Humana Reports an Estimated $4 Billion In Savings From Value-Based Care Models in 2019

Over the years, Humana Inc. (NYSE: HUM) has dedicated itself to value-based care models as a way to drive better outcomes for its members.

Released Wednesday, its most recent annual “Value-based Care Report” again reflected more positive outcomes for the 2.41 million Medicare Advantage (MA) beneficiaries receiving care from primary care physicians in value-based payment models.

In 2019, the Louisville, Kentucky-based insurer continued to reap the rewards of its value-based focus, as it has in years past.

Advertisement

On average, the members in value-based care models experienced better health outcomes at a lower cost as opposed to members in fee-for-service models.

“Value-based care underscores the need to take a holistic view to help members achieve their best health,” Dr. William Shrank, Humana’s chief medical officer, said in a release announcing the findings of the 2019 report.

Humana’s individual MA members in value-based models benefited from a greater frequency of preventive care — between 8% and 19% — for colorectal screenings, diabetic eye exams, osteoporosis management and controlling blood sugar than members in non-value-based agreements. The company’s calculations suggested that an estimated $4 billion was saved due to value-based models in 2019.

Collectively, MA members benefitting from value-based models spent 211,000 fewer days in the hospital and emergency rooms. Overall, the value-based agreements resulted in 10.3% fewer emergency room visits and 29.2% fewer hospital admissions compared to original Medicare.

“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,” Shrank said. “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 (SDoH) is the right thing to do.”

Between addressing SDoH, expanding its in-home care footprint and pushing its value-based care networks, Humana has been on the forefront of finding alternative ways to improve patient outcomes for years.

“Having the foundation to be able to integrate social determinants of health into the operating aspects of our business — we’ve been working on that for a decade now,” Bruce Broussard, Humana’s president and CEO, said in September during the Aging Innovation Global Healthcare Summit. “And that really proved itself out when the health care system shut down. People were isolated [inside] their homes, and there were a number of things that they needed just for basic health care.”

The moves that Humana has made toward the home include its acquisition of home health care behemoth Kindred in 2017, its SDoH-aimed partnerships with innovative auxiliary companies like Papa and SilverSneakers, and its backing of home-based acute medical care provider DispatchHealth

Additionally, in July, Humana announced plans to invest $100 million in the at-home primary care startup Heal.

Its bullishness in home-based care, which is part of its overall value-based plan, is reflected not just in its executives’ public comments, but also its acquisitions and partnerships over the last several years.

“As seen in other industries, we believe consumers will increasingly demand health care solutions that are more convenient and personalized and [that] better meet their needs,” Susan Diamond, the segment president of Humana’s home business, told Home Health News in July. “Deeper relationships with patients are needed, including a better understanding of the home environment, to deliver comprehensive and higher quality care.”

Companies featured in this article: