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Humana Distributes More Than $76 Million in Quality Awards to Physicians Nationwide

4,700 physician practices received rewards for providing quality care

Thursday, October 23, 2014 11:46 am EDT



Public Company Information:

"The continued success of Humana’s Provider Quality Rewards Program is reflective of the importance of providing physician support as they embrace a value-based model of care"

LOUISVILLE, Ky.--(BUSINESS WIRE)--As part of its continued efforts to help physicians transition from fee-for-service to value-based reimbursement models, Humana Inc. (NYSE: HUM) distributed $76.8 million to physicians across the United States who participate in Humana’s Provider Quality Rewards Program. The 2014 reimbursement amount is a 28 percent increase from the $60 million that Humana distributed to physicians last year under the program.

Humana’s Provider Quality Rewards Program is part of Humana’s Accountable Care Continuum, which is a pay-for-value system focused on promoting evidence-based, high quality care. The Continuum recognizes practice complexity by offering several levels of participation through pay-for-value programs including Star Rewards, Model Practice, Medical Home and bonus programs for value-based care.

“The continued success of Humana’s Provider Quality Rewards Program is reflective of the importance of providing physician support as they embrace a value-based model of care,” said Roy A. Beveridge, M.D., Humana’s Chief Medical Officer. “The holistic approach to patient care, which is driven by value-based models, not only helps primary care physicians focus on the total health of their patients, but also reflects the importance of moving from sick care to health care.”

Humana also recently announced its Star ratings for its Medicare Advantage (MA) plans. The company has 22 MA plans that achieved a rating of 4.0 stars or greater, with nine of the Humana plans achieving a 4.5 star rating. Humana also achieved a rating of 5.0 stars for its H1019 CarePlus Health Plans, Inc. HMO plan in Florida.

Approximately 4,700 physician practices received payments from Humana in recognition of improved outcomes for Humana’s Medicare members made during 2013. Reward settlement finalization takes place in 2014 for the 2013 Rewards Program to allow time for final claims submission and supplemental data.

Humana’s 2013 payments to physician practices were based on the practices’ ability to improve quality for many National Committee for Quality Assurance (NCQA) preventive and chronic-condition management Healthcare Effectiveness Data and Information Set (HEDIS) measures including, but not limited to the following:

  • Breast cancer screening
  • Glaucoma screening
  • Colorectal cancer screening
  • Diabetes treatment management
  • LDL control
  • A1C control
  • Nephropathy screening
  • Diabetic retinal eye exam
  • High risk medications

“Humana’s focus is to support primary care physicians with the population health solutions needed to make the transition from volume to value, and to help them become successful population health managers,” said Chip Howard, Humana’s Vice President of Payment Innovation in the Provider Development Center of Excellence. “Humana’s pay-for-value programs not only offer support for physician practices as they move into value-based relationships, but help improve the patient experience.”

Humana has a 26-year accountable care relationship history with more than 1.2 million MA members that are cared for by 38,000 primary care physicians, in more than 900 accountable care relationships across 43 states and Puerto Rico.

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.
Alex Kepnes, 502-580-2990
Corporate Communications

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