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In a value-based care (VBC) model, the quality of care and level of service provided by health plans improve across several measures.

Humana’s 12th annual value-based care report illustrates how Medicare VBC providers garner higher HEDIS scores across all metrics when compared with their non-VBC counterparts. VBC providers’ superior scores reflect the improved quality of care received by their patients.

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What is HEDIS?

Healthcare Effectiveness Data and Information Set (HEDIS® ) measures a range of issues related to performance and quality related to various dimensions of care and service.1

HEDIS scores are important because they:

  • Encourage preventive care
  • Improve accountability and transparency
  • Allow comparisons between health plans

How does value-based care lead to HEDIS improvements?

As illustrated in Humana’s 12th annual VBC report, VBC providers outperformed non-VBC providers in the following areas:

  • Preventive screenings

    Including breast cancer and colorectal cancer

  • Senior care

    Including pain assessment and medication review

  • Condition management

    Including diabetes eye exams and controlling blood pressure

  • Care coordination

    Including transition of care and post-discharge medication reconciliation

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  1. U.S. Department of Health and Human Services website, “Healthy People 2030,”
To learn more, visit Humana Group Medicare
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