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Clinical Tips for Providers
In the next few months,
Humana will be sending important reminders and information targeted
to members about their health conditions. In order for this information
to be most effective, and lead to better disease control, we encourage
our network physicians and other health care providers to discuss
the following with their patients:
February is National Heart Health
Month, so Humana is reminding members with hypertension and hyperlipidemia
about the importance of having their blood pressure and cholesterol,
specifically low density lipoprotein (LDL), checked.
In February
and March, Humana will be reminding our asthmatic members about
the importance of having an updated asthma action plan and medications.
For patients who already have diabetes, it is a good
time to remind them of the importance of knowing their "ABC" numbers
— A1c level, blood pressure and cholesterol level.
March is Colorectal
Cancer Awareness Month, so we encourage providers to remind their
patients, age 50 and older, of the importance of colorectal cancer
screening.
In May, during National Stroke Awareness Month, Humana
members will be reminded of the importance of beta blocker use
after acute myocardial infarction (AMI), when it is deemed necessary
by their physician.
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Humana Supports Patient-Centered
Primary Care Collaborative
Humana is pleased to join the Patient-Centered
Primary Care Collaborative (PCPCC), which is a group that is dedicated
to advancing a new primary-care-based health care model called
the Patient-Centered Medical Home (PCMH).
In supporting the PCPCC,
Humana has joined a membership that includes the four major primary
care physicians' professional societies — including
the American Academy of Family Physicians (AAFP), the American
Academy of Pediatrics (AAP), the American College of Physicians
(ACP) and the American Osteopathic Association (AOA) — as
well as national employers and their associations, quality advocacy
groups, academic centers and consumer advocacy groups.
In addition
to joining the PCPCC, the health benefits companies committed to
the following:
- Working toward the development and implementation
of a series of multipayer medical home pilot demonstrations
- Contributing
to the evidence in current health services research that suggests
patients treated under a medical home model are healthier, experience
a higher quality of care and receive that care more cost effectively.
The
PCMH model is based on evidence that recipients of personalized
primary care live healthier, longer lives.
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Recognition Programs Support Quality Care
Humana encourages
its network physicians to participate in The National Committee
for Quality Assurance (NCQA) physician recognition programs.
This initiative is designed to support and recognize physicians
who deliver consistent, comprehensive care for patients with
specific conditions.
To achieve recognition, physicians must
demonstrate the adherence to nationally recognized standards
and document that patient outcomes meet or exceed benchmark
standards. Programs are as follows: the Diabetes Recognition
Program, the Heart/Stroke Recognition Program, the Back Pain
Recognition Program and the Physician Practice Connections
Recognition Program. Physicians obtain a survey tool from
NCQA and enter the required data. The survey tool for each
program will automatically score the data and inform the
physician if the data meet the recognition program requirements.
When the application and survey process is complete, notification
of recognition is received within 30 days.
The physician or
each physician within a group will be identified on the Humana
Web site with the NCQA recognition seal for the awarded recognition
program.
Physicians who are interested in applying for
recognition should contact NCQA on the Internet at www.ncqa.org or
by calling (888) 275-7585.
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