Quick Start
Why this dashboard exists: Humana is tying admin fees to quality. The top 25% of agencies get an increase, the middle 50% see no change, and the bottom 25% get a decrease. You share in the upside and the downside. (See: Why This Dashboard Exists)
What this dashboard is for: A view of how you and your downline agents are performing on the four quality metrics Humana uses to evaluate your agency, and what to work on to improve. (See: What This Dashboard Is For)
Where to find it: You can access the dashboard from the “Performance” tab on the left-hand panel. (See: Accessing The Dashboard)
Navigating the dashboard: Pre-AEP Tracking (where you stand calendar year to date), AEP Tracking (how AEP is going, live from 10/15), and Action Items (what you can do today to manage your metrics). (See: Navigating The Dashboard)
Want to see your agents? Pre-AEP Tracking and AEP Tracking both include an agent-level view showing how each downline agent is performing, so you can see who needs coaching. (See: the tab sections)
Which tab, when? Before 10/15, use Pre-AEP Tracking to set your focus areas. From 10/15, use AEP Tracking for ongoing progress and Action Items to manage the metrics you can still influence. |
Why This Dashboard Exists
Humana is introducing quality-based changes to admin payments. This affects Spark and every other top-of-hierarchy Humana works with, and other carriers are expected to introduce similar quality-based financial incentives over time.
In response, Spark is rolling out a new set of tools and reporting to help everyone manage quality proactively rather than finding out after the fact. This dashboard gives you visibility into a quality standing that has real financial consequences, early enough to act on it.
What This Dashboard Is For
This dashboard tracks how you and your downline agents are performing on the specific quality metrics Humana uses to evaluate agencies: how many members disenroll quickly, whether required health surveys get completed, how often complaints are escalated, and whether members are choosing top-performing providers.
It is built to help you answer three questions: Where do I stand today? How are my agents performing? What can I do about it?
Draft notice
This dashboard is still in draft. Some tables, charts, or layout details may change before it is finalized, but the metrics themselves and how they are calculated, as described in this guide, will stay the same. |
Understanding Your Score: The Four Metrics
Every agency and agent is scored on four metrics, which are the same 4 metrics Humana is holding their direct partners accountable to. Each metric carries a different weight in the overall score. Rapid Disenrollment carries the most weight and has the single biggest impact on your score.
Metric | Weight | What it means |
Rapid Disenrollment Rate (RDR) | 40% | The share of enrollments that disenroll quickly after signing up, shown as a percentage of new applications (not total applications). Lower is better. |
HRA Completion Rate | 30% | For Special Needs Plan (SNP) members, a Health Risk Assessment, a short required health survey, must be completed after enrollment. This shows the share of your total applications that had the survey completed. Higher is better. |
CTM Rate | 20% | CTMs are formal complaints escalated directly to CMS, the government's Medicare oversight agency, and are the most serious kind of complaint. Shown per 1,000 total applications so agencies of different sizes can be compared fairly. Lower is better. |
TPP Rate | 10% | The percentage of applications where the member's primary care provider is a Top Performing Provider (TPP) under Humana's definition, a provider recognized for quality ("Hearts") and cost ("Badges"), which Humana calls "Care Highlights" in its Find-a-Doctor tool. Higher is better. |
Why you will see "PCP on App %" used as a proxy for TPP
TPP stands for Top Performing Provider: the percentage of applications with a provider designated as top performing by Humana's definition. The first step toward a TPP is having a PCP on the application at all.
That is why the dashboard uses PCP on App % as a proxy. The two are related, PCP on App is highly controllable, and Spark can provide that data in near real time. Improving PCP on App is the most direct first step toward improving your TPP rate. |
Accessing The Dashboard
You can access the dashboard from the “Performance” tab on the left-hand panel.
Navigate to the left-hand panel, click on “Performance”
At the top of the refreshed page, click on “Humana Quality Metrics”
Navigating The Dashboard
The dashboard has three main tabs. Each section below explains what the tab is for, when to use it, what you will see, and where its data comes from.
Which tab should I use?
Tab | Use it to... | Availability |
Pre-AEP Tracking | See where you stand calendar year to date and identify focus areas going into AEP. | Available now. Stays available after AEP starts but no longer updates. |
AEP Tracking | See how things are going during AEP. | Starts 10/15. Shows no data until then. |
Action Items | See what you can do to manage your metrics today. | Available now. Covers HRA and PCP on App; RDR and CTM views coming soon. |
1. Pre-AEP Tracking
What it is for
Pre-AEP Tracking helps Agency Principals understand where they stand calendar year to date leading into AEP, so you can identify focus areas before the enrollment period begins.
This matters because CTM and RDR lag. Once AEP is underway, it will be hard to get a read on them, so the best time to understand your position is before it starts.
