The ‘Volume’ Era is Dead: Humana Data Proves Value-Based Care Cuts Admissions by 24%

Garrett Schmitt

What You Should Know The Report: Humana’s newly released Value-Based Care By the Numbers Report, reveals that Medicare Advantage members in value-based care (VBC) arrangements are seeing significantly better outcomes than those in traditional models. The Data: The impact is measurable and massive: VBC patients experienced 24.3% fewer hospital admissions and 13.4% fewer emergency room visits in 2024. The Shift: The report…

Medicare Advantage members in value-based care see 229,000 fewer inpatient admissions: Humana

Garrett Schmitt,

Humana saw a 24.3% decrease in inpatient admissions, or a 229,000-stay dip, for Medicare Advantage members in value-based care arrangements versus those in traditional Medicare in 2024, according to Humana’s “12th Annual Value-based Care Report,” published Feb. 4. Humana reviewed 2024 data to evaluate outcomes for its Medicare Advantage members. Seventy-one percent of Humana individual MA members…

The VBC Paradox: Why Hospitals Are Doubling Down on Value-Based Care While Revenue at Risk Lags

Garrett Schmitt,

What You Should Know:  – A new report from Sage Growth Partners reveals a striking disconnect in the healthcare industry: while only 20% of C-suite leaders believe progress has been made in value-based care (VBC) recently, 77% plan to increase their participation in these models over the next two years. – The “plot twist” indicates that despite operational hurdles…

Data-Driven VBC: How Tech and AI Are Transforming Value-Based Care

Garrett Schmitt,

The transition from fee-for-service to value-based care (VBC) puts continued pressure on the healthcare industry, especially as organizations push to remain relevant in a competitive environment while improving patient outcomes. The primary goal of VBC is to enhance clinical results and reduce overall healthcare costs, aligning care delivery with the evolving expectations of payers and patients. Learning…

Value-based care tied to better care for patients with heart failure, Humana report finds

Garrett Schmitt, , ,

Humana Healthcare Research has released new data showing that Medicare Advantage patients with heart failure who are treated by value-based care (VBC) physicians are significantly more likely to receive recommended therapies than those in traditional care models. According to Humana’s Value-Based Care Issue Brief, patients in VBC arrangements were nearly 28% more likely to receive full quadruple therapy —…

10 years in: The impact of value-based care

Garrett Schmitt, , , ,

A decade ago, the federal government launched its large-scale Medicare Access and CHIP Reauthorization Act (MACRA) in an attempt to move more physicians into value-based care to rein in exploding costs and improve care. Later this summer, Medical Economics will release the second edition of Medical Economics Insider featuring an in-depth look at how successful MACRA has been…

Fee-For-Service, Accountable Care Organizations, And Medicare Advantage: Why?

Garrett Schmitt, , ,

Abstract This Perspective discusses the fiscal challenge facing Medicare and how that challenge may be differentially met by fee-for-service, accountable care organization (ACO), and Medicare Advantage (MA) payment systems. The non-MA part of Medicare includes both fee-for-service and ACO payment systems and is sometimes referred to as traditional Medicare. Fee-for-service, although in need of reform,…

CMMI and the One Big Beautiful Bill Act are all in on prevention

Garrett Schmitt,

The national conversation around primary care — for both the private and public sectors — is experiencing a profound shift towards prioritizing value, prevention and outcomes over wasteful spending. This transformation comes at a critical time. Despite the shortage of providers the U.S. is now facing, investment in primary care saves money and leads to better outcomes by reducing the…

Making Value-Based Payment The Best Choice For Providers

Garrett Schmitt,

The Center for Medicare and Medicaid Innovation (CMMI) has announced a refreshed strategy to promote evidence-based prevention, empower beneficiaries to achieve their health goals, and promote competition and choice in health care markets. Value-based payment (VBP) can advance that vision, but only if CMMI dramatically amplifies the will among provider organizations to fully commit to generating health…

New Opportunities for Healthcare AI: Decoding the 2026 Medicare Advantage Rate Hike

Garrett Schmitt,

Last month, the Centers for Medicare & Medicaid Services (CMS) released its 2026 Medicare Advantage (MA) Rate Announcement, projecting a 5.06% average increase in payments to MA plans. That’s a notable jump from the 3.70% increase we saw in 2025. More than just a financial adjustment, this signals growing confidence in the Medicare Advantage model—and with…