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EQuIPP® Optimizing your opportunities with Humana

16 Apr

EQuIPP® Optimizing your opportunities with Humana

“The improvement of understanding is for two ends: first, our own increase of knowledge; secondly, to enable us to deliver that knowledge to others.” – John Locke (1632-1704)

If your pharmacy has logged into EQuIPP® this month you may have already seen some important updates with the Humana Quality Network in your My Programs Tab. Before we go into those details, let’s cover the basics of the My Programs Tab and where to find details on the Humana Quality Network. Then, we can jump into understanding the new details provided and how this can improve your pharmacy team’s knowledge-base related to this payer program.

My Programs Tab

When logging into EQuIPP®, the default is to show the “Performance Dashboard”. This is where most pharmacists and pharmacy technicians will go to view performance program details (via the Analyze Performance button) or outliers (via the Outliers button). However, to the right of the tab for “Performance Dashboard” there are several other tabs. The most important of these tabs is the “My Programs” which allows you to see additional details for payer programs. This may provide clarity and comprehensive details regarding the measures that are included for specific payer programs, but it may also provide details such as performance thresholds, and in some cases, financial estimates for the program.

Humana Quality Network

The Humana Quality Network is one such program that provides additional program details for pharmacies via the My Programs Tab. The image below is an example of a pharmacy dashboard and how this may appear for your pharmacy. Please note, that as the program has changed there may be different listings for the Humana My Programs. Be sure to review the dashboard for either the Traditional or Specialty program for the 2021 year!

April 2021 Outlier Updates for the Humana Quality Network

When you view the page for the Humana My Programs it will provide a litany of details on the program design, timeline, and measures to track for the program! At the bottom of this page there is also Program Measures table that provides you patient count, performance scores and outliers available for the program.

Beginning 04/09/2021, Humana’s outliers will be updated weekly and will reflect those patients that are outliers based on the latest 2021 calendar year data!

These patients are identified as outliers based on data from January 1, 2021 up until the Sunday that is prior to the outliers being posted. For example, the outliers available from 04/09/2021 – 04/15/2021 would be based on a measurement period of January 1, 2021 – April 4, 2021. This means the number of outliers available may not match with the expected outliers for the measurement period that is seen in the “My Programs” or in the “Performance Dashboard”.

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Nick Dorich

Nicholas Dorich, PharmD is the Senior Mgr., Pharmacy Accounts for Pharmacy Quality Solutions. His team works directly with pharmacy organizations representing more than 60,000 pharmacies in the United States. Nicholas’ passion in the pharmacy profession includes expanding clinical services for pharmacists and recognition for pharmacists as an integrated member of the patient care team.