The company published an issue brief detailing its strategy for value-based kidney care June 11.
Here are five things to know from the brief:
- As engagement with value-based programs has increased, the medical expense ratios among Humana members has dropped. In 2019, Humana patients with chronic kidney disease had a medical expense ratio of over 100%. This number dropped to 88% in 2024.
- Patients with chronic kidney disease and end-stage renal disease were more likely to follow up with nephrologists when compared to patients in a fee-for-service-only structure, Humana found.
- Humana members in value-based kidney care programs had 5% fewer unnecessary hospital admissions than those in fee-for-service-only care.
- Humana has contracts with several healthcare management companies, including Evergreen Nephrology, Interwell, Monogram Health and Strive Health to coordinate value-based care for 77,000 members with chronic kidney disease. The company also contracts with DaVita Integrated Kidney Care and Fresenius.
- In most value-based kidney contracts, providers are compensated based on an entire patient-care episode. Providers can earn incentives for patient outcomes, including controlling diabetes and blood pressure, delaying the start of dialysis, and guiding patients to a controlled start of dialysis treatment.
Read the full report here.
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 17–19 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.
