Value-based care contributes to satisfaction

Alex Ding, M.D., MS, MBA

Physician Executive, Clinical Strategy

Bio

Dr. Ding is a board- certified, practicing diagnostic and interventional radiologist with experience in practice management, academic and private practice, and health system leadership. He is a physician champion and patient advocate and focuses on clinician engagement, health technology deployment and clinical innovation

Humana MA members cared for by physicians in value-based arrangements reported significantly higher levels of patient satisfaction compared with those associated with non-value-based clinicians.

In a 2020 internal Humana survey similar to the Consumer Assessment of Healthcare Providers and Systems (CAHPS), value-based physicians rated 10% percent higher than non-value-based physicians (3.1 stars vs. 2.9 stars) in each of the eight categories of the CAHPS. The largest differences between the two provider groups was in the overall rating of the health plan and the overall rating of drug coverage, with value-based physicians scoring 1.4% and 1.2% higher, respectively.1

CAHPS percentages are significant for three reasons:

  • A difference of one point can represent as much as a 1-star difference in performance on these measures.
  • CAHPS makes up 24% of the overall Stars rating.
  • CAHPS data is member-reported, coming directly from the perspectives of those being treated.

Humana collaborates with and supports its community of healthcare professionals through extended coverage. Emphases include SDOH, removing financial barriers to treatment and helping keep members safe, particularly during the pandemic, by sending them safety kits that included masks. This support of members and their doctors also contributes to member satisfaction.

Satisfaction is also critical because it directly translates to retention. Some 93% of Humana MA members remained with their value-based primary care physicians in 2020, compared to 91% with non-value based providers.1

Why it matters:

The healthcare experience tends to be defined as much by quality interactions as quality of care. Experience can outshine—and certainly overshadow—the total care delivery system. Patient satisfaction leads to stronger trust in their clinicians, which, in turn, develops greater long-term therapeutic relationships.

Physician satisfaction is just as pivotal, leading Humana to remove prior authorization approvals during much of 2020 to help remove obstacles potentially in the way of patient care.

Beyond the pandemic, a value-based design equips physicians with tools, data and resources to assist in developing a more holistic approach to care. The creation of platforms, such as Humana’s Population Insights Compass, efficiently informs primary care physicians about their patients’ lives and medical histories outside the office in a way that is both easily understandable and actionable.

The tool houses supporting data beyond the direct medical and clinical, and also provides insights into social needs for a more holistic picture of the patient. Compass allows physicians to look out for their whole panel of patients and determine who needs more attention and resources, such as enabling practices to follow up on a missed wellness exam or check-up.

The way forward:

Within the value-based space, support is a minimum expectation. With members and healthcare providers as a focus has driven several initiatives to help make navigating the healthcare system easier and the experience in a complex system more pleasant.

Data-driven research plays a critical role in helping payers like Humana build a foundation for identifying clinical programs that advance its human care commitment to identify members’ most important needs and address them.

Work continues to expand home-based offerings to complement physicians’ treatment in making care more accessible and targeted, and in bringing about increased interoperability. Streamlined, interoperable patient data, available to clinicians and members, can help enhance both the patient and physician experience for more efficient and effective care while reducing administrative hurdles and increasing technology usability.

 

Members clearly recognized physicians’ efforts in care coordination and effective care management. In 2020, continuously enrolled Humana MA members with physicians in value-based agreements (53,625) rated their physician higher (3.1 Stars out of 5) than those 19,239 surveyed who were with physicians in Humana MA non-value-based agreements (2.9 Stars out of 5).1 The results are from internal patient experience surveys similar to the Consumer Assessment of Healthcare Providers and Systems, but not the official CAHPS results. Official CAHPS results do not provide member-level data. A difference of one point is important and in general represents as much as a 1-star difference in performance on these measures.

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