Humana saved $3.5B through programs that drove down hospital use

Sixty-seven percent of Humana's individual Medicare members were connected with primary care physicians in value-based payment models in 2018 — a shift from fee-for-service that has lowered the health insurer's costs and improved outcomes, Humana said Nov. 21.

Humana released cost and quality results from its risk-based care programs in its annual Value-based Care Report. Through its Medicare Advantage value-based care programs, Humana said it reduced spending by $3.5 billion when compared to traditional Medicare programs.

Notably, Humana's Medicare programs drove down hospital use among its private Medicare members. In 2018, Humana's Medicare members in value-based programs saw a 27 percent drop in hospital admissions and a 14.6 percent decrease in emergency room visits when compared to traditional Medicare.

"The Medicare Advantage plan serves as a rich laboratory for value-based care, as it allows for integrated and coordinated management of chronic conditions, and a holistic view of the patient," William Shrank, MD, Humana's chief medical and corporate affairs officer, said in a prepared statement. "Our dialogue with physicians, community organizations and other healthcare providers is essential to developing a sustainable system that improves population health and reduces costs for everyone."

View the full report here.

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