Care Decision Insights

Determine the best fit for your patients with Humana coverage, and begin the conversation about care beyond the hospital.

A physician discusses health opportunities based on data from the Care Decision Insight program with a patient.

Why this matters

If you are a primary care physician (PCP) or specialist making specialty care or outpatient facility referrals for your patients, the Humana Care Decision Insights program may help you determine the best health opportunities for your patients.

  • Independent research supports the premise that certain specialists consistently have improved clinical outcomes, higher quality of care and lower costs.1,2,3
  • For PCP groups, Care Decision Insights data may provide reassurance that the specialist who will see your patient next not only is in network but also is recognized for delivering quality care and improved patient outcomes. For specialists, the Care Decision Insights program gives details regarding how their performance compares to that of their peers.

Learn more, and watch this video about Care Decision Insights or contact your Humana representative.

Primary care physician

When developed and available for Care Decision Insights, the program provides referral pattern information, as well as profiles of specialist groups based on efficiency and effectiveness. You may find this information helpful as you make care decisions for your patients.

For specialty groups

In select markets for select specialties, you will get an in-depth look at your performance measures for efficiency and effectiveness based on Humana claims data. And, you will see "site of service" referral information so you can determine which in-network facilities might be a better fit for your patients.

Follow up with us

As you are provided our claims-based episodes-of-care data, we would like to hear what your experience has been and see what more you might want from us to improve episodic care.

Sources

  1. Katherine Baicker and Amitabh Chandra, "The Productivity of Physician Specialization; Evidence from the Medicare Program," , PDF opens new window, last accessed December, 2018.

  2. "Medicare Provider Utilization and Payment Data: Physician and Other Supplier," , opens new window CMS.gov, last accessed December, 2018.

  3. "Humana proprietary internal analysis," 2014.