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Humana Launches Value-based Hospital Compensation Program

By John Commins  
   April 26, 2018

The nationwide value-based initiative will link hospital compensation with quality improvements in three key areas: patient experience, patient safety, and patient outcomes.  

Humana, Inc. has launched a value-based Hospital Incentive Program that will pay general acute care hospitals more money for delivering on key quality and efficiency metrics.

The nationwide program is designed to encourage more integrated care, reduce duplicative services, readmissions, and complication rates in acute care inpatient settings.

HIP it will base compensation on quality improvements in three key areas: patient experience, patient safety, and patient outcomes. The program is voluntary and open to hospitals with an active commercial contract with Humana.

Metrics used to gauge the improvements will include healthcare-associated infection rates, care coordination, and palliative care, and will incorporate two care certification programs developed by The Joint Commission.  

Within the three core areas of focus are seven measures individually weighted totaling 100% of the eligible incentive, recognizing the hospital's continuous improvement efforts via earned annual rate increases.

"This program expands Humana’s reach in value-based care as we broaden our efforts to provide a better experience for our members and help them achieve their best health," said Caraline Coats, vice president of Humana's Provider Development Center of Excellence.

Humana said that HIP is the latest addition to its commitment to value-based care, which emphasizes:

  • Personal time with clinicians and personalized care;
  • Access to proactive health screenings and preventive services;
  • Improved care for the chronically ill;
  • Using technologies, such as data analytics, that connect physicians and coordinate care;
  • Reimbursement to physicians linked to the patient outcomes rather than fee-for-service.

By the end of 2017, Humana said it had 1.9 million of its 2.9 million (66%) Medicare Advantage enrollees and 140,000 commercial plan enrollees accessing value-based care with more than 52,000 physicians in 43 states and Puerto Rico.

"Many hospitals understand the importance of and embrace value-based care in the inpatient setting, as it creates a more holistic and collaborative approach to care that physicians, patients, and payers alike truly value. Pairing that focus with the opportunity for aligned incentives creates a win-win for the hospitals, patients, and Humana," Humana said.

John Commins is a senior editor at HealthLeaders.

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