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Managed Care November 2007	Substantial Increase Seen in PPO Quality Reporting Interest in PPO quality reporting has expanded to the public sector as well, according to the report. The Medicare program and the federal Office of Personnel Management now require PPO plans to engage in HEDIS reporting.
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 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 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 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 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 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 March 2008	Proposed 2009 HEDIS Measures Address Immunization, Obesity Rates The National Committee for Quality Assurance wants to expand what the committee's Healthcare Effectiveness Data and Information Set (HEDIS) measures look at in 2009.
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 March 2000	NCQA Unveils New PPO Accreditation Program, HEDIS '01
HBS Working Knowledge July 16, 2008 Porter et al.	What Should Employers do About Health Care? Companies that cut health care costs without improving the overall value of care eventually pay a price in terms of employee absenteeism and chronic ailments.
Managed Care April 2000 Michael D. Dalzell	Not-for-Profit Group of Plans Goes After Medicine's Holy Grail Demonstrating long-term health improvement for specific populations is one of managed care's biggest unrealized goals. One group thinks it has the formula.
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 2001	'Quality of care' in eye of beholder The AMA, the Joint Commission on Accreditation of Health Care Organizations, and the National Committee for Quality Assurance have crafted a common set of performance measures for management of adult diabetes...
Managed Care December 2003 Martin Sipkoff	Health Plans Begin To Address Chronic Care Management As with so much else in health care, observing protocols, analyzing data, and rethinking benefit designs are important.
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 May 2006 Martin Sipkoff	Health Plans Are Ill-Prepared for Looming Diabetes Epidemic The problem is outpacing insurers' resources and perhaps even their commitment. Can the chronic care model help?
Managed Care November 2005	Quality Improves at Nation's Health Plans The National Committee for Quality Assurance's annual report states the quality of health plans that report have improved quality, but there is also a rise of consumer-directed health plans which do not report on quality.
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 2007	Second DMAA Report Issued The Disease Management Association of America has issued the second volume of the "Outcomes Guidelines Report."
On Wall Street November 1, 2010 Lauren Barack	Difficult Conversations In Trying Times Michael Olman has watched clients affected by chronic illness. The senior vice president and wealth management specialist at Raymond James & Associates knows these sensitive times require both a deft touch, and a firm handle on financial matters.
Managed Care October 2004	Quality at Accredited Health Plans Takes Big Step Forward The quality of care delivered by health plans that report performance data to the National Committee for Quality Assurance improved markedly in 2003.
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.
BusinessWeek February 4, 2010	How Disease Management Works Providers have convinced many big employers that their services save money and improve employee health.
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 2000	JAMA Study Challenges Key HEDIS Diabetes Measure How often should diabetic patients be screened for retinopathy?
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 April 2001	U.S. Health Care 'Substandard,' Says IOM Report Managed care -- a whipping boy for all that is wrong with health care in the U.S. -- is not to blame for a badly fragmented system that provides incentives to treat acute episodes and not manage chronic illness, according to the Institute of Medicine's landmark report...
Managed Care January 2007 Lola Butcher	Employers Publish Guide on Prevention's Worth The National Business Group on Health introduces the Purchaser's Guide to Clinical Preventive Services
Managed Care November 2004 MargaretAnn Cross	Accrediting Agencies Turn Attention To Consumer-Directed Health Plans If employers make decisions based on United Regional Health Care Foundation's and National Committee for Quality Assurance's rating of traditional managed care plans, shouldn't they want similar ratings of consumer-directed health plans?
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 March 2002	NCQA To Help CMS Monitor Quality of M+C Plans The National Committee for Quality Assurance has been tapped to help the Centers for Medicare and Medicaid Services (formerly HCFA) monitor plans that participate in Medicare+Choice...
Managed Care February 2002 Heidi A. Sauder & Sheri Wallace	Push Is On for Improved Treatment of Women's Psychological Maladies Sure there are diagnostic and treatment challenges, but the money that can be saved for society might make this fertile ground for investment...
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 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.
American Journal of Nursing October 2005 Charlotte Thomas-Hawkins	Self-Management of Chronic Kidney Disease Effective management of this disease requires the patient to be the principal illness manager and this skill requires the nurses guidance and support.
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 April 2005 MargaretAnn Cross	Don't Forget Productivity Gains When Rating Health Programs Disease management conference focuses on outcome measures that address issues such as presenteeism that concern most health care purchasers.
Managed Care October 2007	Headlines On Deadline... Health insurance premiums rose an average of 6.1% in 2007... Employers are backing the development of Web-based health records... Commercial health plans posted improvements in 30 of 44 quality of care measures...
Nurse Practitioner March 2012 Baumann & Dang	Helping Patients with Chronic Conditions Overcome Barriers to Self-Care Here are approaches nurse practitioners can use to reduce or eliminate barriers to self-care in adults with chronic conditions.
Inc. April 2008 Patrick J. Sauer	The Fight of His Life An update to a 2006 article about Bill Van Ness, who was fighting a threatened eminent domain seizure of his property.
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 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 September 1999	Headlines on Deadline... Healthcare industry news briefs.
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.
HBS Working Knowledge April 6, 2015 Michael Blanding	Germanwings Lesson: Organizations Must Pay More Attention to Employee Mental Health The Germanwings tragedy catapulted the issues of mental health and corporate risk and responsibility into the world's headlines.
Financial Planning August 1, 2010 Martin Shenkman	Not Fade Away Planners must care because the aging population brings with it great incidences of chronic illnesses and every aspect of planning is affected.
Managed Care April 2002	NCQA To Judge Plans on Drug Monitoring Health plans could soon be required to develop systems to prevent drug interactions, as well as systems to monitor drug recalls and FDA alerts, under proposed accreditation standards issued recently by the National Committee for Quality Assurance...
Pharmaceutical Executive October 1, 2006	Sales and Marketing: Where the Buck Stops Pharma's ultimate customer is the employer - the guy who pays the health plan's bill. Here's what he wants to know about drugs.
Managed Care May 2001 John Carroll	Two Accrediting Organizations Prepare To Issue DM Standards It's probable that one will become the dominant judge: NCQA or URAC. After it happens, will vendors undergo less scrutiny by individual plans?