Measuring our performance

Learn about the tools we use to measure our performance in making sure you get 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 Humana Healthy Horizons^® in Kentucky medical plan. More than 90% of America’s health plans use this tool. This large amount of data makes it easier to compare plans. Officials use a process created by the National Committee for Quality Assurance (NCQA) to review and check data.

What is measured?

To make sure our enrollees get the care they need, we measure many important health issues, including:

• Antidepressant medication management
• Asthma medication use
• Breast cancer screening
• Childhood and adolescent immunization status
• Comprehensive diabetes care
• Continuing use of beta-blocker treatment after a heart attack
• High blood pressure control
• Weight assessment and counseling for nutrition and physical activity for children/adolescents (WCC)

Helping us improve

These measurements help us determine:

• Any areas of care that may need improvement
• How we can better serve our enrollees
• If our enrollees get the care they need

Our quality improvement program helps guide activities to improve care and treatment for our enrollees. For more information about the quality improvement program call 800-444-9137 (TTY: 711), Monday – Friday, 7 a.m. – 7 p.m., Eastern time

You can view the data HEDIS tracks in a yearly report card that shows a complete view of a health plan’s performance. National magazines and newspapers often publish these report cards.

View the NCQA State of Health Care Quality Report (NCQA website)

To learn more about how we measure our performance, including how our HEDIS measurement process works, download this guide to HEDIS measurements .

Quality Improvement (QI) Program

To help make sure you get quality care, we developed our Quality Improvement 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 Street, WFP 20
Louisville, KY 40202