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New Report Finds Value-Based Care Agreements Benefited Humana Medicare Advantage Members with Reduced Hospitalizations, More Preventive Care During COVID-19 Pandemic

Eighth annual Value-based Care Report shows value-based care agreements helped Humana members spend 245,000 fewer days in the hospital compared to those with physicians not in a value-based care agreement

Humana Inc. (NYSE: HUM) published its eighth annual Value-based Care (VBC) Report today, showing that Humana individual Medicare Advantage (MA) beneficiaries receiving care from primary care physicians in value-based payment models experienced, on average, better health outcomes, lower costs and more preventive care, compared to non-value based models.

The report, comprised of data collected during 2020 and representing the challenges providers and patients experienced during the COVID-19 pandemic, reflects the outcomes and experiences of 2.65 million Humana Medicare Advantage members seeking care from 67,800 primary care physicians who are in value-based agreements.

Key Report Findings:

  • Humana VBC MA members received more care and spent less time in the hospital. Incidents of costly hospital admissions were reduced by 7% and emergency room visits by 12% for members with VBC providers compared to those with Humana non-VBC providers. On average, hospital admission rates were 22% less than Original Medicare in 2020.
  • Rates of telemedicine use for primary care rose faster in 2020 among Humana value-based MA members. During the initial wave of COVID cases, providers in VBC contracts used telehealth at five times the rate compared to practitioners in non-value-based agreements, according to a study of health maintenance organization (HMO) members between March 1-Sept. 30 by Humana Healthcare Research.
  • Humana’s VBC agreements helped reduce total medical costs by 13.4%. More preventive care and lower rates of hospitalization led to an estimated reduction in medical costs of 13.4%, or $3.1 billion that would have been incurred by value-based members had they been enrolled in Original Medicare. These savings are often reinvested into primary care services and other benefits for patients.
  • VBC agreements rewarded quality outcomes and strengthened the pandemic response through reliable payment models for physicians’ practices. Physician practices in value-based agreements pivoted quickly and adapted to a new way of caring for patients. Physicians in value-based contracts with Humana received more of the overall healthcare dollar, earning 17.5 cents of every dollar spent compared to 6.7 cents for non-value-based physicians.

Report Details

The report – which can be found at valuebasedcare.humana.com – details how Humana’s VBC contracted Medicare Advantage providers were in a significantly stronger position to ensure seniors were able to continue accessing essential care despite COVID-19 restrictions, lockdowns and nationwide deferral of care. Their success in providing preventive, routine and urgent care throughout 2020 was due in large part to the innovative technologies, capabilities and services that value-based agreements incentivize and support. Despite the significant challenges of providing care during the worst of the COVID-19 pandemic, providers in value-based agreements were in a better position to adapt and focus on patient needs, including social determinants of health exacerbated by the pandemic, like increased social isolation and food insecurity.

“During a year of unprecedented disruptions, we are grateful for the dedication, care and ingenuity showed by physicians to continue providing high-quality care for our Medicare Advantage members,” said Humana President and Chief Executive Officer Bruce Broussard. “As the population of Medicare Advantage beneficiaries continues to grow, we will continue to collaborate with providers and others on the best ways to address seniors’ critical needs and ensure a strong future for the Medicare guarantee made to our seniors.”

The report tells how VBC providers connected patients to at-home care services, increased their use of telemedicine and addressed food security needs to continue providing high-quality care during the pandemic. As a result, 86% of Humana MA members saw their value-based primary care physicians at least once in 2020, compared to 78% among non-value-based patients.

Humana’s 2021 Value-Based Care Report will be a timely and important resource for those who will help the country navigate through future pandemics such as providers, policymakers and others focused on better health outcomes, increasing value and delivering cost savings.

“Value-based providers had invested in the right infrastructure before COVID-19, allowing them to be more flexible and in a better position to leverage technology, drive more care to the home and be more sensitive to the emerging needs of their patients and communities,” said Humana Chief Medical Officer William Shrank, MD, MPHS. “As we continue to navigate the uncertainties brought on by COVID-19, one thing is clear – the pandemic reaffirmed the imperative for value-based care.”

About Value-Based Care

Value-based care (VBC) is a contracting model that reimburses and rewards healthcare providers for improved patient care and health outcomes rather than paying them solely for the quantity of services they provide, in contrast to a fee-for-service system. Patients may not know their provider has a value-based agreement, but the data shows that these patients are benefitting from the increased time with their doctors and access to additional programs, services and technologies designed to produce better health outcomes.

About Humana

Humana Inc. is committed to helping our millions of medical and specialty members achieve their best health. Our successful history in care delivery and health plan administration is helping us create a new kind of integrated care with the power to improve health and well-being and lower costs. Our efforts are leading to a better quality of life for people with Medicare, families, individuals, military service personnel, and communities at large.

To accomplish that, we support physicians and other health care professionals as they work to deliver the right care in the right place for their patients, our members. Our range of clinical capabilities, resources and tools – such as in-home care, behavioral health, pharmacy services, data analytics and wellness solutions – combine to produce a simplified experience that makes health care easier to navigate and more effective.

More information regarding Humana is available to investors via the Investor Relations page of the company’s website at www.humana.com, including copies of:

  • Annual reports to stockholders
  • Securities and Exchange Commission filings
  • Most recent investor conference presentations
  • Quarterly earnings news releases and conference calls
  • Calendar of events
  • Corporate Governance information


Matt Wheeler
Humana Corporate Communications

Source: Humana Inc.

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