When to use it
Before 10/15, to set priorities and focus areas for AEP.
After 10/15, as a fixed reference point for where you stood going into AEP. It remains available after AEP starts but will not update.
What you will see
Agency-level performance on each of the four metrics, calendar year to date.
Score Driver Analysis: identifies which metric is holding your agency back the most and what to target
Agent-level view: see how each agent under you is performing on the same four metrics, so you can spot who needs coaching or attention before it shows up in your agency-wide number.
Where this data comes from
Humana sends Spark a new quality report (the HARP file) every two weeks. Every metric on this tab, Rapid Disenrollment, HRA Completion, CTM Rate, and TPP, is calculated by Humana at the individual agent level, using Humana's own methodology and their own view of your applications. Spark then rolls those agent-level numbers up to the agency level using a weighted average, so larger agents' numbers count proportionally more toward the agency total.
The only exception is PCP on App %, which comes from Sunfire data.
Why numbers may differ from other Spark reports
Because these figures are Humana's own calculations, not numbers pulled fresh from Spark's systems, they may not exactly match similar-looking metrics elsewhere on the Spark platform. Small differences are expected and usually reflect differences in timing, methodology, or how Humana defines a metric versus how Spark calculates it internally. |
2. AEP Tracking
What it is for
AEP Tracking gives you visibility into how things are going during AEP. It is a copy of what you see in Pre-AEP Tracking, but it shows only AEP-period activity, so you can track progress during a time when CTM and RDR are difficult to read.
When to use it
Starting 10/15, when AEP begins. The tab will not show data before then.
Alongside Pre-AEP Tracking, to compare AEP progress against where you started.
Expect a blank tab until 10/15
AEP Tracking is intentionally empty until AEP starts. This is not an error. Data will begin to appear after 10/15. |
What you will see
The same layout, filters, and metrics as Pre-AEP Tracking. See Pre-AEP Tracking above for a walkthrough of each element.
Agency-level performance on the four metrics during AEP.
Agent-level view: the same agent-level view as Pre-AEP Tracking, so you can see how each downline agent is performing during AEP.
Where this data comes from
Same source as Pre-AEP Tracking: Humana's biweekly quality report (HARP), calculated by Humana at the agent level and rolled up to the agency level by Spark using a weighted average. Humana has committed to biweekly updates of this data during AEP.
The only exception is PCP on App %, which comes from Sunfire data.
As with all HARP-based data, figures may differ slightly from similar metrics elsewhere on the Spark platform because of Humana's methodology and timing.
3. Action Items
What it is for
Action Items tells you what you can do to manage your metrics. It focuses on the metrics you have the most control over, and where Spark can provide data in near real time.
What is available today
HRA Completion: identify agents/applications that need an HRA completed so you and your agents can follow up.
PCP on App: view applications where a PCP was not selected, as a first step toward improving your TPP rate.
Coming soon
Views for RDR and CTM will be added soon. We will let you know when they are available.
Where this data comes from
This data is extracted from Sunfire on a minimum daily basis to enable you to keep a pulse on these metrics.
Quick Tips
Use Pre-AEP Tracking before 10/15 to choose focus areas, since CTM and RDR will be hard to read once AEP starts.
Use the agent-level view in Pre-AEP and AEP Tracking to find which agents need coaching.
Use Action Items to manage HRA completion and PCP on App while you can still influence them.
This dashboard is a draft. Expect some refinement to the layout as it is finalized.
Glossary of Terms
Term | What it means |
AEP | Annual Enrollment Period for Medicare, beginning 10/15. |
AP | Agency Principal: the person in charge of an agency's downline agents. |
NPN | National Producer Number: an agent's or agency's official license ID. |
CTM | Complaint Tracking Module: a formal complaint escalated directly to CMS. |
HRA | Health Risk Assessment: a required health survey for Special Needs Plan (SNP) enrollees. |
RDR | Rapid Disenrollment Rate: the share of enrollments that cancel shortly after signing up. |
TPP | Top Performing Provider: the share of applications where the member's PCP is designated top performing by Humana's definition (quality "Hearts" and cost "Badges"). |
PCP on App % | The share of applications with a primary care provider on the application. Used on this dashboard as a proxy for TPP because it is a first step toward TPP, highly controllable, and available in near real time. |
SNP | Special Needs Plan: a type of Medicare Advantage plan for members with specific health or financial needs. |
HARP | Humana's periodic quality report file that feeds the metrics on this dashboard. |
1FT / 2FT / 3FT | "One / Two / Three From Top": which level of your organization a row represents. 1FT shows numbers rolled up to the AP directly above each agent; 2FT and 3FT show the same agents' numbers rolled up further up the chain, if you have sub-agencies. |