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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 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 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 March 2000 |
NCQA Unveils New PPO Accreditation Program, HEDIS '01  |
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 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 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 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 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 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 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 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 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 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 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 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 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 October 2007 |
Second DMAA Report Issued The Disease Management Association of America has issued the second volume of the "Outcomes Guidelines Report."  |
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 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 June 2007 |
Headlines On Deadline ... NCQA has published an expanded set of measures, guidelines, and technical specifications...A new strategy proposed by America's Health Insurance Plans would create an independent entity to compare the safety... etc.  |
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 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 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 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 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 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 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 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 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 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 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 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 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 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?  |
Managed Care September 1999 |
Headlines on Deadline... Healthcare industry news briefs.  |
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.  |
Pharmaceutical Executive March 1, 2013 Ken Getz |
Building Clinical Trial Awareness for Patients: Why Not Try the Pharmacist? The author explains how building a stakeholder outreach agenda around the community pharmacist can lead to a better outcome in managing the complex ins and outs of a trial protocol.  |
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 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 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 May 2003 Martin Sipkoff |
Working Together on the Medical Side Partly because of employers' demands, health plans are starting to cooperate in ways that improve care.  |
Managed Care June 2001 |
'Quality of care' in eye of beholder The AMA, the Joint Commission on Accreditation of Health Care Organizations, and the National Committee for Quality Assurance have crafted a common set of performance measures for management of adult diabetes...  |
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.  |
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 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 January 2001 Richard B. Dwore |
Study An Opportunity for HMOs To Use Marketing To Increase Enrollee Satisfaction...  |
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...  |
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 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.  |