As of 2020, 67%, or two-thirds, of Humana’s individual MA members seek care from primary care physicians participating in some form of value-based care agreement with Humana.
To support value-based care, Humana developed a continuum of programs that offers financial rewards to primary care physicians for improvements in quality, outcomes and costs. Incentives increase along with the level of risk.
Humana’s value-based primary care continuum shows the broad spectrum of segments under which physicians can benefit from the quality care they provide.
The primary care continuum shows the broad spectrum of segments under which physicians can benefit from the quality care they provide.
Of importance, the continuum is not designed to advance all primary care physicians to global value (or full accountability), but rather to meet and support them where they are on the path to value. Segments of the continuum are designed around a physician or practice’s readiness to accommodate varying levels of accountability.
As value-based care becomes more prominent, the number of Humana individual MA members receiving care from physicians in value-based care arrangements has grown with the addition of a little more than 1 million individuals since the beginning of 2016.
There is no singular path to success in value-based care. Every practice faces its own unique set of challenges and opportunities. These case studies feature organizations from across the country and of varying size sharing how a value-based approach has shaped their clinical and operational models.
