Humana Committed to Quality Improvement

Humana is an industry leader in promoting patient safety and quality care on behalf of its members. In fact, Humana's mission is to help members make informed decisions based on available information. Humana gathers this information from a variety of sources, including The Leapfrog Group.

The Leapfrog Group's growing consortium of major companies and large private and public health care purchasers provides health benefits to more than 37 million Americans in all 50 states. The Leapfrog Group and its members work to improve health care in the following areas:

• Safety
• Quality
• Affordability

One of the ways the group does this is by publishing data from the Leapfrog Hospital Quality and Safety Survey, which uses evidence-based measures and various safety standards to rate the quality of hospitals across the country. Humana encourages all hospitals to respond to the survey at www.leapfroggroup.org.

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Proper Coding for Retinal Eye Exams Necessary for Accurate Data

A recent HEDIS^® (Healthcare Effectiveness Data and Information Set) survey found that many Humana members with diabetes are not receiving an annual comprehensive dilated eye exam, as recommended by the American Diabetes Association and the American Ophthalmology Association. (If a diabetic patient does not have retinopathy, this exam can be given every two years, based on the advice of an eye care professional.)

Though member noncompliance may contribute to these results, improper coding may be a contributing factor. In order to accurately identify Humana members who have or have not had a dilated retinal eye exam, providers are asked to use the codes in the table below when submitting claims.

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Humana Recognizes Practice Improvement Modules Participants

Humana is pleased to recognize internal medicine and subspecialty diplomates who are enrolled in the American Board of Internal Medicine (ABIM) Maintenance of Certification program and who complete ABIM's Practice Improvement Modules (PIMs). Recognizing Humana-contracted physicians who complete PIMs is consistent with Humana's mission of giving members information about health care providers who are committed to improving their practices.

Humana is adding ABIM's designated seal, "Improving Practice Performance," on its Physician Finder Plus tool next to the name of each physician participating in the program. Available on Humana.com, Physician Finder Plus is available to Humana's 11.3 million medical members. Humana will recognize ABIM diplomates for each PIM completed as of January 1, 2006, and will continue to post the designation for up to two years for each completed PIM.

This distinction became available on Humana's Physician Finder Plus tool as of August 1, 2007. For more detailed information or to determine if you are eligible for this program, please call your local Humana market medical officer or call Humana's provider relations department at (800) 626-2741.

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