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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 2000	NCQA Unveils New PPO Accreditation Program, HEDIS '01
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 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 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 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 November 2003	Study Says PPOs Don't Mix Well With Medicare Despite the will and wishes of many members of Congress, Medicare and preferred-provider organizations will not mix well, Mathematica Policy Research warns in a recent report.
Managed Care April 2001 Michael Levin-Epstein	PPO Performance Hard To Gauge; Comparisons to HMOs Not Reliable It's long been said that PPOs, by their varied nature, can't be held to the same quality yardsticks as HMOs. Yet, in time, something will have to suffice...
Managed Care December 2004	Headlines On Deadline ... Preferred Provider Organizations participating in Medicare Advantage can satisfy federal oversight requirements if they've already received accreditation from the National Committee for Quality Assurance.
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 November 2005	NCQA Wonders: Who Keeps Tab On Consumer Plans? National Committee for Quality Assurance is worried about the increase of consumer-directed health plans which tend not to measure or report on their performance.
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 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 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 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 May 2005	Medicare PPOs Face Challenge to Funding All the excitement in the industry about Medicare PPOs died in a hurry last month as the Medicare Payment Advisory Committee (MedPAC) moved closer to recommending that the $10 billion fund for the program be eliminated.
Managed Care May 2002 Frank Diamond	Medicare+EvenMoreChoice: U.S. Encourages PPO Option The government offers financial incentives that include $100,000 in seed money, risk-sharing deals, and higher payment rates
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 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 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 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 October 2004	Headlines On Deadline ... Good news for government workers... PPO demonstration projects for Medicare in 2001 and 2002 ... A class-action lawsuit filed by 900,000 physicians... Seventy-eight percent of the country wants universal health care... etc.
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.
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.
Insurance & Technology May 28, 2008 Peggy Bresnick Kendler	Accounting and Financial Systems: Technological Enhancements Offer Promise -- and Questions Insurers' accounting and financial systems -- including billing, annual reporting, portfolio management and investment management platforms -- are becoming increasingly integrated with other enterprise systems.
Managed Care October 2005	Rx Trend Moderates While PPO Costs Increase Trends for prescription drug coverage will slow down in 2006 to levels that are closer to those of medical coverage, according to a survey.
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 September 1999	Headlines on Deadline... Healthcare industry news briefs.
Insurance & Technology April 19, 2005 Wendy Toth	MMA Means Modernization Policy management systems will need to be updated to provide prescription drug benefits and additional healthcare choices to people who rely on Medicare in accordance with the Medicare Prescription Drug, Improvement and Modernization Act of 2003.
Managed Care May 2007 Frank Diamond	Medicare Advantage Hits Jackpot with Private Fee-for-Service Plans The secret to the success of Medicare private fee-for-service plans is as old as gold. Will beneficiary satisfaction force Congress to keep the faucet turned on?
The Motley Fool January 22, 2007 Dan Caplinger	Understanding Medicare: Claims In general, Medicare provides a level of coverage that is fairly similar to what private health insurance plans offer. Here are some tips for getting the most from it.
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 October 2007	Managed Care Outlook Medical costs, utilization rates decline again.
Managed Care February 2005	Medicare's Drug Coverage Seeks To Strike Compromise Health plan officials are still trying to determine just how the final rules for the new Medicare prescription drug benefit will affect them, because it appears that government officials tried their best to address the competing concerns of all players.
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 November 2007	Patient Advocates Want Part D Changes A Medicare-administered drug benefit would be more affordable and comprehensive than the current private insurance-run drug benefit, say patient advocate groups.
Managed Care November 1999 Richard Hamer	Goals 2000: For HMOs: Administrative Retooling For MDs: Managerial Competency ...While HMOs retrench, physicians need to become more constructive participants....
Managed Care October 2007 John Carroll	Medicare Coverage Rules Are Not Always Last Word Yes, commercial health insurers often take a cue from the government, but that doesn't mean that they follow blindly.
Managed Care December 2006	NCQA Rankings Give Edge to Not-For-Profit Insurers No sooner had the quality rankings of health plans in the nation, as measured by the National Committee for Quality Assurance, been released then it was pointed out that most of the top performers were not-for-profit insurers.
The Motley Fool January 22, 2007 Dan Caplinger	Understanding Medicare: Benefits Medical coverage for seniors is a big part of a strong retirement-protection plan.
The Motley Fool January 22, 2007 Dan Caplinger	Understanding Medicare: Costs The deductibles and co-payments for Medicare Advantage Plans and prescription-drug plans can vary greatly between particular plans. A thorough examination of such plans is necessary for understanding the costs and to make a good decision about which plan to choose.
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 November 1999 Uwe Reinhardt, Ph.D.	Defined Contributions Will Point Employees Toward 'Health Marts' Companies will want to distance themselves from insurance entanglements, giving employees little option but to become more involved....
Managed Care April 2002 Frank Diamond	Medicare+Choice: Uncertain Future for Unstable Program While policy makers haggle over President Bush's budget request for the system, an ominous question looms: Can money solve all the problems?
Managed Care March 2007 John Carroll	Democratic Agenda Places Medicare Advantage at Risk Battle lines are drawn over proposals to raid the Medicare managed care program of funds to be applied to other health care needs. Democrats themselves are split.
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?
Knowledge@Wharton July 30, 2003	Restructuring Medicare Is a Riskier Operation than First Thought Hailed as a bipartisan success when passed in late June, two Medicare reform bills are losing some of their luster as they face closer scrutiny by a conference committee made up of members of both chambers charged with reconciling the legislation this fall.
Managed Care June 2003	For-profit, not-for-profit enrollment holding about steady While HMOs seemed to be losing enrollees to PPOs, the ratio of enrollees in for-profit and not-for-profit HMOs stabilized in the late 1990s, according to data collected by the Centers for Medicare and Medicaid Services.
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 March 2002 Michael Levin-Epstein	Illinois's Medicare Drug Program Called 1st Stab at National Reform The Illinois demonstration program gives the state permission to use federal and state Medicaid dollars to provide prescription drug coverage for 365,000 low-income, elderly Medicare beneficiaries...