Care Highlight provides helps members choose a doctor. Demographics and claims information are used to assess doctors.


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Care Highlight®

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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.

Clinical quality

The effectiveness of treatment that members received may be measured qualitatively.

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.

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 in the following specialties are included:

Evaluated specialty types

Allergy and immunology

Cardiology

Colon and rectal surgery

Endocrinology

Family/general practice

Gastroenterology

General surgery

Internal medicine

Nephrology

Neurology

Neurosurgery



Obstetrics and gynecology

Oncology

Orthopedic surgery

Pediatrics

Plastic surgery

Psychiatry

Pulmonology

Rheumatology

Thoracic surgery

Urology

Vascular surgery





We would like to hear what you have to say. If you have feedback regarding the Care Highlight ratings, please take this brief survey. For all other questions or feedback, please call the toll free number on the back of your Humana ID card.

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.

NCQA seal representing the PQ Certification of the program

Clinical quality	Description
	Highest rating
	Lowest rating
Not enough information to measure.	There is not enough information to rate the doctor.

Cost efficiency	Description
	Highest rating
	Lowest rating
Not enough information to measure.	There is not enough information to rate the doctor.