Humana announced it has distributed $77.2 million to about 3,700 physician groups through its Provider Quality Rewards Program. Humana provides incentives to physicians through its Accountable Care Continuum, a value-based system that offers several levels of participation through programs including Star Rewards, Model Practice, Medical Home and shared savings/full value programs for value-based care.
“The sheer volume of payments distributed through this year’s Provider Quality Rewards Program shows that many physician groups are experiencing success as part of their shift toward value-based care,” said Chip Howard, Humana’s vice president of payment innovation.
Humana said about 59 percent of Medicare its Advantage members are attributed to primary care physicians who are participating in value-based relationships. The company’s stated goal is to have 75 percent of individual Medicare Advantage members attributed to primary care physicians who are participating in value-based relationships by the end of 2017.
Our Take: It’s hard to tell what to make of the numbers. With 3,700 physician groups serving 2.4 million Medicare Advantage members in 2014, that’s about $20,800 in physician practice bonuses for quality, or about $32 per beneficiary.
Further, it took 10 months for the data to clear “to allow time for final claims submission and supplemental data submission.”
These two issues—relatively low rewards and a long time lag for incentive payments—are two fair criticisms of the ACO model.