Contract
H4623

Humana · 2027 Star Ratings

HUMANA REGIONAL HEALTH PLAN, INC. · Local CCP

Parent: Humana Inc.

Summary ratings

Overall
4.0
2026: 3.5+0.5
Part C · health plan
4.0
2026: 3.5+0.5
Part D · drug plan
4.5
2026: 3.5+1.0

2027 footprint

Members, Sep 2026
11K
2027 plans
2
Open to all ($0 premium)
2 (2)
Counties
22
Special needs plans
None
Drug coverage
Yes
MO

Domain stars

Domain20272026Change
HD1Staying Healthy: Screenings, Tests and Vaccines3.03.0±0
HD2Managing Chronic (Long Term) Conditions4.04.0±0
HD3Member Experience with Health Plan4.03.0+1.0
HD4Member Complaints and Changes in the Health Plan's Performance4.03.0+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 Performance4.04.0±0
DD3Member Experience with the Drug Plan5.03.0+2.0
DD4Drug Safety and Accuracy of Drug Pricing3.03.0±0

Part C measures · health plan

Measure2027 result2027 starsvs 2026
C01Breast Cancer Screening70%3.0+1
C02Colorectal Cancer Screening75%4.0new spec
C03Annual Flu Vaccine64%3.0+1
C04Improving or Maintaining Physical Health64%1.0−1
C05Improving or Maintaining Mental Health84%3.0−1
C06Monitoring Physical Activity47%2.0−1
C07Special Needs Plan (SNP) Care ManagementPlan not required to report measure—
C08Care for Older Adults – Medication ReviewPlan not required to report measure—
C09Care for Older Adults - Functional Status AssessmentPlan not required to report measure—
C10Osteoporosis Management in Women who had a Fracture40%2.0−1
C11Diabetes Care – Eye Exam79%4.0±0
C12Diabetes Care – Blood Sugar Controlled91%4.0±0
C13Kidney Health Evaluation for Patients with Diabetes78%4.0±0
C14Controlling High Blood Pressure88%4.0+1
C15Reducing the Risk of Falling58%3.0+1
C16Improving Bladder Control45%3.0+1
C17Plan All-Cause Readmissions10%4.0+1
C18Statin Therapy for Patients with Cardiovascular Disease88%3.0±0
C19Transitions of Care82%5.0±0
C20Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions71%3.0−1
C21Getting Needed Care834.0+1
C22Getting Appointments and Care Quickly854.0+1
C23Customer Service924.0+1
C24Rating of Health Care Quality874.0+1
C25Rating of Health Plan832.0±0
C26Care Coordination884.0±0
C27Complaints about the Health Plan0.115.0±0
C28Members Choosing to Leave the Plan24%3.0±0
C29Health Plan Quality ImprovementMedicare shows only a Star Rating for this topic4.0+2
C30Plan Makes Timely Decisions about Appeals99%4.0±0
C31Reviewing Appeals Decisions100%5.0+1
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 Plan0.115.0±0
D03Members Choosing to Leave the Plan24%3.0±0
D04Drug Plan Quality ImprovementMedicare shows only a Star Rating for this topic5.0+2
D05Rating of Drug Plan874.0+2
D06Getting Needed Prescription Drugs925.0+1
D07MPF Price Accuracy951.0±0
D08Medication Adherence for Diabetes Medications91%4.0+1
D09Medication Adherence for Hypertension (RAS antagonists)92%4.0±0
D10Medication Adherence for Cholesterol (Statins)92%4.0±0
D11Statin Use in Persons with Diabetes (SUPD)86%2.0−1
D12Concurrent Use of Opioids and Benzodiazepines (COB)13%3.0—
D13Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)6%4.0—

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