The company published its annual value-based care report in February. The annual report provides data on savings and outcomes achieved through value-based care — but this year, the report also looks to break down the meaning of value-based care, Dr. Ding said.
Dr. Ding spoke with Becker’s to explain why Humana is getting “back to basics” with value-based care.
This conversation has been lightly edited for length and clarity.
Question: Humana has published a value-based care report each year for the past several years. What’s new for 2025?
Dr. Alex Ding: This is our 11th annual value based care report. In the past, we’ve been highlighting the successes of value-based care. In particular, the part that brings in a lot of interest is the statistics and the data that we bring on various different proof points of how value-based care delivers better health outcomes, better patient experiences, and better manages the healthcare costs of the overall system. But one of the things we have found is that a lot of people only understand value-based care as a very superficial term. As I engaged with physicians, provider organizations and clinic operators, I found that I needed people to better understand at a deeper level what value-based care is, as opposed to just being a term that people knew was a good thing.
So the theme of this year’s reports is back to basics. The point of that theme is really helping people to understand what value-based care is, as opposed to just being some term they have heard thrown around the industry. We go back and talk about, at a fundamental level, what is value-based care? Then, what are some ways in which you can operationalize it, rather than thinking about it in very abstract terms.
Q: What is the biggest roadblock to implementing value-based care?
AD: I think it’s oftentimes underappreciated what a significant change this is in how a practice operates and how one practices medicine. Care delivery transformation is really hard, because you can’t just pay physicians differently and keep everything else the same and expect health outcomes to improve as a result. That requires a lot of big operational changes, which require capital investment, not to mention just the challenge of implementing those.
In our report, we show that 70% of our individual Medicare Advantage members are seeing primary care providers that are in value-based care contracts. We also show that our Medicaid members see value based primary care providers in significant amounts as well. One of the things I often hear is the biggest challenge is that practices are trying to practice under both models at the same time. They’ve got fee-for-service and value-based care contracts. Medicare Advantage has really provided the flexibility to increase to the critical mass you need for value-based care. But some of the other insurance products that providers take, like commercial, aren’t as amenable to the transition to value-based care. That often leads providers to practice with one foot in each canoe, and it’s exceedingly difficult to practice two models at the same time in one place.
Q: By the time you publish 2026’s report, where do you hope to make progress, improvements or refinements?
AD: It’s a continued, steady drumbeat toward moving to more value-based care, and helping support practices to get to where they want to be on the value-based care continuum. We’ve got plenty of years of data that shows that value-based care practice really does deliver better patient experiences, better health outcomes, and creates financial stability for practices and the healthcare system overall.
Q: What will value-based care look like in the next decade?
AD: One of the things we really need to talk about as a country is the sustainability of our healthcare system. We’ve heard about challenges. We’ve heard about points of abrasion and challenges with experience in the overall system. We’ve shown that value-based care can improve sustainability. It can improve experiences, both for patients and the practicing clinician, and it also really improves value and outcomes. Zooming out, in 10 years we’d like to see us continue to move the entirety of the healthcare system toward more and more value.