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.

Breast cancer

Breast cancer is the most common invasive cancer in women. The five-year survival rate of breast cancer is over 90% when caught early.

Cervical cancer

By getting regular Pap tests, cervical cancer can be found early and sometimes prevented entirely. If detected early, cervical cancer is one of the most successfully treated cancers.

Colorectal cancer

Colorectal cancer usually develops from precancerous, abnormal growths in the colon or rectum. Screening tests can find these abnormal growths so they can be removed before they turn into cancer.

Diabetes test

More than 30 million people in the United States have diabetes, and one in four of them don’t know they have it. Over 1/3rd of adults have prediabetes and 90% of those are unaware they have it.

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 within 28 days of the diagnosis. A higher rate reflects appropriate treatment and better performance.

Appropriate Treatment for Upper Respiratory Infection (URI)

Assesses the percentage of episodes for beneficiaries three months of age and older with a diagnosis of Upper Respiratory Infection (URI) that did not result in an antibiotic dispensing event. A higher rate indicates appropriate treatment for URI (i.e., the percentage of episodes that were not prescribed an antibiotic).

Appropriate testing with pharyngitis (CWP)

Assesses the percentage of episodes for beneficiaries three years of age and older with a diagnosis of pharyngitis, dispensed an antibiotic and received a group A streptococcus test for the episode. A higher rate indicates completion of the appropriate testing required to merit antibiotic treatment for pharyngitis.