4,700 physician practices received rewards for providing quality care
LOUISVILLE, Ky. -- (Business Wire)
As part of its continued efforts to help physicians transition from
fee-for-service to value-based reimbursement models, Humana Inc. (NYSE:
HUM) distributed $76.8 million to physicians across the United States
who participate in Humana’s Provider Quality Rewards Program. The 2014
reimbursement amount is a 28 percent increase from the $60 million that
Humana distributed to physicians last year under the program.
Humana’s Provider Quality Rewards Program is part of Humana’s
Accountable Care Continuum, which is a pay-for-value system focused on
promoting evidence-based, high quality care. The Continuum recognizes
practice complexity by offering several levels of participation through
pay-for-value programs including Star Rewards, Model Practice, Medical
Home and bonus programs for value-based care.
“The continued success of Humana’s Provider Quality Rewards Program is
reflective of the importance of providing physician support as they
embrace a value-based model of care,” said Roy A. Beveridge, M.D.,
Humana’s Chief Medical Officer. “The holistic approach to patient care,
which is driven by value-based models, not only helps primary care
physicians focus on the total health of their patients, but also
reflects the importance of moving from sick care to health care.”
Humana also recently announced its Star ratings for its Medicare
Advantage (MA) plans. The company has 22 MA plans that achieved a rating
of 4.0 stars or greater, with nine of the Humana plans achieving a 4.5
star rating. Humana also achieved a rating of 5.0 stars for its H1019
CarePlus Health Plans, Inc. HMO plan in Florida.
Approximately 4,700 physician practices received payments from Humana in
recognition of improved outcomes for Humana’s Medicare members made
during 2013. Reward settlement finalization takes place in 2014 for the
2013 Rewards Program to allow time for final claims submission and
supplemental data.
Humana’s 2013 payments to physician practices were based on the
practices’ 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
including, but not limited to the following:
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Breast cancer screening
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Glaucoma screening
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Colorectal cancer screening
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Diabetes treatment management
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LDL control
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A1C control
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Nephropathy screening
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Diabetic retinal eye exam
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High risk medications
“Humana’s focus is to support primary care physicians with the
population health solutions needed to make the transition from volume to
value, and to help them become successful population health managers,”
said Chip Howard, Humana’s Vice President of Payment Innovation in the
Provider Development Center of Excellence. “Humana’s pay-for-value
programs not only offer support for physician practices as they move
into value-based relationships, but help improve the patient experience.”
Humana has a 26-year accountable care relationship history with more
than 1.2 million MA members that are cared for by 38,000 primary care
physicians, in more than 900 accountable care relationships across 43
states and Puerto Rico.
About Humana
Humana Inc., headquartered in Louisville, Ky., is a leading health and
well-being company focused on making it easy for people to achieve their
best health with clinical excellence through coordinated care. The
company’s strategy integrates care delivery, the member experience, and
clinical and consumer insights to encourage engagement, behavior change,
proactive clinical outreach and wellness for the millions of people we
serve across the country.
More information regarding Humana is available to investors via the
Investor Relations page of the company’s web site at www.humana.com,
including copies of:
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Annual reports to stockholders;
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Securities and Exchange Commission filings;
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Most recent investor conference presentations;
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Quarterly earnings news releases;
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Replays of most recent earnings release conference calls;
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Calendar of events (including upcoming earnings conference call dates
and times, as well as planned interaction with research analysts and
institutional investors);
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Corporate Governance information.
Contacts:
Humana Inc.
Alex Kepnes, 502-580-2990
Corporate Communications
akepnes@humana.com
Source: Humana Inc.
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