Learn how we use HEDIS to measure the performance of Humana′s Medicaid plans in Indiana and ensure you get the care you need to manage your health.


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Humana Healthy Horizons in Indiana

Your care means a lot to us, and we aim to make a difference in your health and well-being. Learn how we measure our progress in improving quality.

We have a Quality Improvement (QI) Program that aims to:

Improve the health of all members

Ensure positive outcomes

Lower the cost of care

Organize care

Promote Value

Improve the quality and safety of clinical and nonclinical care and services

Meet national quality standards

Receive high customer and provider satisfaction

Achieve top enrollee health outcomes

Our QI Program conducts the following activities:

Assess the unique needs of members

Assess the availability of providers for members in every region of the state

Ensure we are serving members with diverse cultural and language needs

Ensure we are serving members with complex health needs

Establish safe clinical practices with all of our providers

Manage all quality of care and quality service complaints

Provide quality oversight of all clinical services

Meet the quality requirements of the Centers for Medicare and Medicaid Services (CMS)

Monitor and evaluate enrollee and provider satisfaction

The tools we use

We use a tool called HEDIS® (Healthcare Effectiveness Data and Information Set) to track the performance of your PathWays 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

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 Humana Healthy Horizons® in Indiana meets our PathWays members’ needs

Show us any areas that need improvement and how we can better serve our members

Annual provider reviews

We review our in-network providers 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 providers. We use member feedback during these annual provider reviews.

Learn more about how to submit feedback about your provider

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

Humana Healthy Horizons is committed to providing you with the information needed for you to make informed decisions about your health care. This is the reason we are sharing some of the most common healthcare services and what they cost, but may not be owed by the member.

CPT Code	Procedure Description	Cost
99203	Routine Visit	$105.12
99341	Home Health Visit	$46.88
92521	Speech Therapy	$128.12
97165	Occupational Therapy Evaluation	$96.67
92019	Eye Exam and Treatment	$68.50
97161	Physical Therapy Evaluation	$96.67
45378	Hearing Aid Exam Both Ears	$64.38
S0613	Annual Breast Exam	$32.34
93000	EKG	$13.49