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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
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
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
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 2000 |
NCQA Unveils New PPO Accreditation Program, HEDIS '01 |
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
January 2001
Richard B. Dwore |
Study An Opportunity for HMOs To Use Marketing To Increase Enrollee Satisfaction... |
Managed Care
March 2001
Frank Diamond |
Don't Be Misled by the Hype: Credentialing -- Important, but Difficult HMOs may be trying harder, but PPOs seem less interested. Then there's the whole issue of credentialing's relationship to the licensure process... |
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
September 2002
Patrick Mullen |
Interview: Richard L. Hamer Market-research organization InterStudy's director says that the push for patients' rights has grown into a concern for quality directed mainly at doctors. |
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 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
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 2005
MargaretAnn Cross |
Momentum Shifts Toward Consumer-Directed Plans Looking at past enrollment shifts and at the evolution of managed care can shed light on how to compete in the new market for account-based consumer-directed care. |
Managed Care
July 2002 |
Survey predicts more demand for pharmacy precertification Respondents said that their customers -- employers, for the most part -- will want to see more pharmacy precertification. |
Managed Care
November 1999 |
Another Group Hopes To Measure Quality of Care There's a new player in quality measurement: the National Forum for Healthcare Quality Measurement and Reporting.... |
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? |
Managed Care
June 2003 |
PPOs continue to be favored by covered employees Even in slow economic times, consumers for the most part continue to choose preferred provider organizations over other types of health insurance, even though the choice that PPOs give costs more, according to recent data. |
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
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
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 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
February 2004 |
Headlines On Deadline ... Developing quality benchmarks for consumer-directed health plans will be the mission of a committee launched by the American Accreditation HealthCare Commission, which is still primarily known by its original acronym, URAC. |
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
March 2002
Charles Downey |
The Department of Managed Care California sets a precedent again, with a bold effort to regulate the HMO industry. While the new Department of Managed Health Care is facing down 50,000 consumer gripes monthly, director Daniel Zingale intends to keep administrative red tape from overwhelming everyone... |
Managed Care
November 2000 |
For first time ever, HMO enrollment drops in 1999 National HMO enrollment fell by 400,000 last year, from its all-time high of 81.3 million. For at least two years, a wider array of managed care products and an ever-smaller pool of people still covered under indemnity plans slowed the rate of HMO enrollment growth... |
Managed Care
May 2000 |
The latest blow to managed care? The Texas attorney general's decision in the Aetna case is the latest in a long string of events that has gutted the fundamentals of managed care. Many in health care think that some or all of these developments have stripped health plans of their ability to manage care effectively.... |
Managed Care
August 2006 |
Slowdown in Premium Increase Expected to Continue Into 2007 The only thing falling in terms of health care costs seems to be the rate of increase of premiums - good news for employers and other purchasers. |
Managed Care
July 2002
Frank Diamond |
Premium Hikes: No Cause for Celebration Lost market share and further erosion of public trust will be the long-term by-products of this short-term solution. |
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
October 2007 |
Managed Care Outlook Medical costs, utilization rates decline again. |
Managed Care
September 1999 |
Headlines on Deadline... Healthcare industry news briefs. |
Managed Care
March 2006 |
Will HMOs' Robust Profits Make Good Political Fodder? Those looking for any excuse to bash HMOs, including political gain, will turn anything into a weapon, including a recent study pointing to healthy profits. |
Insurance & Technology
April 2, 2004
Anthony O'Donnell |
Jopp Moves to URAC While at the Health Insurance Association of America, CIO Devin Jopp saw his position shift from an information capacity to a more operational capacity, as exemplified by his secondary role as COO of the HIAA's business programs. |
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
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
May 2002
Sharon Baker |
Self-Funded HMOs on the Rise Escalating premiums, changing attitudes play a role in employers' decision to take on the same thing that burned many physicians: financial risk |
Managed Care
June 2004
John Carroll |
This Regulator Works For the Governator California is the only state that has a department that deals exclusively with HMOs. A new sheriff's in town. |
Inc.
June 2008 |
How To Choose A Health Care Plan: Finding the Right Plan Advice on what companies should consider when choosing a group heath plan. |
