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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
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
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
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 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
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
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 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
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 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 2000 |
NCQA Unveils New PPO Accreditation Program, HEDIS '01 |
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
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
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
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
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
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
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
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
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
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. |
BusinessWeek
October 22, 2009 |
Two Ways to Fund Reform Separate House and Senate health-care bills cover costs differently. |
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
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 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 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 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
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
February 2006 |
Medicare's Efficiency Over-Hyped, Study Claims The belief that Medicare is a more efficient system than employee-sponsored health insurance comes under fire in a study that claims there are hidden costs in the government program. |
Managed Care
September 2003 |
Medicare+Choice expenses increasing for enrollees Those who argue that Medicare and managed care don't mix well have new data to take to the fight. A Commonwealth Fund report states that the average out-of-pocket costs for Medicare+Choice enrollees soared 10 percent this year. |
Managed Care
May 2002 |
Primary Care Suffers Under M+C, Study Says Medicare+Choice compares unfavorably with traditional fee-for-service Medicare in 9 out of 11 features linked to primary care, according to a study funded by the U.S. Agency for Healthcare Research and Quality that is generating interest and controversy |
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
February 2004
John A. Marcille |
The Administration Delivers A Major Gift to Managed Care Which brings me to the announcement that Medicare payments to health plans participating in what was called Medicare+Choice but is now known as MedicareAdvantage will increase by a record 10.6 percent. |
Managed Care
March 2006 |
Managed Care Outlook Health care spending in the United States is expected to grow at the current rate through 2015. |
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. |
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 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
July 2000
Michael Levin-Epstein |
Congress Asked To Take Action As HMOs Flee Managed Medicare Thanks mainly to the increasing cost of providing a prescription drug benefit, HMOs are exiting Medicare+Choice, the system that was supposed to manage the health of the nation's senior citizens, in droves. Only an act of Congress can save Medicare+Choice, but is seems doubtful that will happen. |
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
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
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
May 2005 |
Medicare PPOs Face Challenge to Funding All the excitement in the industry about Medicare PPOs died in a hurry last month as the Medicare Payment Advisory Committee (MedPAC) moved closer to recommending that the $10 billion fund for the program be eliminated. |
Managed Care
February 2008 |
Antitrust Exemption Sought in Congress The so-called Community Pharmacy Fairness Act (HR 971) would allow independent pharmacies to negotiate collectively with health plans, insurers, and PBMs, including plans under Medicare parts C and D. |
Managed Care
October 2000 |
Quick Fix May Be in Store for M+C, But Meaningful Change Likely To Wait Whatever diversion prescription drug proposals have provided, Medicare+Choice is back on Congress's radar screen. While sentiment is again running strong among legislators to address the wounded program, Congress is now racing a clock ticking ever closer to the elections... |
Managed Care
August 2000 |
Medicare+Choice pullouts' deep, deep sting The health plan exodus from Medicare+Choice will affect 934,000 people in 2001 -- more than were affected in 1999 and 2000 combined, according to the Health Care Financing Administration. |
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
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
May 2000
Michael Levin-Epstein |
Marketing Medicare+Choice? Mind Your Ps and Qs, Says OIG A lot of Medicare HMOs' marketing materials don't cut it, says a report by the Office of the Inspector General. It adds that the Health Care Financing Administration is partly to blame.... |
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
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 |
