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Measuring our performance

Learn how we measure our performance. We want to make sure we give you the care and services you need to manage your health.

A nurse visits a patient at home

Making sure you have the care you need

Learn about the tools we use to measure our performance so we make sure you have the care you need. Check out how we’re doing in our annual reports.

The tools we use

We use a tool called HEDIS® (Healthcare Effectiveness Data and Information Set) to track the performance of your Florida Medicaid plan. More than 90 percent of health plans in America use this tool. Having this large amount of data makes comparing plans easier. Officials check this data using a process created by the National Committee for Quality Assurance (NCQA).

What is measured?

To make sure we give our members the care they need, we measure the performance of many important health issues, including:

  • Antidepressant medication management
  • Asthma medication use
  • Breast cancer screening
  • Childhood and adolescent immunization status
  • Childhood and adult weight/body mass index assessment
  • Comprehensive diabetes care
  • Continuing use of beta-blocker treatment after a heart attack
  • High blood pressure control

Helping us improve

These measurements:

  • Help us see that our Humana Healthy Horizons® in Florida plan meets our members’ needs
  • Show us any areas that need improvement and how we can better serve our members

Check our scores

You can see for yourself how we score each year. We want you to feel confident that you have made the right choice in your plan. Members can view the data that HEDIS tracks in a yearly report card that shows a complete view of a health plan’s performance. These report cards are often published by national magazines and newspapers.

View the State of Health Care Quality Report, opens new window

Learn more

If you’re interested in knowing more about the measures, you can read more through the NCQA website, opens new window.

View the guide to HEDIS® measurements, opens new window

Annual physician reviews

We review our in-network physicians each year to make sure they’re:

  • Providing appropriate care for our members
  • Complying with Humana guidelines and requirements

We encourage our members to let us know about their experience(s) with their physicians. We use member feedback during these annual physician reviews.

Learn more about how to submit feedback about your physician(s)

Quality Improvement (QI) program

To help us provide you with quality care, we developed a program to make sure we are always improving. To receive a copy of the Quality Improvement Program Description Overview, write to:

Humana Quality Operations Compliance and Accreditation Department-QI Progress Report
321 W Main St., WFP 20
Louisville, KY 40202

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