Quality Improvement & Outcomes

Latest Headlines

Latest Headlines

Improve customer experience by harnessing data like Wal-Mart

Looking to successful consumer-oriented companies like Wal-Mart and Proctor & Gamble can help insurers survive the transition to and thrive within the evolving health insurance market.

Global outcomes contracting a bridge between volume and value

Premera Blue Cross believes it has found a way to transition from the fee-for-service payment model toward the newer value-based system--a global outcomes contracting program.

AHIP Institute: Consumers and exchanges intricately intertwined

Several themes emerge as I peruse the agenda for AHIP Institute 2013 held later this week in Las Vegas--consumers are key, but the millions of new consumers about to enroll in health insurance...

CareFirst medical home saves more in second year

Healthcare costs for the 1 million members participating in CareFirst's patient-centered medical home totaled $98 million less than the insurer projected, resulting in 2.7 percent savings, according to the announcement.

MLR provision cost insurers $2.1B in rebates

The reform law's medical-loss ratio provision saved consumers $2.1 billion in only one year, says a new study published by the Kaiser Family Foundation.

Will exchanges see real competition among insurers?

The White House claimed a victory last week when it announced more than 120 insurers intend to sell plans on the federally-run health insurance exchange and that 90 percent of consumers would choose...

Blues plan integrates medical, mental health management

Blue Cross Blue Shield of Vermont has created a new company with the state's largest private psychiatric hospital to integrate healthcare with mental health and substance abuse services.

Anthem settles suit, expands options to obtain HIV/AIDS meds

In a settlement, Anthem Blue Cross of California has agreed to allow patients with HIV/AIDS to obtain their medications from pharmacies, instead of its standard mail-order pharmacy program.

On a quest for price transparency, drop confidentiality clauses

There's a growing trend in the healthcare industry–disclosing costs for services. In any other industry, that's a no-brainer necessity for a consumer to make an informed decision about what to purchase. But when it comes to health insurance, consumers often must determine whether to undergo a test, procedure or exam without knowing those services' accompanying price tags. 

CEO: WellPoint consolidation to improve execution, accountability

After only two months on the job, WellPoint CEO Joseph Swedish is shaking up the company's management, consolidating its business into two primary units.