Managed Care

Colorado adopts doctor rating standards, health system reforms

AmedNews.com reports on new laws in Colorado which will enable physicians to review and contest health plan rating systems, patients to have standardized and possibly electronic health plan IDs, and insurance companies to develop new types of plans that the state may help consumers purchase.



MI hospitals to stop billing for preventable medical errors

The Michigan Health & Hospital Association joins a growing list of hospital associations, states and payers who have adopted policies to stop billing patients for certain serious preventable errors ("never events") and hospital-acquired conditions. This follows on from Medicare's decision to cease payment from 2008, for specific hospital medical errors.



Rhode Island approves patient safety legislation to create medical error database

Rhode Island lawmakers have approved patient-safety legislation that would create a database for voluntary reporting of medical errors by healthcare providers and insurance companies, to compliment existing reporting requirements. The legislation would also establish a 14-member care-advisory committee to review the database findings and create quality-improvement strategies.



Anyone Else Need a Report Card?

Physicians have long been vocal in their concerns over the ever-growing number of report cards attempting to report on the physician's quality of care. Many of these reports are of course made available by the insurers. What's a doc to do?



American Medical Association's New Health Insurer Report Card

The American Medical Association (AMA): recently launched the Cure for Claims campaign to help improve processing medical claims with health insurers. They have created their first National Health Insurer Report Card on claims processing.

The Report Card illustrates the claims processing performance of Medicare and seven national commercial health insurers:

  • Aetna
  • Anthem Blue Cross Blue Shield
  • CIGNA
  • Coventry Health Care
  • Health Net
  • Humana


MA: Blues Plan Joins Google Health

From HealthData Management: Massachusetts Blue Cross Blue Shield is now offering members services through Google Health. Members will be able to import claims data into their personal health records.

Blue Cross Blue Shield of Massachusetts
http://www.bluecrossma.com/common/en_US/index.jsp

Google Health
http://www.google.com/health



NC: Health Care Options for the Uninsured

iHealthBeat: The North Carolina Institute of Medicine has launched a new web site to help uninsured residents find health care services.

Consumers can view information on safety-net services, offering health care at no cost or at a reduced cost. Their mission is to provide free and reduced cost healthcare services to North Carolina residents.



Medicaid to Cease Reimbursement to Hospitals for 'Never Events' and Avoidable Errors

Medicaid to Cease Reimbursement to Hospitals for 'Never Events' and Avoidable Errors

Beginning in October, the New York State Medicaid program will deny reimbursements on 14 “never-events”- avoidable hospital complications and medical errors. These “never events” include surgical errors such as procedures performed on the wrong body part or the wrong patient.



WI: Making Health Care Costs More Transparent

AHA News: The Wisconsin Association of Health Plans are currently implementing plans to allow health plan enrollees have out-of-pocket cost estimates available.

Beginning September 1st, enrollees can request an estimate of out-of-pocket costs before receiving services.

Health Plans Under Association

  • Abri Health Plan
  • Anthem Blue Cross Blue Shield
  • Arise Health Plan


CIGNA Launches Web Site Ranking Doctors and Hospitals

Fierce Healthcare: CIGNA has launched a national web site ranking doctors and hospitals by cost and quality measures. The web site also provides its beneficiaries with additional tools to help them obtain care.

The CIGNA web site names hospitals in specific regions with the lowest death and complication rates. It offers a list of questions patients can ask their doctor in regards to a specific condition. They have also developed a patients tools section to help viewers locate nearby pharmacies with the lowest prices.

More on Press Release:



Anthem Blue Cross and Blue Shield Introduces Transparency Initiative in Maine

Hi-Wire: The Anthem Blue Cross and Blue Shield (Anthem) in Maine announced the expansion of its industry-leading transparency initiative. Anthem members are now able to use the ‘Anthem Care Comparison’ online tool. It provides the total estimated costs for nearly 40 specific medical procedures performed at local area hospitals.



Houston Releases Web Site for Residents To Compare Insurers

The Houston Chronicle reports, a new Web site designed to help consumers and small businesses learn more about their health insurance options.

It offers a range of ways to compare health plans, including side-by-side comparisons of monthly premiums, deductibles and coverage options. Users of the site can search for information in various ways, such as plans with monthly premiums of less than $100 or deductibles under $500 annually.



Errors force BCBS of TN to postpone doctor ratings program

As previously blogged, starting in April, BlueCross BlueShield of Tennessee were to make physician quality and cost data available online, incorporating practices such as disclosing how doctors are ranked and providing them a way to appeal incorrect ratings, in line with a model that New York's Attorney General Andrew Cuomo created last year.



BlueCross BlueShield of Tennessee to make physician quality, cost data available online

Starting in April, people insured by BlueCross BlueShield of Tennessee will soon be able to compare doctors on quality of care and costs, part of a broader push to give consumers enough information to make wise choices on medical treatment, report The Tennessean.



CWF report shows how public employee health plans use their clout to improve quality

The new Commonwealth Fund report What Public Employee Health Plans Can Do to Improve Health Care Quality: Examples from the States is designed to help state public employee health plans and other large purchasers make strategic decisions about developing or coordinating quality improvement initiatives.