare Advantage members treated by providers in VBR relationships

Cared for by approximately:

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44,000 primary care physicians

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In more than 900 VBR relationships

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Across 43 states and Puerto Rico