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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 October 2005	Headlines On Deadline ... Defensive medicine is something the public seems to be very aware of... Pay-for-performance initiatives got a boost...
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 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 October 2005	P4P Programs Used To Get Docs Online For both doctors and patients, health information is crucial -- that's what many pay-for-performance programs hopes to promote.
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 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 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 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 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	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 May 2004 Martin Sipkoff	Will Pay for Performance Programs Introduce a New Set of Problems? Paying incentives to physicians to practice evidence-based medicine appears to be an idea whose time has come. Such programs -- even if successful -- may create a new set of problems.
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 May 2007 MargaretAnn Cross	Following the Leaders Top pay-for-performance programs point to increased focus on hospital incentives, efficiency measures, coordination, and standardization.
Managed Care April 2007	A Conversation With Emad Rizk, MD: Disease Management Beyond the Call Center The man who heads McKesson Health Solutions, the third largest disease management program in the country, says it's time to roll out a new model.
Managed Care January 2002 Patrick Mullen	Interview: Peter Lee The head of the Pacific Business Group on Health says the coming trend in care will be patients making informed decisions before they get sick...
Managed Care May 2003	Employer Coalition Leaps at Challenge of Grappling With Misaligned Incentives The executive director of the Leapfrog Group says that the organization pleads guilty to trying to create 'aspirational' standards for health care.
Managed Care March 2004 Martin Sipkoff	Can Transparency Save Health Care? If everyone can see what everyone is doing, we'll have better care at lower costs. First task: Create common standards.
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 2006	A Conversation With Michael L. Millenson: Health Care Reform Movement Has Only Scratched Surface Michael L. Millenson has long been frustrated by the pace of change says that - ready or not - health care reform is finally on the way.
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 January 2005 Alice G. Gosfield	P4P: Transitional at Best Pay-for-performance (P4P) programs promise a fair shake for provider and insurance plan, but a former chairman of the National Committee for Quality Assurance sees many design flaws to overcome.
Insurance & Technology August 18, 2010 Nathan Golia	Insurers Take Lead in EHR Implementation With guidelines for meaningful use of electronic health records established, health carriers expect IT improvements on the provider side to lower healthcare costs by reducing care redundancies and readmissions.
Managed Care September 2007 Martin Sipkoff	Go Carefully When Measuring Quality Gauging and rewarding good work in health care is a noble goal with potentially negative consequences.
Managed Care November 2000 Patrick Mullen	Don't be fooled Don't be fooled, warns noted health care economist J.D. Kleinke: High-quality care costs more, not less. The Internet will increase demand for the best care...
Managed Care April 2004	What's Past is Prologue? Don't Bet on It Many things that were supposed to happen -- like electronic medical records -- didn't, this health care futurist reminds us. Tomorrow needs to be shaped.
Managed Care December 2001	Disease Management Outsourcing As DM shifts its focus to outcomes-based care, the EVP of American Healthways suggests that larger health plans consider outsourcing care of chronic patients.
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 July 2000	Lee N. Newcomer joins Vivius The former senior VP for health policy at UnitedHealth Group joins a company that aims to shift power from HMOs to patients and physicians.
Managed Care January 2006	Is Managed Consumerism the 'Third Way'? The health care economist says that consumers ought to share in the savings from making the right choices. Insurers, providers, and hospitals should make sure that options exist.
Managed Care December 2004 Adler & Schukman	The Role of Managed Care In Patient Safety & Error Reduction Patient safety and medical errors have become the focus of increasing attention from the public, policymakers, and accreditation agencies. Managed care organizations clearly are important stakeholders in this issue.
Managed Care June 2002	'We Changed The Way Kaiser Makes Decisions, Views Itself' Lawrence's tenure as Kaiser CEO came at a tumultuous time for the country's largest classic HMO. An interview with David M. Lawrence.
Managed Care December 2000 Patrick Mullen	Employer Demands Will Change Healthcare The CEO of a large Florida employer coalition insists that the information that companies are beginning to demand will force the industry to change...
Managed Care May 2005 MargaretAnn Cross	Are Consumers Really Directing Their Own Care? In theory, consumer-directed health plans put the reins of decision making into the hands of their members. But medical management departments are alive and well inside CDHPs -- and may even expand under these plan designs.
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 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 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 November 2005 Patrick Mullen	This Biologics Industry Spokesman Knows That Health Plans Can Only be Won Over by the Financial Argument. Biotech's focus is expanding from products that treat relatively rare diseases to treatments for conditions that affect much larger populations, including various cancers, diabetes, rheumatoid arthritis, and asthma because of health plan costs.
Managed Care March 2005	'This Country Cannot Continue With the System We Now Have' As a vice president of Pfizer Health Solutions, a major disease management company, John Sory knows how difficult it is to bring systematic care to the chronically ill. He discusses Pfizer's work with Florida's Medicaid program.
Managed Care April 2006 Patrick Mullen	A Conversation with Paul Fronstin, PhD: Current Crop of Consumer-Directed Plans More 'Lite' Than 'Heavy' Paul Fronstin, a senior research associate at the Employee Benefit Research Institute, speaks about Medicare, health benefit trends, and managed care.
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 July 2004 Patrick Mullen	Matthew Holt: Internet Pundit Thrives on the Biggest Issues Integrated health care systems are seizing the momentum in care coordination from HMOs, says the author of the well-read Internet Healthcare Blog.
Managed Care May 2006	They Wrote the Book on Fixing the System How could the largely private U.S. health care system, characterized by arguably more competition than any other health care system in the world, be performing so poorly?
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 May 2004	'Random Gifts of Information' Should Never be Ignored The CMO of Blue Cross and Blue Shield of Minnesota is hopeful that the goal of true population management is near.
Managed Care March 2000	Tracking the Tracker of Health Care's Trends The president of the Medical Group Management Association encourages changes that would bring physician practice and medical record-keeping in step with the times, and decries the lack of medical standards across plans.
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 2000	Interview: Peter Boland Will the electronic revolution overthrow managed care? Not necessarily, but it may help define a new role for MCOs not far in the future...
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 1999	Headlines on Deadline... Healthcare industry news briefs.