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Humana Discloses Results to Date in Ongoing Initiatives To Improve Quality and Reduce Costs for America’s Seniors

Wednesday, March 25, 2015 8:00 am EDT



Public Company Information:

"Humana applauds HHS for its continued commitment to fostering and expanding value-based reimbursement in the traditional, fee-for-service Medicare program"

WASHINGTON--(BUSINESS WIRE)--In conjunction with the White House launch event this morning for the Health Care Payment Learning and Action Network, Humana disclosed today its results to date from various initiatives designed to improve quality and reduce costs for America’s seniors.

The disclosure came in conjunction with Department of Health and Human Services (HHS) Secretary Sylvia Burwell’s recently announced goal of tying 30 percent of Medicare payments to quality or value by the end of 2016 through alternative payment models such as Accountable Care Organizations (ACOs), patient-centered medical homes or bundled payment arrangements. She set a further goal of tying 50 percent of payments to these models by the end of 2018.

The Health Care Payment Learning and Action Network, composed in part of chief medical officers of organizations like Humana, is designed to foster the kinds of public-private partnerships that will be necessary for these goals to be achieved. Humana Chief Medical Officer Roy Beveridge, M.D., will lead Humana’s representation in the Network.

“Humana applauds HHS for its continued commitment to fostering and expanding value-based reimbursement in the traditional, fee-for-service Medicare program,” said Bruce D. Broussard, Humana’s President and Chief Executive Officer, who participated in the White House launch event. “We believe that expanding pay-for-performance programs will result in improved population health for Americans – as evidenced by the 1.3 million Humana Medicare Advantage members in 43 states who are already benefitting from Humana’s accountable care programs.”

Humana’s quality and cost improvements to date include:

  • Improving Access to Accountable Care: While HHS aims to have 30 percent of Medicare payments in alternative payment models by the end of 2016 and 50 percent by the end of 2018, Humana has 53 percent of its members in accountable care relationships today and is on course to have more than 75 percent in accountable care relationships by 2017.
  • Improving the Quality of Patient Care: Humana’s accountable care relationships are improving the quality of patient care delivered to its health plan members. In 2014, Humana’s accountable care providers had a Healthcare Effectiveness Data and Information Set (HEDIS) Star score average of 4.25 as compared to providers outside of accountable care settings with a HEDIS Star score average of 3.65.
  • Reducing Hospital Readmissions and ER Visits: While HHS has reduced the Medicare fee-for-service hospital readmission rate from 19 percent in 2011 to 17.5 percent in 2013, Humana members in accountable care relationships have a 4 percent lower hospital readmission rate than traditional, fee-for-service Medicare and 7 percent fewer emergency room visits per thousand beneficiaries.
  • Lowering Costs: Humana experienced a 19 percent cost improvement in total in 2013 for members who were treated in an accountable care setting compared with members who were treated by providers in original Medicare settings.

About Humana

Humana Inc., headquartered in Louisville, Ky., is a leading health and well-being company focused on making it easy for people to achieve their best health with clinical excellence through coordinated care. The company’s strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people we serve across the country.

More information regarding Humana is available to investors via the Investor Relations page of the company’s web site 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;
  • Replays of most recent earnings release conference calls;
  • Calendar of events (including upcoming earnings conference call dates and times, as well as planned interaction with research analysts and institutional investors);
  • Corporate Governance information.


Humana Inc.
Corporate Communications:
Tom Noland, 502-580-3674