Value-based care: a holistic approach to care

 

Coordinated, value-based care

According to the National Council on Aging, nearly 80% of seniors have two or more chronic conditions.1 Such patients, as well as others with complex conditions and health needs, require care that is cross-disciplinary and coordinated.2

Humana facilitates whole-person healthcare through primary care, behavioral health, pharmacy services, and more. Humana value-based care decreases hospitalizations and improves health outcomes.

Patients spend more time on average with their primary care physicians, helping providers better understand and treat their needs.3

For healthcare providers, developing relationships with patients allows them to focus on disease prevention and holistic management of chronic diseases.4

Read more about our Value-Based Care in nephrology Issue Brief.

1. National Council on Aging, "Chronic Inequities: Measuring Disease Cost Burden Among Older Adults in the U.S.  A Health and Retirement Study Analysis," Page 5, Figure 2 April 2022. https://ncoa.org/article/the-inequities-in-the-cost-of-chronic-disease-why-it-matters-for-older-adults

2. The Journal for Nurse Practitioners, "Improving Care Coordination of Patients With Chronic Diseases," 2022.

3. Humana, "Value Based Care Report 2023," November 2023. 

4. Humana, "Value Based Care Report 2023," November 2023. 

Senior-focused primary care

Our Humana Healthcare Research team, in collaboration with a leading researcher and professor from Harvard University, released a groundbreaking study on the effectiveness of senior-focused primary care.  

 

Key findings include: 

  • Better access to healthcare: Patients of value-based, senior-focused primary care organizations received 17% more primary care visits.
  • Reduced health disparities: Senior-focused primary care organizations ­­­narrowed racial and socioeconomic disparities, as Black and low-income beneficiaries had 39% and 21% more primary care visits, respectively.
  • Better health outcomes: While more research is needed, patients of SFPC organizations may benefit from better health outcomes. These benefits include more recommended cancer screenings, controlled blood pressure, improved medication adherence and lower likelihood of poorly controlled diabetes. As a result, senior-focused primary care patients had 11% fewer emergency department visits, 6% fewer hospitalizations, and were 10% less likely to be readmitted to the hospital within 30 days.

 

How Humana facilitates clinical care

At CenterWell, a Humana Inc. company, doctors, nurses, specialists, social workers, and mental health professionals collaborate on patient care teams. These patient centers also function as wellness centers where patients can socialize, exercise, take classes, and participate in activities that support their health.

1. Comparison based on a study by American Public Health Association published in January 2021, where the average primary care exam was 18 minutes.

The future of affordability: Reducing unnecessary costs today to sustain healthcare for tomorrow

A key principle of VBC is focusing on quality and outcomes, rather than the volume of services provided. This often manifests as better primary care, care coordination, and less unnecessary utilization of procedures and hospital admissions. This, ultimately, lowers overall costs, with more appropriate use of healthcare services and reduction of services that provide little to no value to patients.

In VBC, patients have fewer unnecessary hospital admissions and emergency department visits, as this model prioritizes preventive care and managing chronic conditions. Providers are able to proactively address health issues before they escalate to the need for acute care.1


1. Humana's 11th Value-Based Care Report, "Back to the Basics: A Patient's Pit Crew for Better Health," 2025. https://assets.humana.com/is/content/humana/2088482_CM-2024-VBC_Report_11x8.5pdf-1