You’ve probably heard a lot of value-based care, but what is it exactly?
Value-based care (VBC) is a healthcare delivery model that prioritizes improving patient care and outcomes, through cost-efficiency and provider performance. Let’s go back to the basics so you can more richly understand exactly what it is.
Strategic advantages of VBC
VBC reimburses providers based on how well they improve patient health, which encourages providers to focus on care quality, patient satisfaction and overall performance. The fee-for-service reimbursement structure incentivizes costly and often unnecessary procedures—focusing on "sick care" rather than health maintenance, leading to misaligned incentives.
Types of value-vased care models
Bundles
Healthcare providers charge a fixed fee, regardless of how many providers treat the patients.
Shared savings
Providers are reimbursed using a fee-for-service model, but payment is based on quality and cost targets.
Shared risk
Often referred to as the downside-risk model because the provider is accountable to the Accountable Care Organization (ACO), this model allows providers to share savings.
Global capitation
Providers assume 100% of the risk and are paid a set amount per patient. Providers can keep any savings remaining, but they must also take on all losses.
85% of value-based care patients vs only 75% of non-value-based care patients saw their PCP at least once in 2023.
Regular appointments mean better prevention and healthcare maintenance.
VBC tools and resources
Humana is committed to providing you with the resources and support you need to succeed in value-based care.
Innovative reporting platforms
Our Population Insights Compass tool is a centralized reporting platform that enables providers to adopt a holistic view for treating patients.
Address access to care
Humana Community Navigator®, our free resource directory, connects patients and providers with financial assistance, food pantries and transportation resources.
Improve patient care
Improve your Star practice quality and strategy with tipsheets, screenings and guidelines designed to support your treatment plans.
Monthly learning series
Humana education teams host webinars covering topics from annual wellness to care coordination, with opportunities for continuing medical education.
Readiness assessment tool
Sign in to gain access to our readiness assessment to understand your current value-based care capabilities.
Your VBC journey starts here
For administrators
See our 7 steps for success for overcoming challenges of data management systems, organizational culture and more.
For providers/clinicians
Learn how implementing VBC into your practice can reduce burnout and improve job satisfaction for providers.
For policy makers
Promoting value-based care within your community helps drive better population health and reduced healthcare costs.