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Managed Care December 2007	Web Site Helps Track Health Plan Rankings U.S. News & World Report and the National Committee for Quality Assurance have released the third edition of America's Best Health Plans, an annual ranking of health maintenance organizations and point-of-service 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 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.
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 February 2006	Managed Care Offered to More Medicaid Enrollees A chart illustrates the percentage of medicaid enrollees in managed care, for the years 1996 to 2004.
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 April 2005	Medicare Modernization Act to Increase Public Sector Spending Nearly 50 Percent While the burden on the public sector to supply health care benefits to Medicare and Medicaid enrollees will increase, on the private side, a reevaluation of current forms of health insurance coverage may take place as growth in premiums continues to outpace growth in compensation.
Managed Care March 2008 Frank Diamond	What Makes Harvard Pilgrim So Good? It's the nation's leader in member satisfaction and quality of care, according to NCQA. Dynamic leadership and dominance of a region where excellent docs and plans abound are part of 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 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 February 2002	Hospital costs lead way in health care expenditures The share of the gross domestic product attributed to health care increased slightly more than overall GDP growth from 1999 to 2000 -- the first time that's happened in nine years...
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...
The Motley Fool February 24, 2009 Brian Orelli	Health Insurers Hammered. Again. Health insurers were blown away by the Centers for Medicare and Medicaid Services' announcement that it plans to raise the 2010 Medicare Advantage payment rates by only 0.5%.
Managed Care December 2006 MargaretAnn Cross	Confronting The Medicare Cost Shift Plans are increasingly concerned about the degree to which providers overcharge them to make up for losses from government programs.
Managed Care July 2004 Martin Sipkoff	Managed Medicaid Business Might Be Worth the Difficulties Financial, regulatory, and access problems continue. Still, this remains a growth industry and some have found a way to profit.
The Motley Fool November 18, 2010 Brian Orelli	Worry-Free Dendreon? One step closer to national reimbursement from the Centers for Medicare and Medicaid Services to pay for its prostate cancer treatment Provenge.
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 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 April 2002	More Than Just 'Chipping' Away at Problem of Uninsured Children CHIP (the Children's Health Insurance Program) continues to grow by leaps and bounds. About 4.6 million children in the U.S. received coverage through CHIP in fiscal year 2001. That's an increase of 38 percent from fiscal year 2000...
The Motley Fool September 1, 2010 Brian Orelli	Dendreon: One Step Closer to Worry-Free Back in July, the Centers for Medicare & Medicaid Services announced that it planned on reviewing the reimbursement for Dendreon's prostate cancer treatment Provenge.
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 June 2006	All Insurers Face Similar Spending Growth The rapid rate of growth in health spending relative to national income is raising concern among policymakers -- is the U.S. health care system financially stable?
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 May 2007 John Marcille	Pay for Performance Proceeds at Proper Pace The incrementalist pay-for-performance will be with us long after Medicare private fee-for-service plan is history.
The Motley Fool July 1, 2011 Brian Orelli	Dendreon Is Drama-Free ... for Now For a drug that has had so much drama during its existence, the final decision by the Centers for Medicare and Medicaid Services to pay for Dendreon's prostate cancer treatment Provenge was pretty anticlimactic.
Managed Care April 2007	Headlines On Deadline ... Members of Blue Cross and Blue Shield companies and privately-held health plans tend to rate their overall service experience notably higher than enrollees of non-Blue plans owned by publicly-traded companies...More employers are offering consumer-directed health plans... etc.
Managed Care July 2002	Memo Clarifies CMS Guidelines on Injectables Injectable drugs should be covered by Medicare if beneficiaries administer them less than 50 percent of the time, according to a clarification on this issue by the Centers for Medicare and Medicaid services that's set to take effect Aug. 1.
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 September 2002	Medicare holds down physician pay Compensation increased at a comparatively small rate from 2000 to 2001 for both primary care physicians and specialists, according to the Medical Group Management Association.
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 2001	CMS Defends Plan To Let States Tailor Medicaid Benefits Centers for Medicare and Medicaid Services Administrator Thomas Scully has defended the Bush administration's plan to allow states to opt out of mandatory Medicaid-coverage requirements...
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?
Managed Care April 2004	Medicaid DM To Get Boost From CMS The federal government plans to give Medicaid disease management a lift by matching the money states pay to run such programs.
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 July 2002	CBO Weighs Effect of Growing Deficit on Fed Programs Health care programs such as Medicare and Medicaid figure to suffer, thanks to a growing federal budget deficit, according to a report by the Congressional Budget Office.
Managed Care August 2005	Credit Ratings Look Rosy for Rest of 2005 Standard & Poor's expects the health insurance industry sector to continue to improve its credit rating in the second half of the year.
Managed Care February 2007	Managed Care Outlook Coverage for children leads policy debate.
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	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 August 2000 Carey Lee Straetz	Managing Medicaid Rolls Often State-by-State Affair Despite the strong economy, Medicaid enrollment may be slowly rising after a three-year decline. The challenges for serving this population are huge.
The Motley Fool February 28, 2008 Brian Lawler	Medicare, Health Care, and Megabucks A new government report forecasts big growth in health-care spending in the next ten years, meaning there will be some major growth opportunities in the pharmaceutical sector.
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 December 2001	CMS Medicaid Managed Care Proposal Under Close Scrutiny Bioterrorism. Medicaid managed care plans. No link between them? Guess again. It all has to do with how proposed Medicaid regulations would affect patients' rights and funding for Medicaid programs ranging from nursing home care to emergency rooms...
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 August 2006	Headlines On Deadline ... Aetna is unveiling something it calls the Medicare Open Plan, targeted for employers who want to offer retirees age 65 or over a fee-for-service Medicare Advantage plan.
Pharmaceutical Executive April 1, 2007 Jill Wechsler	Washington Report: Medicaid Sets the Pace for Pharma Pricing Forget Medicare price negotiations. Pending changes in Medicaid drug-pricing formulas will put even more pressure on pharmaceutical prices.
Managed Care April 2005 Frank Diamond	Starting Medicare Advantage Plan Brings Special Set of Problems The feds will help you launch a health plan for the elderly, but just what does it take to get something like this operating in so short a time?
Managed Care March 2008	CMS Hybrid Payment System Shows Promise Combining Medicare fee-for-service payments with new incentive programs could help physician groups save money for Medicare and reach quality-of-care targets.
The Motley Fool September 23, 2009 Brian Orelli	Witch Hunt, Round 2? Humana mails Medicare Advantage members about health-care reform, and not everyone approves.
Managed Care June 2002 John Carroll	DM and Medicare: A Marriage Made in Heaven? With a budget of about $230 billion for 40 million patients, many with chronic ailments, is it any wonder that disease management and Medicare are courting?