Humana compared calendar year 2019 prevention measures for approximately 2.1 million Medicare Advantage members seeking care from providers in a value-based arrangement to approximately 873,800 members who sought care from providers under standard Medicare Advantage settings.
Humana also compared medical cost and utilization for calendar year 2019 for approximately 1.9 million Medicare Advantage members who sought care from providers practicing value-based care to approximately 900,000 members seeking care from providers under standard Medicare Advantage settings, as well as to Original fee-for-service Medicare.
Listed below is a snapshot of the report’s key findings:
- Humana individual Medicare Advantage members benefitted from preventive screenings. Humana MA members seeking care from physicians in value-based agreements received screenings between 8 percent and 19 percent more often for colorectal screenings, diabetic eye exams, osteoporosis management and controlling blood sugar than those Humana MA members who received care from physicians in MA non-value-based arrangements.
- More Humana MA members stayed in their homes, not the hospital. Humana MA members receiving care from physicians in value-based care arrangements with Humana collectively spent 211,000 fewer days as hospital inpatients and less time seeking care in emergency rooms in 2019, compared to those Humana MA members receiving care from physicians in non-value-based care models. More broadly, Humana MA members served by physicians/practices in value-based agreements visited emergency rooms 10.3 percent less often (90,500 fewer visits) and had a 29.2 percent lower rate of hospital admission (165,000 fewer admissions) compared with Original Medicare.
- Care costs are lower for Humana Medicare Advantage members. An estimated $4 billion in plan-covered medical expenses would have been incurred by Humana Medicare Advantage members if they had they been under Original Medicare’s fee-for-service model instead of in value-based agreements.
As of June 30, 2020, Humana’s total Medicare Advantage (individual and group) membership was approximately 4.5 million members.