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Humana to distribute $77 million in bonus payments to physicians

About 3,700 physician groups will receive payments in recognition of improved quality outcomes for Medicare members.

Susan Morse, Senior Editor

Humana will distribute $77.2 million in bonus payments to physician groups nationwide who participated in its Provider Quality Rewards Program last year, the Louisville, Kentucky-based health insurer announced Thursday.

Humana has made the payments since 2012, to physicians who are participating in value-based care.

The goal is to increase the approximately 59 percent of Humana individual Medicare Advantage members who have primary care physicians participating in value-based relationships, to 75 percent by the end of 2017.

This aligns with the federal initiatives to providers to tie Medicare payment to quality. By 2016, 30 percent of Medicare benefits are to be based on  alternative payment models, and by 2018, 50 percent are to be tied to value of care.

[Also: HHS ups timeline for value-based switch, wants 50 percent in ACOs by 2018

Approximately 3,700 physician groups will receive payments from Humana in recognition of improved outcomes for Medicare members, during 2014.

Reward settlement finalization takes place in 2015 to allow time for final claims and submission and supplemental data submission.

"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 in the Provider Development Center of Excellence.

Humana's 2014 payments to physician groups were based on their ability to improve quality for many National Committee for Quality Assurance preventive and chronic-condition management Healthcare Effectiveness Data and Information Set measures including, but not limited to: Breast cancer screening,colorectal cancer screening; diabetes treatment management; LDL control; A1C control; and high-risk medications.

Humana's Provider Quality Rewards Program is part of its Accountable Care Continuum that recognizes physician group preparedness for value-based arrangements by offering programs such as Star Rewards, Model Practice, Medical Home and shared savings/full value programs for value-based care.

Twitter: @SusanJMorse

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