How Humana puts members at the center of care

Let’s take a closer look at three examples of Humana’s member-centric model.

1. Value-based care (VBC) approach

   Humana has adopted a VBC framework that prioritizes quality of care over patient volume. VBC leads to a better patient experience and improved outcomes.

   More time spent with providers

   VBC physicians are able to spend more 1:1 time with patients, ensuring medical concerns are properly addressed

   Integrated vs. episodic approach

   Holistic approach ensures care coordination among specialists, factoring in the unique needs of each member

   Focus on preventive services

   Preventive screenings, health assessments and wellness programs keep members healthy and reduce chronic disease

   

   VBC patients have 70% fewer hospital readmissions.

2. Interoperability solutions

   Humana is an industry leader in interoperability solutions that facilitate the seamless exchange of patient information. Giving providers fast and easy access to data enables better member care.

   Faster diagnostic tests thanks to requests submitted within provider workflows (no need to call or fax)

   Reduced care delays and quality-gap closures by highlighting patient care opportunities

   Reduction in denials for lack of medical records

   

   Humana has more connected health systems and interoperability solutions than any of its competitors.

3. Prior authorization changes

   Humana is at the forefront of improving the prior authorization process, so patients can get the care they need.

   Faster access to care

   New gold card program waives prior authorization requirements on certain items and services for eligible providers

   Streamlined approval processes

   Decisions within one business day on 95% of electronic prior authorization requests

   Reduced requirements

   Humana is cutting 1/3 of prior authorizations for outpatient care, expediting access to certain diagnostic services

   

   35 million prior authorizations are submitted each year for MA patients