Skip to main content

During this unprecedented time, please know that we are doing our best to support our communities, our members and the healthcare providers caring for them. To date, Humana has taken numerous actions to ensure the members we serve can access care, while promoting social distancing and minimizing potential exposure to COVID-19.

For information on the benefit and process updates, visit the provider COVID-19 home page. As more guidance becomes available and Humana continues to reevaluate processes and policies in light of the COVID-19 public health emergency (PHE), information and resources on this site will be updated. We encourage you to visit regularly.

Recent telehealth changes and their impact on Medicare Advantage (MA) quality

To support providers with caring for their Humana patients while promoting both patient and provider safety, Humana has expanded the scope, reimbursement rules and channels for telehealth services. For patients who had yet to complete their Annual Wellness Visit (AWV), you can perform these visits via telehealth.

On this page, we have provided a table that highlights how MA quality measures can be addressed via telehealth, as well as with in-home test kits. You will see that during these visits you can satisfy a number of measures and positively impact the performance of others by discussing them with your patients.

Please visit www.Humana.com/provider/coronavirus/telemedicine for more information including frequently asked questions we have received regarding these changes.

If there are additional ways we can support you and your practice, please:

  • Contact your Humana representative
  • Call our Provider Relations department at 1-800-448-6262, 8 a.m. – 8 p.m. Eastern time, or
  • Send an email to AskStars@humana.com
Clinical HEDIS measures Can be SATISFIED by telehealth (incl. audio only) Can be SATISFIED with an in-home test Kit Breast Cancer Screening (BCS) Yes1 No Care for Older Adults – Medication Review (COA-Med) Yes No Care for Older Adults – Pain Screening (COA-Pain) Yes No Colorectal Cancer Screening (COL) Yes1 Yes Controlling Blood Pressure (CBP) Yes No Eye Exam for Patients with Diabetes (EED) Yes1 No Hemoglobin A1c Control for Patients with Diabetes (HBD) Yes1 Yes2 Kidney Health Evaluation for Patients with Diabetes (KED) No No Osteoporosis Management in Women who had a Fracture (OMW) No No Statin Therapy for Patients with Cardiovascular Disease (SPC) No3 No3 Transitions of Care Notification of Inpatient Admission No No Receipt of Discharge Information No No Patient Engagement After Inpatient Discharge Yes No Medication Reconciliation Post-Discharge (MRP) Yes No
1 Can be satisfied during a telehealth visit when a patient-reported service is documented in a submitted medical record
2 Can be satisfied when a returned hemoglobin A1c (HbA1c) test kit results of 9% or less
3 Prescription written at the time of care may and will only satisfy the associated measure when the record indicates the generic name (or brand name), strength/dose, route and date when the medication was dispensed or shipped to the member, and a prescription claim billed through Humana is present.
Patient Safety (Part D) measures Can be SATISFIED by telehealth (incl. audio only) Can be SATISFIED with an in-home test Kit Medication Adherence for Cholesterol (Statins) (MedA-Statin) No No Medication Adherence for Diabetes Medications (MedA-Diabetes) No No Medication Adherence for Hypertension (angiotensin-converting enzyme (ACE) or angiotensin-receptor blocker (ARB) (MedA-HTN) No No Comprehensive Medication Review (CMR) Yes No Statin Use in Persons with Diabetes (SUPD) No3 No3
3 Prescription written at the time of care may and will only satisfy the associated measure when the record indicates the generic name (or brand name), strength/dose, route and date when the medication was dispensed or shipped to the member, and a prescription claim billed through Humana is present.
Patient Experience (CAHPS/HOS) Can be SATISFIED by telehealth (incl. audio only) Can be DISCUSSED via telehealth (incl. audio only) Can be SATISFIED with an in-home test Kit Access to Care (Did you experience any difficulty scheduling your appointment?) No Yes No Access to Care (Did you have trouble with your prescription drug plan covering any prescriptions drugs you were taking?) No Yes No Coordination of Care (Did your personal doctor talk about all the prescription drugs you were taking?) No Yes No Coordination of Care (Did your personal doctor seem informed and up to date about the care you got from specialists?) No Yes No Patient Discussion (Did your doctor or other healthcare provider talk to you about falling or problems with balancing or walking?) No Yes No Patient Discussion (Did your doctor or other healthcare provider suggest any healthcare treatment, such as using a cane or walker, having your blood pressure checked, or having regular vision or hearing test?) No Yes No Patient Discussion (Have you ever talked with a doctor, nurse, or other healthcare provider about leaking of urine?) No Yes No Patient Discussion (Did your doctor, nurse, or other healthcare provider talk to you about ways to control or manage leakage of urine?) No Yes No Patient Discussion (Did your doctor or other healthcare provider advise you to start, increase, or maintain your level of exercise or physical activity?) No Yes No Patient Discussion (Has your doctor or other healthcare provider talked to you about your mental or emotional health, or things like feelings of stress, depression or anxiety?) No Yes No