Humana Report Finds Value-Based Care Improves Outcomes for Medicare Advantage Members
- Medicare Advantage members in value-based care arrangements had 24.3% fewer inpatient hospital admissions than those in Original Medicare in 2024.
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Humana Medicare Advantage members receiving value-based care had 13.4% fewer emergency department visits and 7.6% fewer hospital admissions than members in non-value-based care arrangements.
- Medicare Advantage members receiving value-based care reported higher satisfaction with their care, including a 13-point higher Net Promoter Score than those using fee-for-service.
The report draws on Humana’s leadership in value-based care and 2024 data showing that Medicare Advantage members receiving care under value-based arrangements experience fewer unnecessary emergency department visits, fewer hospitalizations, higher satisfaction, and more preventive care. These results demonstrate that value-based care is not only a better way to deliver better health outcomes — it’s a smarter model to create a sustainable healthcare system.
Why Value-Based Care Matters
“Value-based care means seeing the whole patient — not just the chart. It’s the reason I chose medicine in the first place. Every path in value-based care leads to one goal: helping people achieve their best health,” said
The report also highlights benefits for clinicians, including more time with patients and improved primary care practice sustainability – contributing to lower rates of clinician burnout and improved care delivery.
Value-based care enables a team of clinicians to holistically, proactively care for a patient’s care needs. In contrast, the fee-for-service model puts clinicians in a reactive stance with no incentives to deliver preventive care or to reduce costly, low-value care. Value-based care shifts the priority from patient volume to patient health outcomes.
Humana’s newest Value-Based Care By the Numbers Report reaffirms over a decade of evidence that value-based care models deliver a better healthcare system for patients and clinicians.
Impact on Patients: Less Time Spent in the Hospital
According to Humana’s 2024 analysis, Medicare Advantage members receiving care from value-based clinicians spent less time in the hospital and were less likely to rely on emergency care compared with patients in non-value-based arrangements.
- 24.3% fewer inpatient admissions for value-based care patients with Medicare Advantage plans versus those enrolled in Original Medicare in 2024
- 13.4% fewer emergency department visits and 7.6% fewer admissions for Humana Medicare Advantage members treated by value-based clinicians than those not in a value-based arrangement
Improved Management of Chronic Conditions
The report also highlights stronger chronic disease management for Medicare Advantage members in value-based care arrangements, particularly among older adults managing multiple conditions.
- More eye exam screenings and kidney health evaluations for members who have diabetes
- Higher use of statin therapy for members with cardiovascular disease
- Higher medication adherence rates for hypertension and diabetes medication
More Preventive Care
Preventive care remains a cornerstone of value-based care. Humana’s analysis of its Medicare Advantage, value-based care members found higher rates of:
- breast cancer screening
- colorectal cancer screening
- osteoporosis management
Higher Patient Satisfaction
In addition to clinical improvements, patients reported:
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Higher patient satisfaction of their health plan, health care, care coordination, customer service, and more for Humana Medicare Advantage members receiving value-based care per Consumer Assessment of
Healthcare Providers and Systems (CAHPS) survey data - 13 points higher Net Promoter Score for Medicare Advantage members receiving value-based care than those with fee-for-service providers
Helping Older Adults Thrive with Personalized Primary Care
For older adults managing multiple chronic conditions, value-based care offers a more coordinated and proactive approach than traditional fee-for-service models. According to the CenterWell Aging Well in America survey, conducted with
Research published in NEJM Catalyst by
- 20% more primary care visits per year
- 6% more regularly scheduled visits
- Higher continuity of care (75% of senior-focused primary care patients vs. 55% of FFS patients)
Expanding Value-Based Care Across the System
Beyond primary care models, Humana’s report also identifies opportunities to extend value-based care into specialty care. For example, Medicare Advantage patients diagnosed with heart failure experience a higher quality of care and better evidence-based medication prescription adherence under value-based care arrangements.
“Value-based care is no longer an aspiration – it's a necessity,” said
To support this transition, Humana is investing in technology and data-sharing capabilities that enable providers to deliver more coordinated care. In October, Humana and Providence announced a new data exchange initiative using national interoperability standards to streamline secure data sharing. This collaboration supports upcoming regulations from the
Read Humana’s Value-Based Care By the Numbers Report in full here.
About Humana
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Media Contact
kschabert@humana.com
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