Our Commitment to Quality Care

April 19, 2016

Our commitment to quality care has been, and always will be, strong.

Dear Agent,

Over the years, we have talked to you about our commitment to quality care for our Humana members. It’s our ongoing mission and focus day-in/day-out. With that in mind, we want to share some thoughts with you on our recent STARs results.

We feel that our most recent Star quality ratings for the 2018 plan year published by the Centers for Medicare and Medicaid Services (CMS) are not an accurate representation of that commitment to quality. As a response, we intend to file for reconsideration in order to secure a more accurate Star representation of our product quality.

It’s also important to know that our 2017 product offering is strong and Star ratings do not reflect the value proposition our PPO plans provide our Medicare beneficiaries.

Humana Believes:

  • Bonus Year 2018 Star Results do not fully reflect Humana’s focus on quality care for our members
  • Humana believes strongly in the universal benefits of the Integrated Care Delivery Model

Humana Provides Quality Care for Members:

  • Our HEDIS quality score, demonstrating the achievement of clinical outcomes, is at a record-high(HEDIS is a tool used by more than 90 percent of America’s health plans to measure performance on important dimensions of care and service).
  • Our clinical engagement helps bend medical cost trends and effectively enables our senior members to age with grace in their homes. Examples of clinical programs: Humana Chronic Care Program, Humana At Home, Transitions, Special Needs Programs, StayHealthy, and Remote Monitoring.
  • Clinical programs lead to higher-quality experience for members:
    • Humana Chronic Care Program results in 46% fewer hospital admissions
    • Transitions Program results in 36% reduction in hospital readmissions
    • Preventive screenings, like regular physical exams, cancer checks, and flu and pneumonia shots, are just one way we help our members improve their health
  • Our provider value-based care engagement covers 61% of individual MAPD members. Value-based care means better quality to help outcomes, with lower cost for people with Medicare.
  • Savings from higher-quality outcomes lead to lower cost of care enabling Humana to offer additional benefits for our members.

More people stick with Humana Medicare Advantage plans.

Based on the 2016 report, “Senior Shopping and Switching,” fewer people voluntarily left Humana Medicare Advantage plans during the 2015 annual election period than the industry average — Humana offers you the opportunity to start your clients with the plans more people stay with.

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