Provider Medicare Quality
The traditional fee-for-service reimbursement model revolves around sick care and paying for services provided rather than focusing on outcomes and aligning incentives. The misalignment inherent in the traditional model can lead to inefficiencies in care delivery, quality and outcomes. The pay-for-value model focuses on promoting evidenced-based, high-quality care that leads to improved care coordination, lower health care costs and better outcomes. The focus on the three areas of cost, quality and outcome is often referred to as the “triple aim.” Humana’s support of value-based reimbursement is the foundation on which we developed our Accountable Care Continuum.
We offer financial rewards for improvements in cost, quality and outcomes. We created a continuum of programs to encourage primary care physicians in their development of population health management capability and focus. As a PCP develops these capabilities, there is additional opportunity to advance down the continuum along the “path-to-risk” or full accountability.
Humana’s Provider Quality Rewards Program supports providers along the Continuum of Care. Our Rewards Program meets the provider practices where they are in their current practice model to help them move across our value-based programs.