Primary care physicians in the Louisville, Ky.-based insurer’s Provider Quality Rewards Program affiliate with about 63 percent of Humana’s individual Medicare Advantage members. Payments were based on physicians’ ability to improve quality for National Committee for Quality Assurance preventive and chronic condition management Healthcare Effectiveness Data and Information Set measures.
“As the industry continues to shift toward value-based payment, programs such as these are proving that care tied to quality metrics can have a meaningful impact on a patient’s health,” Humana CMO Roy Beveridge, MD, said in a prepared statement. “Physicians are benefiting, too, by being paid for the complex care they are delivering.”
Humana first distributed quality-based payments in 2012 to support physicians transitioning from fee-for-service to valued-based reimbursements. Payment finalization occurs in 2016 for the 2015 program to adjust for final claims and additional data submission.
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