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Managed Care November 1999 Peter I. Juhn, M.D.	An Evidence-Based Approach To Care Depends on All Parties -- Physicians Included ...transforming the delivery of care into a systematic approach that is based on the best medical evidence -- is dependent on more than just laying out the rules...
Managed Care June 2001 Frank Diamond	HMO/Physician Strain Creates Invisible Costs Perhaps goodwill is too much to ask for. However, peaceful coexistence can certainly help all players reach their mutual goal -- a smooth relationship that helps to get the job done...
Managed Care November 1999 Margaret E. O'Kane	Quality-Measurement Organizations Look Beyond HMO and POS Plans Now that the hard part -- forging quality-measurement systems for HMOs and point-of-service plans -- has been done, the next step is to adapt these programs to the rest of the health care industry....
Managed Care November 1999 Karen Ignagni	Health Plans Will Use New Tools To Help Physicians Practice Better For the first time, plans are in a position to work with physicians to improve outcomes, efficiency, and patient safety....
Managed Care March 2007 Tom Reinke	NCQA Shifts Focus On Physician Performance NCQA's 2007 HEDIS physician performance manual puts greater emphasis on cost of care. Many organizations, including some health plans, use these specifications to evaluate physician performance.
Managed Care May 2003 Martin Sipkoff	Working Together on the Medical Side Partly because of employers' demands, health plans are starting to cooperate in ways that improve care.
Managed Care February 2001 Michael S. Victoroff	Helping Patients Make Informed Decisions Now Harder Thanks to Range of Treatment The duty of informed consent necessitates that physicians discuss with their patients the realistic expectations and risks associated with treatment. When no protocol shows a distinct advantage, there is no duty to inform, which creates an ethical problem for physicians...
Managed Care May 2000 Mark G. Weiner, M.D., and Eric Pifer, M.D.	Computerized Decision Support and the Quality of Care The notion of quality of care in medicine is not new, but it is becoming increasingly important as the competitive health care market demands objective measures to compare physicians, hospitals, and managed care organizations....
Managed Care January 2004 Martin Sipkoff	Transparency Called Key To Uniting Cost Control, Quality Improvement NCQA President Margaret O'Kane and a panel of clinically oriented administrators call for emphasis on making the best care financially attractive to physicians, plans, and employers.
Managed Care August 2004 Bob Carlson	Preparing for NCQA: What Not To Do Deciding to seek NCQA accreditation sets an HMO up for lots of preparatory work. Make sure the effort is well spent.
Managed Care January 2001	HealthPartners Sets Ambitious Member Goals Minneapolis-based HealthPartners is rolling out the next phase of its Partners for Better Health Program. New measures include outcomes standards for reduction of heart attacks, depression, and diabetes-related complications in its 660,000 members...
Managed Care July 2001 Harry L. Leider	HMOs Need To Share Gains of DM Programs Physicians are more likely to buy in if they see better outcomes -- and financial rewards that go with them...
Managed Care June 2005 Martin Sipkoff	The Re-Emergence of the Primary Care Physician A new model of care developed by the American Academy of Family Physicians places primary care physicians back at the center of care delivery.
Managed Care September 2001 Jack McCain	Minnesota Buyers Coalition Back On Feet, Plans Expansion An employer group called Minnesota's Buyers Health Care Action Group (BHCAG) tries to contract directly with local groups of health care providers. After setbacks, they're still at it...
Managed Care September 1999	Physicians Seen As Next in Line For NCQA Review The National Committee for Quality Assurance says it will begin an accreditation program for medical groups two years from now....
Managed Care March 2001 Michael D. Dalzell	Preventive Care: Can We Do a Better Job? HMOs place great stock in disease prevention, but some highly recommended services go uncovered. Plans and purchasers often don't agree on priorities...
American Family Physician November 1, 2000 Allen L. Hixon & Ronald W. Chapman	Medicine and Society Healthy People 2010: The Role of Family Physicians in Addressing Health Disparities...
Managed Care November 2000 Bob Carlson	E-Health's Greener Pastures The trend is unmistakable: Physician executives are leaving their high-pressure, high-paying jobs at health plans, and are starting from scratch in the nascent e-health industry. The lure? A chance to leave their mark on something...
Managed Care August 2005	NCQA Compares Plans On Chronic Disease The National Committee for Quality Assurance plans to offer a snapshot based on its well-known HEDIS report that it hopes will let employers and workers get a quick, but comprehensive, view of how health plans handle four chronic diseases.
Managed Care April 2001	Purchasers Still Not Focused On Quality, Says Business Group It's a common lament that all but the biggest companies buy health benefits primarily on the basis of price, not quality. New findings by the Washington Business Group on Health back up that assertion...
Managed Care July 2003 MargaretAnn Cross	Money Pit: Is Accreditation Always Worth the Cost? Some plans swear by the benefits of obtaining an "excellent." Others say that customers care much more about cost.
Managed Care October 2001 Frank Diamond	Indirect Costs: Asking plans to keep employees on the job Employers in revolt against fast-rising premiums could ask HMOs to pay more attention to time-loss management. NCQA's interest may encourage this approach...
Managed Care October 2002 MargaretAnn Cross	Tracking Disparities in Care Having employer-sponsored benefits does not guarantee good service. Differences in race, education, and income are also factors.
