Humana gives provider groups $93.6M in quality payments

Louisville, Ky.-based Humana is giving provider groups participating in its Provider Quality Rewards Program more than $93.6 million.

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Here are five notes:

1. Almost 4,465 provider groups spanning the United States will receive a portion of the payment’s total.

2. Since 2012, the payer has reimbursed physicians for quality care outcomes.

3. Of Humana’s individual Medicare Advantage members, nearly 63 percent are affiliated with primary care physicians who participate in value-based relationships.

4. The company’s Provider Quality Rewards Program emphasizes evidence-based, high-quality care. Humana based its 2015 payments based on providers’ abilities to improve several quality metrics including, but not limited to:
•    Breast cancer screening
•    Colorectal cancer screening
•    Diabetes treatment management
•    LDL control
•    A1C control
•    High-risk medications

5. Humana released data on the care quality outcomes earlier this month for nearly 1.2 million MA members affiliated with providers that participate in value-based reimbursement model agreements with Humana. The resulted revealed improvements across categories such as medical costs, chronic condition management and improved Healthcare Effectiveness Data and Information Set scores.

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