Provider Medicare Quality Rewards Program
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 often is 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 quality, outcomes and cost. We created a continuum of programs to encourage primary care physicians (PCPs) in their development of population health management capability and focus. As a PCP develops these capabilities, there is additional opportunity to advance across the continuum along the path to value or full accountability.
Humana’s Provider Quality Rewards Program supports physicians along the value-based-care continuum. Our rewards program meets practices where they are in their current practice models to help them move across our value-based programs.