The percentages below represent Humana individual MA members
seeking care from physicians in each category of the continuum.
of individual MA members in VBC model
Full responsibility for Medicare Parts A, B and D through monthly capitated payments
Fee-for-service (FFS) + 100% responsible for Medicare Part B expenses and sharing of Part A (may have shared savings or complete responsibility for Part D)
FFS + bonus + care coordination payment + higher portion than bonus + shared savings in Medicare Parts A, B and D
FFS + bonus + potential for limited shared savings (upside only) in Medicare Parts A, B and D
of individual MA members in NVB model
FFS + additional compensation for meeting quality measures
Pays for the services a patient receives
Source: Humana Value Based Care Report, 2020
Source: Humana Value Based Care Report, 2020
of Humana MA members have at least one chronic condition.
of Humana MA members have at least two chronic conditions.
CHF = Congestive Heart Failure, CKD = Chronic Kidney Disease, CAD = Coronary Artery Disease.
Source: Humana Value Based Care Report, 2020
The percentages below represent Humana individual MA members
seeking care from physicians in each category of the continuum.
of individual MA members in VBC model
Full responsibility for Medicare Parts A, B and D through monthly capitated payments
Fee-for-service (FFS) + 100% responsible for Medicare Part B expenses and sharing of Part A (may have shared savings or complete responsibility for Part D)
FFS + bonus + care coordination payment + higher portion than bonus + shared savings in Medicare Parts A, B and D
FFS + bonus + potential for limited shared savings (upside only) in Medicare Parts A, B and D
of individual MA members in NVB model
FFS + additional compensation for meeting quality measures
Pays for the services a patient receives
Source: Humana Value Based Care Report, 2020
Source: Humana Value Based Care Report, 2020
Notes: Behavioral health was identified based on primary diagnosis
Source: Humana Value Based Care Report, 2020
Source: Humana Value Based Care Report, 2020
6.7
cents
per dollar
17.5
cents
per dollar
Claims and capitated payments (in cents per dollar)
Source: Humana Value Based Care Report, 2020
Source: Humana Value Based Care Report, 2020
Source: Humana Value Based Care Report, 2020
Source: Humana Value Based Care Report, 2020
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