Contract
H4461

Humana · 2027 Star Ratings

CARITEN HEALTH PLAN INC. · Local CCP · offers special needs plans

Parent: Humana Inc.

Summary ratings

Overall
4.5
2026: 4.0+0.5
Part C · health plan
4.5
2026: 4.0+0.5
Part D · drug plan
4.5
2026: 3.0+1.5

2027 footprint

Members, Sep 2026
388K
2027 plans
53
Open to all ($0 premium)
35 (27)
Counties
303
Special needs plans
Chronic or Disabling Condition, Dual-Eligible
Drug coverage
Yes
ALAZILKSMONMTNTX

Domain stars

Domain20272026Change
HD1Staying Healthy: Screenings, Tests and Vaccines3.03.0±0
HD2Managing Chronic (Long Term) Conditions4.04.0±0
HD3Member Experience with Health Plan5.05.0±0
HD4Member Complaints and Changes in the Health Plan's Performance5.04.0+1.0
HD5Health Plan Customer Service5.04.0+1.0
DD1Drug Plan Customer Service5.05.0±0
DD2Member Complaints and Changes in the Drug Plan's Performance5.03.0+2.0
DD3Member Experience with the Drug Plan5.05.0±0
DD4Drug Safety and Accuracy of Drug Pricing3.03.0±0

Part C measures · health plan

Measure2027 result2027 starsvs 2026
C01Breast Cancer Screening79%4.0±0
C02Colorectal Cancer Screening81%4.0new spec
C03Annual Flu Vaccine67%4.0+2
C04Improving or Maintaining Physical Health67%2.0−3
C05Improving or Maintaining Mental Health83%3.0+2
C06Monitoring Physical Activity48%2.0±0
C07Special Needs Plan (SNP) Care Management85%4.0±0
C08Care for Older Adults – Medication Review98%4.0−1
C09Care for Older Adults - Functional Status Assessment97%5.0—
C10Osteoporosis Management in Women who had a Fracture59%4.0+1
C11Diabetes Care – Eye Exam82%4.0−1
C12Diabetes Care – Blood Sugar Controlled91%4.0±0
C13Kidney Health Evaluation for Patients with Diabetes75%4.0±0
C14Controlling High Blood Pressure87%4.0±0
C15Reducing the Risk of Falling66%4.0±0
C16Improving Bladder Control42%2.0−1
C17Plan All-Cause Readmissions10%4.0+1
C18Statin Therapy for Patients with Cardiovascular Disease90%4.0+1
C19Transitions of Care74%4.0+1
C20Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions72%4.0+1
C21Getting Needed Care865.0±0
C22Getting Appointments and Care Quickly885.0±0
C23Customer Service914.0±0
C24Rating of Health Care Quality905.0±0
C25Rating of Health Plan905.0±0
C26Care Coordination895.0±0
C27Complaints about the Health Plan0.155.0+1
C28Members Choosing to Leave the Plan12%4.0±0
C29Health Plan Quality ImprovementNot enough data available—
C30Plan Makes Timely Decisions about Appeals100%5.0+2
C31Reviewing Appeals Decisions99%4.0±0
C32Call Center – Foreign Language Interpreter and TTY Availability100%5.0±0

Part D measures · drug plan

Measure2027 result2027 starsvs 2026
D01Call Center – Foreign Language Interpreter and TTY Availability100%5.0±0
D02Complaints about the Drug Plan0.155.0+1
D03Members Choosing to Leave the Plan12%4.0±0
D04Drug Plan Quality ImprovementNot enough data available—
D05Rating of Drug Plan905.0±0
D06Getting Needed Prescription Drugs915.0±0
D07MPF Price Accuracy941.0±0
D08Medication Adherence for Diabetes Medications90%3.0+1
D09Medication Adherence for Hypertension (RAS antagonists)91%4.0+1
D10Medication Adherence for Cholesterol (Statins)91%4.0+1
D11Statin Use in Persons with Diabetes (SUPD)88%3.0±0
D12Concurrent Use of Opioids and Benzodiazepines (COB)12%4.0—
D13Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)4%5.0—

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