Humana’s quality and cost improvements to date include the following, according to a news release:
1. Improving access to accountable care: Humana currently has 53 percent of its members in accountable care relationships and is on course to have more than 75 percent in accountable care relationships by 2017.
2. Improving the quality of patient care: In 2014, Humana’s accountable care providers had a Healthcare Effectiveness Data and Information Set (HEDIS) Star score average of 4.25 as compared to providers outside of accountable care settings with a HEDIS Star score average of 3.65.
3. Reducing hospital readmissions and ER visits: Humana members in accountable care relationships have a 4 percent lower hospital readmission rate than traditional, fee-for-service Medicare and 7 percent fewer emergency room visits per thousand beneficiaries.
4. Lowering costs: Humana experienced a 19 percent cost improvement in total in 2013 for members who were treated in an accountable care setting compared with members who were treated by providers in traditional Medicare settings.
Humana’s disclosure came on the same day that HHS announced a new initiative supported by the Patient Protection and Affordable Care Act to continue to move the Medicare program, and the country’s healthcare system at large, toward value-based reimbursement.
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