Spending on employee and retiree healthcare has skyrocketed in recent years, which is why 62% of organizations say managing these costs is a top priority, according to a recent survey.1
Humana’s healthcare model, programs and initiatives rein in costs without sacrificing quality. Here’s a look at four key features of Humana’s approach to controlling healthcare costs.
Value-based care model
Humana is a leader in value-based care (VBC), with 71% of Humana Medicare Advantage (MA) members in VBC arrangements.2 Cost control is embedded within the VBC model, as illustrated by these stats from Humana’s most recent value-based care report:2
24.3%
fewer inpatient admissions*
13.4%
fewer ER visits for VBC patients**
7.6%
fewer admissions for VBC patients**
By keeping members out of the hospital, the VBC model helps rein in healthcare spending. The VBC model also promotes more efficient care delivery, with an emphasis on coordination and integrated care.
*For patients aligned with VBC providers
**Compared with non-VBC MA members
Emphasis on prevention
A focus on preventive care helps detect health issues early, preventing the onset or progression of some chronic diseases. Humana’s approach includes:
Preventive screenings: Including screenings for diabetes, colorectal and breast cancers, osteoporosis, depression and more.
Medical nutrition therapy: Helps eligible members manage and potentially improve chronic health conditions with services such as nutrition/lifestyle assessments and personalized diet plans.
Fitness and wellness programs: Can include in-person group fitness through SilverSneakers®, virtual exercise classes, and personalized wellness coaching.
There’s a direct correlation between wellness programs, preventive screenings and reduced healthcare costs. For example, one study found that total average healthcare expenses were reduced by 16% for MA members who participated in SilverSneakers® compared with non-participating MA members.
Pharmacy cost management
Humana’s pharmacy cost management measures help plan sponsors keep drug spending in check. These measures include:
Coverage for generic drugs: Humana generally prioritizes generic drugs and biosimilars on formularies, providing lower-cost options for members.
Medication therapy management: Helps control drug costs by avoiding wasteful spending. Pharmacists review prescriptions to identify duplication, unnecessary medications or harmful combinations.
Access to virtual care
Telehealth reduces costs by enabling care in a lower-cost setting, preventing emergency department (ED) visits, and helping reduce readmissions. For example:
According to one study, telehealth visits led to 28% fewer ED visits among patients who used it within seven days of the onset of symptoms.4
Telehealth video follow-ups after ED discharge are associated with fewer ED revisits for older adult patients.5
The American Medical Association notes that access to virtual care “improves continuity of care and prevents minor issues from escalating into costly events.”6
- "Cost Crisis or Business as Usual? Employer Responses to Soaring Healthcare Costs,” AON, January 21, 2026, accessed March 30, 2026
- 12th annual value-based care report, Humana, accessed March 30, 2026
- "Participation in Silver Sneakers Leads to a Substantial Decrease in Overall Healthcare Costs and Improved Health Outcomes for Seniors,” PR Newswire, April 20, 2021, accessed March 30, 2026
- Vivek V. Shah et al., “Association between in-person vs. telehealth follow-up and rates of repeated hospital visits among patients seen in the emergency department,” JAMA Network, October 25, 2022, accessed March 30, 2026
- Nicolas M. Kahl, “Evaluating the impact of home telehealth video visits on older adults following emergency department discharge,” The American Journal of Emergency Medicine, October 2025, March 30, 2026
- Jennifer Lubell, “How telehealth drives care improvement and saves money,” AMA, January 22, 2026, accessed March 30, 2026
Humana is a Medicare Advantage HMO and PPO organization and a stand-alone PDP prescription drug plan with a Medicare contract. Enrollment in any Humana plan depends on contract renewal.
To learn more, visit Humana Group
Medicare
Download PDF