Network Provider Transparency

Transparency of Cost and Quality Information

• Federal health programs to promote transparency regarding health care quality and price
• Making relevant information available to beneficiaries and providers

Read Executive Order 13410  

The Department of Defense TRICARE Management Activity requested Humana Military Healthcare Services to support the executive order and to make cost and quality information available to referring military doctors.

In Fall of 2007 Humana Military will enable network providers to view information about their practices.  The information relates only to care of TRICARE beneficiaries.  It includes:

• Administrative Quality
  • Compliance with government requirement to submit TRICARE claims electronically
  • Compliance with government requirement to return consultation reports for patients enrolled to Military Treatment Facilities
  • Beneficiary complaints
               
• Practice Affordability
  • Provider’s average allowed charges for common Episodes of Care

After a review period, providers will be able to opt out of this initiative altogether if they choose.  HMHS plans to allow Military Treatment Facility (MTF) providers in the TRICARE South Region to view a summary of these measures.  The summary will be in the form of stars depicting relative performance in the two categories, Administrative Quality and Practice Affordability.

Humana Military currently does not plan to make provider specific information on these measures available to beneficiaries or the public.

To learn more about this initiative please log in to MyHMHS for Providers.