Humana pays out more than $93M to providers under quality rewards program
4,465 providers participated in the insurer's provider quality rewards program for improved outcomes for Medicare members.
Humana has distributed more than $93.6 million to approximately 4,465 providers who participated in the insurer's provider quality rewards program for improved outcomes for Medicare members during 2015, the insurer announced Wednesday.
Approximately 63 percent of Humana individual Medicare Advantage members are affiliated with primary care physicians who are participating in value-based relationships.
Humana has paid physicians for quality care outcomes since 2012.
The initiative offers several levels of participation through programs including star rewards, model practice, medical home and shared savings/full value programs.
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Humana's 2015 payments to providers were based on their ability to improve quality for many National Committee for Quality Assurance (NCQA) preventive and chronic condition management Healthcare Effectiveness Data and Information Set (HEDIS) measures. These include breast cancer screening, colorectal cancer screening, diabetes treatment management, and high-risk medications.
"As the industry continues to shift toward value-based payment, programs such as these are proving that care tied to quality metrics can have a meaningful impact on a patient's health," said Dr. Roy Beveridge, Humana's chief medical officer. "Physicians are benefitting, too, by being paid for the complex care they are delivering."
Earlier this month, Humana announced care quality outcomes for approximately 1.2 million Medicare Advantage members affiliated with providers in value-based reimbursement model agreements with Humana.
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The results showed improvements across categories such as medical costs, chronic condition management, and improved HEDIS scores, Humana said.
"This year's payments suggest that physicians who provide care in value-based relationships continue to experience success," said Chip Howard, Humana's vice president of Payment Innovation in the Provider Development Center of Excellence. "Physicians participating in our value-based programs are making significant strides in improving their patients' health and care experience."
Twitter: @SusanJMorse
