How to choose the right value-based care provider for you

When it comes to your health, your primary care provider (PCP) plays a big role. They’re the person you turn to for checkups, advice, prescriptions, test results, referrals and more. And as you age, especially if you’re living with chronic or complex health conditions, that relationship becomes even more important.

But not all providers are the same. That’s why finding the right PCP—especially one who works in a value-based care (VBC) model—can make a difference in your healthcare experience, how you’re treated and how much your care costs.

Your PCP is your greatest health asset. This guide can help you think through what matters most when choosing a new provider.

What is value-based care and how does it help you?

Value-based care focuses on results, not just services. Instead of being paid based on how many procedures or visits they complete, value-based providers are paid for helping you improve your health.

This can lead to:

• Fewer hospital stays
• Fewer emergency room visits
• More time with your doctor
• A care plan that reflects your whole life, not just your medical chart

According to the most recent Humana value-based care report, Humana Medicare Advantage members receiving value-based care have experienced:

• 32.1% fewer inpatient admissions than those with Original Medicare
• 7.2% fewer hospital admissions than non-value-based-care Medicare Advantage members
• 11.6% fewer ER visits than non-value-based-care Medicare Advantage members

This shows that value-based care can make a big difference for your well-being, as well as your out-of-pocket costs.

Start with what matters to you

Everyone has different priorities. Some want a doctor who takes time to explain things. Others want someone who understands what it’s like to live with a chronic illness. Some may care most about convenience or language.

Before you choose a PCP, ask yourself:

• What do I want in a doctor?
• What kind of support do I need?
• What frustrates me most about past doctor visits?

Write down your answers. Use them to guide your search.

What does a good patient experience look like?

You shouldn’t have to settle for rushed visits or feeling ignored. Look for providers who offer the kind of care experience that works for you. Here are some signs of a good patient experience.

• They listen and communicate clearly
• Do they let you finish your thoughts before jumping in?
• Do they explain things in a way you understand?
• Do they treat you with respect, regardless of age, race, income or condition?

If English isn’t your first language, ask if they offer services in your preferred language or provide translation help.

You can get an appointment when you need one

• Are you waiting weeks or months to be seen?
• Do they offer same-day or next-day appointments?
• Is virtual care an option?

Value-based providers often see fewer patients so they can spend more time with each one and offer faster access to care.

The staff treats you like a person

A caring doctor is great. But the experience should start at the front desk and carry through to the nurses, technicians and support staff.

• Are you greeted warmly?
• Do they help you navigate next steps?
• Do they return your calls and messages?

If the staff is kind, patient and organized, it can make your whole experience less stressful.

Is the office senior-friendly?

The layout and design of a medical office can say a lot. Providers who specialize in care for older adults often design their spaces to make them safer and more welcoming.

Look for features like:

• Non-slip floors
• Wide doorways and hallways
• Lower exam tables
• Bright lighting and clear signage

If mobility is a concern for you, ask if they offer help getting in and out of the building or exam rooms.

Are services conveniently located?

It helps when one location offers more than just medical visits. Some senior-focused clinics offer:

• On-site lab work
• Prescription pickup or delivery
• Dental and vision care
• Health coaching
• Behavioral health support
• Group classes or social events

If you rely on public transportation or have trouble getting around, having these services in one place can reduce the number of trips you have to make.

Is the care affordable?

High-quality care doesn’t have to cost more. In fact, value-based care providers often help patients save money by:

• Preventing avoidable emergencies or hospital visits
• Coordinating care to avoid duplicating tests
• Reviewing prescriptions to cut out unnecessary medications

You can use tools like Humana’s Find Care tool with Care Highlight^® ratings to compare PCPs. This tool shows:

• Green hearts for care quality (more hearts means better performance on things like screenings and follow-up)
• Green badges for cost efficiency (more badges means lower out-of-pocket costs compared to similar doctors)

How close is the office to you?

Location matters, especially if you’re managing multiple appointments or don’t drive. Consider:

• Is it on a bus line or paratransit route?
• Can a family member easily drive you there?
• Do they offer telehealth visits?
• Is there help available for arranging rides or transportation?

Choose a provider that fits your life—not the other way around.

Are you comfortable changing providers?

It’s okay to switch doctors if your needs change. Maybe your old provider isn’t responsive or you’ve moved or you want someone with more experience in senior care. You’re not being disloyal—you’re taking care of your health.

To recap, here are some things to look for:

• Clear, respectful communication
• Short wait times and appointment availability
• A kind, helpful care team
• An office that’s easy to get around
• Multiple services in one place
• High-quality and cost-effective care
• A location and schedule that work for you

The choice is yours

You deserve a doctor who treats you with respect, sees the whole picture and helps you feel confident about your care. Whether you’re new to Medicare or simply ready for something better, the right PCP can be a powerful partner in your health.

Are you ready for proactive, personal and accessible care that puts you first? Learn more.