TRICARE providers

Care management

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

Blue Button

Humana Military is pleased to announce the addition of the Blue Button application to enhance communication between TRICARE beneficiaries and their providers. Beneficiaries now have easy access to their Electronic Health Records (EHR) through Blue Button, a web tool available on beneficiary self-service. This information can be printed and shared with you and other members of the beneficiary’s healthcare team. Blue Button maintains information such as diagnoses, medications, Care Considerations, medical procedures, lab results and referrals and authorizations in one convenient location.

Care Considerations & provider feedback

Humana Military is excited to offer a care management program for TRICARE Prime beneficiaries with recommendations about potential clinical risks, gaps in care and opportunities for improving beneficiary healthcare known as Care Considerations. Humana Military is partnering with ActiveHealth Management®, a leading provider of health management services, to help identify gaps in care in order to improve clinical outcomes. Using a data mining tool called CareEngine®, ActiveHealth Management will aggregate and analyze medical claims, lab results, pharmacy and self-reported data.

Once beneficiaries with gaps in care are identified, Humana Military will reach out to both the beneficiary and their provider with individualized Care Considerations to encourage actions to improve their healthcare. The physician-focused Care Consideration explains the issue discovered, includes the evidence-based citation to medical literature and suggests a recommendation.

Feedback on Care Considerations is used to update ActiveHealth CareEngine®, ensuring future recommendations are accurate, so we encourage you to provide your comments to this care management program! Your input also provides information not available from claims, such as drug allergies or a procedure that is not appropriate. Instructions on providing feedback are available on the consideration message. Provide feedback now

Humana Military is eager to provide this opportunity to partner with you to improve health outcomes in our TRICARE population. Thank you for your participation in the TRICARE program and for helping us ensure these beneficiaries receive the best possible care.

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.

Disease management

Humana Military assists beneficiaries with managing chronic diseases to improve their health. Eligible beneficiaries in the TRICARE East 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. Learn more

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 but not limited to, comprehensive diabetes care, breast cancer screenings, cervical cancer screenings and colorectal screenings.

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. Learn more

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, a healthier population, lower healthcare costs and increased patient satisfaction—all of which will help TRICARE remain a U.S. healthcare leader. Learn more