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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 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 April 2000 |
With AMAP Gone, Quality Judgments In Hands of Others When the American Medical Association shut down its physician accreditation program, AMAP, last month, several physician leaders expressed concern that the profession had lost its best chance to demonstrate efficient, high-quality care....  |
Managed Care December 2002 |
California Puts Doctor Scores On Report Cards The competency of physician groups is often as important as HMO performance in determining patient outcomes, California health regulators have decided  |
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 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 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 December 2006 |
Compensation Monitor More than half of the nation's HMOs use pay-for-performance programs.  |
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 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 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 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 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 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 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 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...  |
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 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 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 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 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 2000 |
NCQA Unveils New PPO Accreditation Program, HEDIS '01  |
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 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 September 1999 |
Headlines on Deadline... Healthcare industry news briefs.  |
Managed Care July 2000 |
Are Gatekeepers Failing To Control Specialty Costs? The importance of a gatekeeper in keeping costs down has been challenged again -- this time in a study that compares physician utilization for HMOs and point-of-service plans.  |
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 July 2004 Tony Berberabe |
NCQA's New Online Survey Tries To Tame the Paper Tiger This tool includes a document library where health plan applicants store the forms needed to show that they are worthy of accreditation.  |
Managed Care November 1999 |
U.S. Supreme Court To Hear Suit Against HMOs Over Incentives Can HMOs be sued for the practice of offering bonuses to physicians who help them keep the cost of care down?...  |
Managed Care July 2007 |
Managed Care Outlook The future holds too few docs.  |
Managed Care February 2007 |
Quality is Important, But Productivity Rules Despite a rise in the use of quality incentives to determine physician compensation, productivity remains the predominant determinant.  |
Managed Care October 2002 John A. Marcille |
Has the Time Come for NCQA To Get Tough With HMOs? Perhaps it's just coincidence. The National Committee for Quality Assurance issues its State of Health Care Quality report the same month that a study is published in the Journal of the American Medical Association that dismisses the idea of grading health plans. Talk about irony.  |
Managed Care September 1999 Bruce J. Goldstein, J.D. & Mark D. Abruzzo, J.D. |
Health Plans That Decredential Docs Must Do It Correctly and Expect a Fight  |
Pharmaceutical Executive March 1, 2007 Jeffrey Zornitsky |
Sales Management: Get Committed By better managing relationships with physicians, pharma companies can develop a base of dedicated prescribers.  |
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 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 November 1999 Michael D. Dalzell Senior Editor |
HMOs, Physicians Discover They Really Need Each Other Some HMOs may be more willing than you think to help financially troubled medical groups survive. A willingness to cooperate is key.  |
Managed Care August 2002 |
NCQA: Law Prevents Weighing Racial, Ethnic Care Disparities Public policy must change before the National Committee for Quality Improvement can insist that health plans collect and report data that can be used to highlight disparities in care among racial and ethnic groups, according to an NCQA spokesman.  |
Managed Care January 2006 |
Compensation Monitor A recent poll reveals that doctors distrust pay for performance programs.  |
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 January 2002 Ed Rabinowitz |
When Physicians' Skills Fail, Collaboration Beats Punishment New programs hold promise for rehabilitating sound physicians who have, for any number of reasons, lost some of the skills they started with...  |
Managed Care April 2000 Karen L. Trespacz, J.D. |
League of Their Own: What Makes a Winning IPA? In a familiar cartoon, a professor writes long, learned equations on a blackboard. To connect the profundities on either end, he writes in the middle, "Then a miracle occurs." IPAs, done well, are the miracles that connect the ends of health care.  |
Managed Care December 2000 |
Headlines on Deadline... Physician fees under Medicare will go up an average of 4.5 percent next year... The number of HMOs participating in the Federal Employees Health Benefits Plan dropped by 40 percent... The California Public Employees' Retirement System has seen a 40-percent increase in medical costs... etc.  |
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 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 July 2002 John A. Marcille |
Capitation as Whipping Boy: Court Takes on Touchy Issue If plans are to keep coverage decisions reasonable and fair, they'll need tools that involve physicians and patients in the decision-making process. Capitation is one of those.  |
Pharmaceutical Executive January 1, 2007 Jeffrey Zornitsky |
Sales Management: Get Committed By better managing relationships with physicians, pharma companies can develop a base of dedicated prescribers.  |
Managed Care May 2000 |
Texas-Aetna Incentives Settlement Worries Some Capitated Physicians If the Texas deal ignites a trend away from the use of incentives to keep utilization down, then some capitated physicians worry it will put them in a tight spot.  |
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 2006 Arthur Lazarus |
Expert Opinions Create Liability for Physicians Physicians cannot rely on courts, drug companies, or HMOs to protect their freedom of speech. Their experience and knowledge form the foundation of all medical opinion.  |