Humana Medicare Advantage Members Benefit From Improved Health Outcomes, Preventive Care & an Estimated $4 Billion in Reduced...
October 07 2020 - 8:00AM
Business Wire
Humana Inc. (NYSE: HUM) unveiled today its annual Value-based
Care Report, detailing that 2.41 million Humana individual Medicare
Advantage beneficiaries receiving care from primary care physicians
in value-based payment models experienced, on average, better
health outcomes, lower costs and more preventive care, as opposed
to fee-for-service models. Results reflect data collected during
calendar year 2019.
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Value-based care, a key priority in the Medicare Advantage
program, rewards quality and effectiveness of care rather than
quantity of care. By aligning incentives with providers and, most
importantly, with members, we foster deeper collaboration, more
proactive and preventive care, and a more profound commitment to
the experiences and outcomes of our members. Incorporating
integrated care delivery and social determinants of health
screenings can provide value-based providers with a clearer of a
patient’s personal experience and to deliver the best services to
help them achieve their best health.
Report Details
The report details how Humana’s holistic approach helped its
Medicare Advantage members, 85.1% of whom were living with at least
two chronic conditions in 2019, and supported its primary care
physicians in their efforts to better manage patients’ health.
Humana’s population health strategy for addressing the impacts of
health-related social needs, as well as the company’s response to
the COVID-19 pandemic, are also examined in the report.
Humana President and CEO Bruce Broussard said he believes that,
in a value-based care model, providers caring for Medicare
Advantage members have reinforced a broader view of caring for
people living with multiple chronic conditions.
“The premise of human care – where we listen to and address the
specific physical health, behavioral health and health-related
social needs of our members and their care teams – is amplified in
value-based care agreements,” said Broussard. “Our collaboration
with primary care physicians and their care teams is helping to
deliver simpler and more convenient care and reducing avoidable
hospitalizations.”
Key Findings
Listed below is a snapshot of the report’s key findings:
- Humana individual Medicare Advantage members benefitted from
preventive screenings. Humana MA members seeking care from
physicians in value-based agreements received screenings between 8
percent and 19 percent more often for colorectal screenings,
diabetic eye exams, osteoporosis management and controlling blood
sugar than those Humana MA members who received care from
physicians in MA non-value-based arrangements.
- More Humana MA members stayed in their homes, not the
hospital. Humana MA members receiving care from physicians in
value-based care arrangements with Humana collectively spent
211,000 fewer days as hospital inpatients and less time seeking
care in emergency rooms in 2019, compared to those Humana MA
members receiving care from physicians in non-value-based care
models. More broadly, Humana MA members served by
physicians/practices in value-based agreements visited emergency
rooms 10.3 percent less often (90,500 fewer visits) and had a 29.2
percent lower rate of hospital admission (165,000 fewer admissions)
compared with Original Medicare.
- Care costs are lower for Humana Medicare Advantage
members. An estimated $4 billion in plan-covered medical
expenses would have been incurred by Humana Medicare Advantage
members if they had they been under Original Medicare’s
fee-for-service model instead of in value-based agreements.
A strategic advantage of the value-based model is that it equips
physicians with tools, actionable data and resources that provide
an expanded view of patients’ health to assist in developing a more
holistic approach to care. In turn, physicians can provide more
targeted education, monitoring and coordinated, longitudinal care
to their patients. William Shrank, MD, MPHS, Humana’s chief medical
and corporate affairs officer, said he believes that value-based
care models will become even more effective as we foster even
greater interoperability in data and systems, facilitating improved
visibility and coordination.
“Value-based care underscores the need to take a holistic view
to help members achieve their best health,” said Dr. Shrank.
“Central to this is the ability for value-based physicians to have
access to a full and complete picture of patients’ health -
including their clinical, behavioral and social needs. The COVID-19
pandemic further emphasizes the need to address barriers to social
isolation, food insecurity, and transportation among seniors.
Addressing social determinants of health is the right thing to do,
and we believe helps our members spend more Healthy Days at
home.”
The 2019 results, as with the previous results, cannot be
directly compared year-over-year due to multiple demographic
changes in Humana’s member population. This is the fourth year that
the company has issued the annual report and the seventh for
reporting on health, quality and costs results for its Medicare
Advantage beneficiaries seeking care from physicians in value-based
payment models.
Report Methodology
Humana compared calendar year 2019 prevention measures for
approximately 2.1 million Medicare Advantage members seeking care
from providers in a value-based arrangement to approximately
873,800 members who sought care from providers under standard
Medicare Advantage settings.
Humana also compared medical cost and utilization for calendar
year 2019 for approximately 1.9 million Medicare Advantage members
who sought care from providers practicing value-based care to
approximately 900,000 members seeking care from providers under
standard Medicare Advantage settings, as well as to Original
fee-for-service Medicare.
As of June 30, 2020, Humana’s total Medicare Advantage
(individual and group) membership was approximately 4.5 million
members. For more information, visit humana.com/valuebasedcare.
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 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 and conference calls
- Calendar of events
- Corporate Governance information
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version on businesswire.com: https://www.businesswire.com/news/home/20201007005161/en/
Alex Kepnes Humana Corporate Communications (502) 287-3567
akepnes@humana.com
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