Humana Military Provider

Care management

Humana Military cares about the health of our TRICARE beneficiaries, and we offer several programs designed to help improve and sustain patients' health.

Case management

Humana Military nurses provide case management services to TRICARE beneficiaries with intricate health needs. If you have a patient with a complex case whom you think may benefit from case management, please refer the beneficiary for these services to Humana Military.

Disease management

Humana Military assists beneficiaries with managing chronic diseases to improve their health. Eligible beneficiaries in the TRICARE South Region are under age 65, not eligible for Medicare and living with heart failure, asthma, chronic obstructive pulmonary disease, diabetes, major depression or anxiety disorders. Registered nurses work with the beneficiaries and their physicians to identify problems, establish goals and monitor progress through regular follow-up care.

MyActiveHealth

Humana Military has partnered with ActiveHealth Management to offer the MyActiveHealth portal, a website for TRICARE Prime beneficiaries enrolled with a civilian Primary Care Manager (PCM) to help improve their health and better manage any chronic health conditions. MyActiveHealth gives beneficiaries a secure way to store their health information, health data and medical history securely, and it offers a variety of health resources and tools.

HEDIS® performance measures

The Department of Defense (DOD) has challenged Humana Military to collaborate with its network providers to improve the Healthcare Effectiveness Data and Information Set (HEDIS) scores of TRICARE beneficiaries. HEDIS is a widely used set of performance measures in the managed care industry, developed and maintained by the National Committee for Quality Assurance (NCQA).

The HEDIS performance measures address a broad range of important health issues, including:

  • Comprehensive diabetes care
  • Breast cancer screening
  • Cervical cancer screening
  • Colorectal screening

In addition, HEDIS scores share the same goals with the Care Considerations you may receive from Humana Military about your patients. Care Considerations alert providers and beneficiaries about specific health concerns, including needed preventive screenings. When patients schedule and receive screenings or take other steps to better manage their health, their HEDIS scores rise.

Care considerations & provider feedback

Humana Military has partnered with ActiveHealth Management® to help TRICARE beneficiaries improve their health and better manage chronic health conditions. ActiveHealth Management analyzes medical claims, lab results, pharmacy, and self-reported data, to identify potential gaps in care.

We’re sharing this information by sending Care Considerations to TRICARE beneficiaries and their providers. Providers can use these Care Considerations to begin a dialogue with patients to encourage them to take a more active role in maintaining their health as well as seek needed preventive care services.

We’re also asking you to provide feedback regarding your patients’ Care Considerations. Submitting feedback helps incorporate important patient information that claims data can’t supply, such as drug intolerance or allergies. Such information can help increase the accuracy of future recommendations for the patient and help them improve their health and wellness overall.

It only takes a minute to offer feedback on Care Considerations . You can provide it here on the web, or you can fax your Care Consideration to the number provided on the form.

Healthy People 2020

In January 2000, the Department of Health and Human Services launched Healthy People 2010, a comprehensive, nationwide health promotion and disease prevention agenda. This initiative contains 467 objectives designed to serve as a road map for improving the health of all people in the United States. We have moved toward Healthy People 2020.

A limited set of the objectives, known as the leading health indicators , are intended to help everyone more easily understand the importance of health promotion and disease prevention and to encourage wide participation in improving health in the next decade. These Indicators were chosen based on their ability to motivate action, the availability of data to measure their progress, and their relevance as broad public health issues.

Consider the impact you can have on TRICARE beneficiaries’ overall health and wellness by implementing health promotion programs and prevention education around these Leading Health Indicators. Coupled with your continued focus on high-quality medical intervention for disease and injury, such programming can really make a difference.

The end results will be improved military readiness, make for a healthier population, lower health care costs and increase patient satisfaction—all of which will help TRICARE remain a U.S. health care leader. For more information on Healthy People 2010 - 2020 objectives or if you would like to become a Healthy People 2010 - 2020 partner, visit HealthyPeople.gov or call 1-800-367-4725.