Answers to some of your Medicare questions from Humana

“Accountable care” and “value-based care” are healthcare terms that you hear a lot today, but what do they really mean when it comes to you and your health? Lisa Ward, Indiana State Sales Director for Humana, describes the importance of Medicare beneficiaries finding the right care.

What do the terms “accountable care” and “value-based care” mean to you?

• Traditionally, providers get paid based on the number of services they provide to patients. As a patient, this means that your doctor gets paid each time he or she provides you with care, whether it’s a standard check-up or a surgical procedure.
• Health care in America is moving in a new direction and one that revolves around you: the patient. In addition to treating illness – which can be very expensive – we are also focusing on preventing illness. For this to work, people will need more proactive, personalized care and more face-time with primary care doctors. Members routinely tell us that they want a health care team that focuses on their entire well-being and this is moving our communities in that direction.
• This philosophy is what you sometimes will hear referred to as accountable care or value-based care.

How do patients benefit from their physician being part of this type of healthcare?

• This type of care is designed to benefit the patient in several ways, including more time with your doctor, and increased focus on preventive, coordinated care.
• We believe this type of care is good for everyone, whether you are active or dealing with various health issues that prevent you today from experiencing the life you desire.
• If you have chronic conditions, which tend to be more prevalent in older adults, seeing a care team that practices value-based care may be a great way to get the proper treatment and management for your conditions.

How is Humana partnering with providers to benefit Medicare-eligible patients?

• At Humana, we’ve partnered with value-based providers to offer a transformational healthcare model here in Indiana that provides our Medicare-eligible members access to more comprehensive, personalized care.
• Our healthcare needs can change from time to time so it’s important to find healthcare designed to meet those needs. Humana has experience with Medicare and we work with these providers to offer them various tools to help care for our members to meet these needs and keep them healthy.

What are some of the positive outcomes Humana has seen for its Medicare patients?

• According to Humana’s 2014 population health results, on average, current Humana Medicare Advantage members served by providers participating in this type of transformational care have experienced: fewer ER visits and hospital admissions, higher screening rates, including those for colorectal cancer (+7 percent) and breast cancer (+6 percent), and healthier outcomes versus members who were treated by providers in standard Medicare Advantage settings.

How can Medicare beneficiaries access this Transformational Healthcare?

• Medicare beneficiaries can access healthcare designed for them by researching value-based providers that offer this type of care, and plans that include these types of providers in their network
• One of the ways Medicare beneficiaries may be able to access this Transformational Healthcare is through a Humana Medicare Advantage plan. We have plans designed to fit all types of Medicare needs.
• And accessing this type of care is covered in our Humana Medicare Advantage plans without any increase in monthly premium costs. Many preventive screenings are covered under MA plans and our network includes providers that focus on this type of care. .
• Medicare beneficiaries can visit or call your local licensed Humana sales agent at Humana Medicare Advantage office at 1-800-552-0771.


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