Value-based care – no progress since 1997?

By MATTHEW HOLT Humana is out with a report saying that its Medicare Advantage members who are covered by value-based care (VBC) arrangements do better and cost less than either their Medicare Advantage members who aren’t or people in regular Medicare FFS. To us wonks this is motherhood, apple pie, etc, particularly as proportionately Humana is the insurer that relies the most on Medicare Advantage for its business and has one of the larger publicity machines behind its innovation group. Not to mention Humana has decent slugs of ownership of at-home doctors group Heal and the now publiciy-traded capitated medical group Oak Street Health. Human has 4m Medicare advantage members with ~2/3rds of those in value based care arrangements. The report has lots of data about how Humana makes everthing better for those Medicare Advantage members and how VBC shows slightly better outcomes at a lower cost. But that wasn’t really what caught my eye. What did was their chart about how they pay their physicians/medical group What it says on the surface is that of their Medicare Advantage members, 67% are in VBC arrangements. But that covers a wide range of different payment schemes. The 67% VBC schemes include: Global capitation for everything 19% Global cap for everything but not drugs 5%FFS + care coordination payment + some shared savings 7% FFS + some share savings 36% FFS + some bonus 19%FFS only 14% What Humana doesn’t say is how much risk the mid...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Health Policy Value-Based Care Humana Matthew Holt Source Type: blogs