Please review these threads thoroughly. There is a LOT of corruption, coercion, harassment, stalking and lack of actual patient care at Humana. Every word we speak has to pretty much be a "talking point" and all talking points lead to Humana making profit and certainly not with the patient/members best interest. Nurses will get in trouble for say addressing and educating about a recent heart attack (just as a very small example of the broader issue), yet not offering mail order pharmacy or not scheduling their annual wellness visit during the same call when clearly managing health post heart attack is priority...as well as if we don't address stars...you know, all those stars measures they stopped caring about years ago until what, March of this year?
11 replies (most recent on top)
@rb wow... This is eye opening. Tell me where to get/read this information. Yes, we are doing it all wrong! What a waste of time! Where can I find this info? Thx!
@rb - 💯💯💯💯💯💯💯
There's a lot more detail to this and they just don't really teach how to actually do any of it correctly but claim they are to try and get the STARS back. It will not work. It needs to be done correctly and charted correctly and not half-assed liked they are attempting to do with that bullsh-t charting. They will be laughed out of the room once again. Once again we see it and they are blind mice chasing their tails.
@kq Nope lol
They didn't tell you that the two BPs to get the lowest level have to be between
• <140/90 mm Hg.
• <130/80 mm Hg.
Only.
And age cannot be above 85 did they?
@fw That's insane!
@ar For NCQA or CMS Stars, you are allowed to mix and match the lowest systolic and lowest diastolic as long as they are taken on the same date of service. Therefore, creating a BP reading that doesn't even exist. Let's hypothetically say the AM was 175/80 and PM was 130/90, the BP that gets reported would be 130/80 since those are the two lowest of the day even though the patient's actual BP was never 130/80 at either reading.
@am I believe you have inspired me to do the same.
@ar - I guess that COULD be what Stars wants but I seriously doubt it.
@am - good to know! Another thing that doesn't set right in regards to Stars measures, is that they want us to assess BP every call (which is great in itself of course), however the problem lies in that they only want us to chart the lowest BP measure for that day. So if someone tells me AM BP was 175/96 and PM BP 133/72, I am told to chart the low BP for the stars measure. It's cr-p! Obviously I still educate and intervene by calling the Dr, and I do also chart the high reading as well. It just isn't right!
@OP Many of these agencies will accept anonymous reports. I sent some PROOF to Medicaid just last week. Let the good times roll.