There is mounting evidence to confirm that value-based care models are more cost-effective than fee-for-service, according to Humana’s fifth Value-Based Care Report, which said bundled payments and value-based payer-provider partnership are key to this process.
Compared to traditional Medicare, Medicare Advantage plan led to 20.1 percent lower medical costs or 3.5 billion in healthcare spending. Even in commercial non-value-based care settings, Humana sidestepped $249 million in unnecessary expenditures through value-based care.
In value-based care contracts the cost of covered medical care was 1.4 percent lower. Though the quality hasn’t suffered as a result of fall in healthcare spending, with utilization, readmissions, and emergency department visits all sloping downward and medication adherence and overall health improving.
Preventive care has played a major role in decreasing utilization costs. Though it increased upfront spending it ultimately led to savings.
Value-based care model gains a greater foothold and the savings extend to each stakeholder. Last year 60 percent of providers engaged in value-based contracting with Humana receiving shared savings.
In Humana’s value-based arrangement, providers saved and gained as well. Humana Medicare Advantage providers earned nearly $0.16 for every dollar that went to primary care. While those in fee-for-service or other models pocketed about $0.06 for every primary care dollar spent.
Providers and payers benefited and saved by engaging in bundled payments, said the payer, which expanded its bundled payment model this year. Three out of every four providers involved in Humana’s total joint replacement bundled model were compensated for positive patient outcomes, which included post-treatment care.
Thus, value-based model benefited the provider and the patient as well.