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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Clinical Tips for Providers
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Recognition Programs Support Quality Care
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