![]() If you’re interested in learning more about Humana’s Medicare plans and the providers in our network, we’d love you to get in touch. We encourage you to do your own research on different healthcare delivery and reimbursement models. We have more choice than ever before in how we approach our health and how we access care. One thing is clear: when it comes to healthcare, the power has shifted to the consumer. Just like their value-based care counterparts across the country, the providers in our value-based care network are rewarded for delivering proactive, integrated care-grounded in dignity and respect-that contributes to better health and a better experience for their patients. 10 As of September 2018, we have more than 2 million Medicare Advantage members cared for by more than 52,000 primary care physicians across 43 states and Puerto Rico. 9 Humana’s Commitment to Value-Based CareĪt Humana, we’re proud to have an extensive-and growing-value-based care presence. 8Īccording to recent reports, patients served by value-based providers receive more preventive care and see costs that are more than 15 percent less than those who go to fee-for-service providers. 8On the other hand, there is little incentive for FFS provider to deliver proactive, holistic care, as they are compensated for their volume of services, regardless of patient outcomes. In fact, the reimbursement models your medical providers operate under can have a big impact on your care and the amount you pay for it.Ī fee-for-service model allows patients to freely choose their physicians and hospitals with little interference from their insurance provider. 7 What Reimbursement Models Can Mean for Patient Careįor patients like you, the issue of reimbursement may seem unimportant-or at least unrelated to your consumer experience. 16 Over the past decades, the health care services had witnessed a vast variety of quality improvement activities. 5,6This model is slowly but surely gaining popularity across the country. Paradigm shift of quality indicators in health care The future of health care services and their management is changing. Under a VBC model, health care providers are compensated for the quality of care they provide (versus the quantity)-and the overall outcomes of that care. is ushering in a new era: one of value-based care (VBC). 3 But with recent increased pressure for better outcomes and lower costs (particularly since the passage of health care reform legislation in 2010), the U.S. 2 Under this model, they are paid for each office visit, test, and procedure performed. 1 Historically, providers have been reimbursed on a fee-for-service (FFS) basis. In layman’s terms, this refers to how healthcare providers, like physicians and hospitals, are compensated for their services. ![]() But right now, the industry is undergoing one of its biggest transformations in recent history. The passage of the United Nations Convention on the Rights of Persons with Disabilities (CRPD or the Convention) has been hailed as the culmination of a paradigm shift from the biomedical model of disability to the social and human rights-oriented model. Healthcare in our country is complex and continuously evolving.
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