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Dear Physician and Office Staff: At Humana, we strive to develop
technology that will inform and educate both our providers and members.
We would like to highlight two of our Web-based tools that have
been created to help Humana members evaluate and compare hospitals
and physicians. These tools, which are accessible to members through
Humana’s secure Web site, provide information that members
can use when choosing a participating physician or hospital that
best meets their individual needs. Humana works with WebMD® Quality Services to obtain publicly available information, which is used to compare hospitals based on clinical outcome, processes and structure measures. Members can select the measures, along with the weighting of each, to determine the overall results by procedure. Based on the combination of measures and weights chosen, consumers will see hospital comparison results that will be unique to their own preferences and needs. Within the Compare Hospitals tool, Humana members
who live in certain areas can compare the estimated cost for a particular
procedure. The estimates are based on what Humana members have incurred
for the entire course of treatment — including fees from facilities
and physicians. The tool estimates the cost of more than 30 inpatient
and outpatient diagnostic procedures. The Physician Profile provides members with information comparing an individual physician’s performance in adherence to nationally recognized, evidence-based indicators of care with other physicians in the same market. These indicators for such conditions as diabetes, asthma, heart disease and preventive services are based on Humana claims data. Essentially, members can see how a particular physician follows standard, evidence-based guidelines when compared to other physicians treating similar conditions. The Physician Profile tool only includes information if there is sufficient amount of data available about a physician and condition. We encourage our providers to submit comments and input via a feedback form, available by contacting Humana Provider Relations at 1-800-626-2741. Both the Physician Profile and Compare Hospitals tools are part of Humana’s ongoing initiatives on transparency, which aim to provide information to consumers based on the efficiency (cost performance) and effectiveness (clinical performance) of hospitals, physicians and other providers in an easy-to-understand, consumer friendly format. Sincerely,
Bruce Perkins |
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