Humana: How value-based care can improve the patient, provider experience

Value-based care leads to a better patient experience—and a better experience for physicians, too, a new study from Humana shows.

The insurer released its 10th annual look at the performance of its value-based care arrangements and found that patients treated under a value-based care program reported higher experience scores on the Consumer Assessment of Healthcare Providers and Systems survey compared to those treated in fee-for-service.

The report suggests these improvements are likely due to the fact that physicians have more time to spend with their patients as well as improvements afforded by greater care coordination and care transitions.

"What you often hear in fee-for-service is that the physician is glued to the computer, they're in and out in five or 10 minutes and they can maybe take care of one or two problems," Kate Goodrich, M.D., chief medical officer at Humana, told Fierce Healthcare. 

"But patients come into the door with multiple problems very often," she said, "and I think that's a big part of it often in value-based care."

For example, enhanced care coordination can be critical to avoiding unnecessary readmissions, Humana said. If a patient is quickly contacted by the care team and connected to post-acute services, it can help minimize the risk that they end up back in the hospital.

Patients treated under value-based care models are also more engaged with preventive and primary care, according to the report. Most (85%) saw their primary care provider at least once in 2022, compared with 75% of those in not-value-based programs.

Humana saw 30.1% fewer inpatient admission in 2022 for its value-based care population compared to those enrolled in traditional Medicare, saving 214,000 admissions. In addition, there were 12.7% fewer visits to the emergency room compared to the fee-for-service population, the report found.

The insurer said that 70% of its Medicare Advantage prescription drug plan members were enrolled in value-based care in 2022, the highest tally it's recorded in a decade of the report.

But in addition to leading to a better experience for patients, Humana found that similar factors also improved satisfaction for physicians and other clinicians. These models free them up to practice at the top of their licenses and gives them more time to spend with patients.

Goodrich said in her role as CMO she's spent time visiting many of Humana's value-based primary care practices, including its own in-house CenterWell providers and others, and has heard consistently that the additional time with patients is a massive boost.

Burnout among medical professionals is a huge problem coming out of the pandemic, and Goodrich said value-based models can help ease that stress.

"This economic model supports the delivery of care that allows for more time with patients, better support structures, and really being able to be very thoughtful about ensuring your patients get the right care at the right time," she said.

Despite the potential of value-based care, the shift has been very gradual. Goodrich said one of the major factors as to why is a lack of data on how these models perform, which can make practices hesitant to invest in making the switch, a transition that can be difficult and complex.

However, the bank of data is growing. And, while that doesn't necessarily eliminate the challenges in transitioning, it can make a clearer case.

"I personally believe we're a bit of at an inflection point where I feel like we ought to start seeing it accelerate, because we actually do have the proof points now," Goodrich said.