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Home / Value-based care / For providers

VBC empowering providers and patients

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Humana’s Bundled Payment Program

Our value-based bundled payment program aims to reward specialty providers for delivering cost efficient care while maintaining or improving clinical outcomes.

Humana’s bundles encompass 4 different programs:

1. Total joint replacement (TJR): Medicare Advantage (MA)-only
2. Spinal fusion (cervical and lumbar): MA-only
3. Coronary artery bypass grafting (CABG): MA-only
4. Pacemaker insertion: MA-only

While the focus of VBC delivery may be on primary care, the bundles program recognizes the critical role specialists play in patient well-being by choosing the most appropriate care pathway.

Benefits of bundled payment programs

· Advocates for specialists: Our retrospective, episodic, total cost-of-care models offer value-based opportunities to specialists.
· Focus on reducing costs: We aim to reduce costs across a patient’s entire episode of care.
· Improve quality outcomes: Maintaining or improving quality care outcomes.
· No risk obligation for providers: Physicians can share in savings created by choosing the most appropriate care pathway. If the episode cost of care is below the established target, the practice earns gainshare. If the target is not met, the practice is not at risk financially.

Specialty providers engaged in a bundles program offer both short- and long-term benefits to their patients, while also having an opportunity to earn gainshare.

Benefits of value-based care

Improved patient outcomes

Reduced administrative burden

Financial incentives

Enhanced collaboration

Work satisfaction

Humana’s value-based care in nephrology brief

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