Managed Care May 2003	Program Rewards Physicians For Delivering High-Quality Care Bonuses for delivering high quality care will be the focus of a three-market program spearheaded by the National Committee for Quality Assurance and supported by a coalition of physicians, health plans, large employers, and the Centers for Medicare and Medicaid Services.
Managed Care September 2004	O'Kane Gives the OK To Focus More on Providers The head of the National Committee for Quality Assurance, Margaret E. O'Kane, says health plans want to encourage physicians in the never-ending quest for quality.
Managed Care June 2007 MargaretAnn Cross	What the Primary Care Physician Shortage Means for Health Plans Insurers fear rising costs and poorer outcomes if members are less able to get appointments with family physicians and general internists.
Managed Care August 2001	Four Views of Managed Care Ethics The evolution of managed care has posed ethical problems for physicians, plan administrators, and even patients. Four ethicists find that questions are many, while satisfactory answers are in short supply...
Managed Care April 2000	NCQA To Put Report Cards On the Web The National Committee for Quality Assurance hopes to elevate the degree to which quality of care factors into people's choice of health plans. NCQA is placing health plan report cards on its web site...
Managed Care December 2003 Margaret E. O'Kane	NCQA To Look More Closely At Issues Small Employers Care About Why don't small employers consider health care quality information the same way large employers do when making benefits decisions? We asked the president of NCQA.
Managed Care December 2002 Margaret E. O'Kane	Taking the Lead for Accountability Critics complain that some HMOs withhold data, but NCQA President Margaret O'Kane responds that HMOs are exemplary in measuring and reporting quality.
Managed Care October 2000	HEDIS Performance: Routine reporting drives improvement Results published in NCQA's State of Managed Care Quality 2000 put a stake in the ground in terms of how well health plans care for members with costly chronic conditions -- and established how much room exists for improvement.
Managed Care March 2007	NCQA Toughens Evaluation of PPOs Preferred provider organizations will be evaluated on the same set of standards, clinical measures, and patient experience ratings that the NCQA uses to evaluate HMOs and POS plans.
Managed Care November 1999 Steve Wetzell	To Cure Risk Aversion, Employers Eye Risk Adjustment ...The more employers can get consumers involved in the game, the more providers will become directly accountable to consumers. Under traditional managed care, employers -- without realizing it -- have put themselves in the middle of the relationship between physicians and their patients...
Managed Care September 2007	NCQA Standards Focus on PPO Performance Preferred provider organizations that are seeking National Committee for Quality Assurance accreditation will now be required to report clinical quality results through HEDIS.
Managed Care June 2007	Headlines On Deadline ... NCQA has published an expanded set of measures, guidelines, and technical specifications...A new strategy proposed by America's Health Insurance Plans would create an independent entity to compare the safety... etc.
Managed Care March 2001 John A. Marcille	Should That Apple a Day Be Red, Green, or Golden? So if everyone's at least in agreement that preventing illness should be a common goal, why is a mutual understanding of "prevention" so elusive?
Managed Care November 1999	NCQA-AMA Plan Would Reduce Paper Duplication ...NCQA will allow health plans to use data from AMA's American Medical Accreditation Program to satisfy NCQA's credentialing standards....
Managed Care September 1999	Headlines on Deadline... Healthcare industry news briefs.
Managed Care August 2004 MargaretAnn Cross	Spend Money on Healthy People! The accepted insurance model is to provide care intended to make sick people well. There are new arguments that small investments in persuading people to live healthier lifestyles will result in large reductions in cost in later years.
Managed Care July 2000	NCQA To Accredit DM Programs, HEDIS Software The National Committee for Quality Assurance will soon offer its blessing to disease management programs. NCQA is developing a DM certification program intended to recognize regimens that effectively manage chronic illnesses. The program will go live next year.
Managed Care August 2005 John Carroll	California Doctors Fear That NCQA Would Be Too Lenient With Plans Should the National Committee for Quality Assurance take over part of the job of overseeing health plans? It seems to be working in some states.
Managed Care January 2007	Change From Salary to Relative Value Units Leads to Higher Income for Physicians A Minnesota medical group that contracted with HealthPartners was able to improve cost of care, physician compensation, and patient access without harming patient satisfaction when the group converted from a salary payment system for physicians to one solely dependent on physician productivity.
Managed Care April 2000 Tim Olsen	Physician, Tarnish Not Thine Image Doctors who use the news media to criticize others, rather than initiate a constructive dialog about difficult issues such as antibiotic resistance, help erode the profession's influence.
Managed Care November 2004 Jack Ebeler	Congress Should Provide Incentives For Adoption of EMR Systems One important way that we can improve care for people with chronic diseases is to have medical records that are online and accessible when needed.
Managed Care March 2000	NCQA Unveils New PPO Accreditation Program, HEDIS '01
Managed Care January 2005	NCQA Hopes 10-Best Lists Spur Consumer Interest Medicaid Top 10: BlueCross BlueShield of Western New York... HealthPlus of Michigan... UPMC Health Plan... Medicare Top 10: Blue Cross and Blue Shield of Massachusetts... Capital Health Plan... HealthPartners... etc.