Humana's value-based kidney care strategy: 5 things to know

Value-based strategy helped Humana improve outcomes and reduce costs for patients with chronic kidney disease and end-stage renal disease. 

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: 

  1. 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.

  2. 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.

  3. Humana members in value-based kidney care programs had 5% fewer unnecessary hospital admissions than those in fee-for-service-only care.

  4. 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.

  5. 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.

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