
While the number of performance bonuses given out by the government for value-based care declined this year, a new report by Humana says it saw 20 percent lower costs for members treated by providers in value-based reimbursement arrangements than for those in traditional fee-for-service settings.
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Humana's 2015 value-based care results compared physicians and patients treated under value-based agreements versus those in traditional fee-for-service settings.
The report released Wednesday found: Physicians in value-based relationships with Humana had 19 percent higher Healthcare Effectiveness Data and Information Set, or HEDIS scores, and that patients treated by physicians in value-based agreements had better health outcomes.
This included 6 percent fewer emergency room visits; 8 percent higher colorectal cancer screening rates; 6 percent higher breast cancer screening rates; and 13 higher rates of osteoporosis management, according to the insurer based in Louisville, Kentucky.
Humana is among the top Medicare Advantage health plan providers. As of September 30, approximately 63 percent of Humana individual Medicare Advantage members were seeing providers in value-based payment relationships.
Overall, value-based arrangements resulted in 20 percent lower costs, Humana said.
However, on November 1, the Centers for Medicare and Medicaid Services released the results of the value-based purchasing program for inpatient hospital discharges that reportedly showed 200 fewer hospitals will receive incentive payments than in 2016.
In 2017, 1,612 hospitals will receive about $1.8 billion in incentive payments, CMS said. About 1,343 out of the total 2,955 will have a negative payment adjustment for 2017.
In its study, Humana compared quality metrics and outcomes for approximately 1.2 million Medicare Advantage members who were affiliated with providers in value-based reimbursement model agreements to 170,000 members who were affiliated with providers under standard Medicare Advantage settings.
Unlike value-based reimbursement model agreements, standard Medicare Advantage settings don't have additional incentives for providers who meet quality or cost targets.
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Humana said it also achieved better management for older adults, whose assessment rates for pain screening and medication review were higher by five and ten percent, respectively.
Medicare Advantage patients with chronic conditions received better quality from physicians, clinicians and other providers in value-based agreements, Humana said.
Humana has an integrated and coordinated health approach for a defined, measurable patient population, Humana said.
"Since many chronic conditions are the result of long-term behavioral decisions, it's essential that health plans and physicians are in complete alignment," said Roy A. Beveridge, MD, Humana's chief medical officer.
Twitter: @SusanJMorse