Report finds value-based care agreements benefited members with reduced hospitalizations, more preventive care during COVID-19 pandemic

Nov. 17, 2021

Humana Inc. published its eighth annual Value-based Care (VBC) Report, 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, according to a Human press release.

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.

Humana press release

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