To help our members, as well as prospective Humana customers, make more informed choices about their healthcare, Care Highlight® recognizes doctor practices that meet quality and cost-efficiency guidelines. You can find a doctor’s ratings using Humana’s
Care Highlight®
Overview
When assessing doctors, Humana uses administrative and claims information over a 3-year period. Ratings are provided at the physician group level in each specialty type so that we can provide ratings for more doctors. Our method for evaluating these ratings is consistent with national standards and was developed using feedback from doctors.
Care Highlight ratings are only a guide to choosing a doctor. Members should discuss with their existing doctors before making a decision, and given that such ratings have a risk of error, they should not be the sole basis for selecting a doctor. Humana does not give performance-based payments to doctors based on these ratings.
The meaning of hearts and badges
Clinical quality
The effectiveness of treatment that members received may be measured qualitatively.
Clinical quality | Description |
|---|---|
 | Highest rating |
 | Lowest rating |
Not enough information to measure. | There is not enough information to rate the doctor. |
Here are some examples of how we determine the rating:
- How often are patients readmitted after a hospital stay?
- How often do patients develop complications after surgery?
- How often are appropriate testing and treatment ordered by the doctor?
Cost-efficiency
Cost efficiency is the cost of treatment that members received compared to treatment provided by similar doctors. Treatment could include services such as doctor's visits, lab tests, related medication, surgeries done in hospitals, etc.
Cost efficiency | Description |
|---|---|
 | Highest rating |
 | Lowest rating |
Not enough information to measure. | There is not enough information to rate the doctor. |
Here are some examples of how we determine the rating:
- The total cost for services
- The number and types of services performed
- Resources used to treat the doctor's patients
Doctors that are evaluated
Doctors in the following specialties are included:
Evaluated specialty types
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Your feedback is valuable
We would like to hear what you have to say. If you have feedback regarding the Care Highlight ratings, please take this brief
We want to ensure that the program is useful to our members and fair to our doctors. Your feedback will be reviewed by Humana and considered in making program enhancements.
“By earning Physician Quality Certification, Humana has shown its commitment to quality includes transparent, rigorous review of the physicians with whom it works. That measurement, transparency and collaboration between organizations are cornerstones of better care.” Margaret E. O’Kane, NCQA President