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Healthcare Effectiveness Data and Information Set (HEDIS)

HEDIS is a widely used set of performance measures in the managed care industry. Humana Military works with providers to improve the HEDIS scores of TRICARE beneficiaries.

Low back pain

This measure calculates the rate of adults between the ages of 18-50 enrolled in TRICARE Prime/Plus with a primary diagnosis of low back pain who did not have an imaging study (plain X-ray, MRI, CT scan) within 28 days of the diagnosis. A higher rate reflects appropriate treatment and better performance. Learn more

Children with Upper Respiratory Infection (URI)

Testing assesses children three months to 18 years of age who were given a diagnosis of upper respiratory infection (URI) and were not dispensed an antibiotic prescription. A higher rate indicates appropriate treatment of children with URI (i.e., the proportion for whom antibiotics were not prescribed). Learn more

Appropriate testing for children with pharyngitis

Testing assesses children two to 18 years of age who were diagnosed with pharyngitis, dispensed an antibiotic and received a group A streptococcus test. A higher rate represents better performance (i.e., appropriate testing). Learn more

Antibiotic medications are widely used in the treatment and prevention of
bacteria. However, antibiotics are not always needed for common illnesses such
as sinus infections, sore throats, ear infections, etc.

Learn more