Humana value-based practices. Encouraging results and a question
A recent article in the November 24 issue of Fierce Healthcare summarizes results from value-based care from the insurer Humana in their latest annual value-based care report.
According to Humana, Medicare Advantage (MA) members receiving value-based care had more preventive care, lower costs, and better outcomes in 2020 compared to those in traditional Medicare.
As of Dec. 31, 2020, Humana’s total MA membership was approximately 4.6 million members, including roughly 3.96 million individual MA members and 613,200 group members.
Two thirds of Humana’s MA individual members (67% or 2.65 million) already receive care from physicians in value-based agreements.
Humana’s report reveals that despite delays in care during the pandemic, members affiliated with value-based care physicians fared better in terms of quality than those in non-value-based mode. For instance, in 2020, 86% of MA members saw their value-based physician at least once, compared to 78% of those in non-value-based agreements. This result accompanies successes in encouraging screening and prevention and reported greater satisfaction of MA members with their physicians.
But the most striking result in the report is that, according to the Humana Healthcare Research group, members affiliated with value-based physicians and receiving home health services had a 60% lower risk of readmission within 30 days following a hospital discharge a 45% lower readmission risk within 60 days (compared to those members affiliated with non-value-based physicians). 90-day healthcare costs were also lower by 11%, including costs associated with home healthcare.
These figures are derived from internal Humana September 2021 data which are not public. It would be important to know which methods the Humana Healthcare Research group used to control for differences in baseline covariates and other characteristics that separate these two types of members.
Also, physicians with those value-based contracts fared better as well receiving more of the healthcare revenues, a steadier revenue stream, better working conditions (infrastructure, telemedicine, and the wellbeing that comes from a sense of belonging) and this, despite (or thanks to) the pandemic.
In the course of 2020, Humana transferred 95,000 more MA members (approximately 2.5% of its membership) to value-based contracts.
Chief Medical Officer and Co-founder
Pharma industry veteran with 30+ years in large Pharma & in leading small biotechs, spearheading large initiatives and securing funding, psychiatry practice and research for 10+ years.