What the Data Tell Us about Value-based Care

As we wrapped up 2017, we were able to announce two exciting reports that share what we’re learning about value-based care.

The first was our inaugural value-based care report, “Making Progress, Seeing Results (opens in new window).” In it, Humana reports that patients seen by physicians in value-based relationships are seeing 6 percent fewer inpatient hospital admissions, 7 percent fewer emergency department visits and an increase in preventive screenings for breast and colon cancers. Additionally, we’ve seen a decrease in overall health care costs, compared to those affiliated with standard Medicare Advantage settings.

The report also showed that in 2016, Humana’s distribution of overall payments to health care providers was higher for those in value-based care arrangements. According to American Academy of Family Physicians (AAFP) data, primary care physicians (PCPs) receive 6 percent of the total distribution of health care payments nationally. Humana’s distribution to PCPs was 16 percent in 2016.

The second report we released was the AAFP-Humana study that looked at physicians’ readiness for value-based payment. This report was a follow-up to a similar study conducted in 2015, and showed that more family physicians are adopting value-based payment models despite facing the same barriers: lack of staff time (90 percent), lack of transparency between payers and providers (78 percent) and lack of standardization of performance measures (78 percent). To see more about the study, go to http://humananews.com/wp-content/uploads/2017/11/Data-Brief2017_Value-Base_FINAL4.pdf (opens in new window).

We are always looking for new ways to support physicians in achieving better outcomes for their patients and their practice. I invite you to reach out to the Office of the CMO to share your experience and insights: ocmo@humana.com.

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Roy Beveridge, M.D. Senior Vice President and Chief Medical Officer