Quality Improvement & Outcomes

Latest Headlines

Latest Headlines

List of overused services a gift to payers seeking to curb costs

Payers have been working to reduce the healthcare industry's ever-rising costs, starting with shifting reimbursements to focus on quality care instead of volume. Well, payers were handed a...

Is UnitedHealth liable for doctor who caused hep C outbreak?

UnitedHealth is fighting charges in Nevada state court that it improperly kept a doctor with "substandard" medical practices, including infecting patients with hepatitis C, within its network.

HCSC Exclusive: Intensive medical home cuts high-risk patient costs

Faced with the reality that only 10 percent of all patients drive at least 60 percent of all healthcare costs, Health Care Service Corporation (HCSC) and its Blues plans have taken action to lower...

Highmark joins price transparency movement

Highmark puts the final touches on its new cost estimator tool, contributing to a broader industry-wide movement to increase transparency of medical costs while highlighting quality providers.

Promoting generic drugs could save insurers billions

Despite the so-called "patent cliff" last year, many insurance companies still believe they can realize substantial savings by promoting generic drugs to their members.

Aetna, Cigna launch more ACOs in Texas

Texas has been the focus of accountable care organizations for both Aetna and Cigna as the insurers roll out new cost-saving collaborative programs in the state.

WellPoint cautious about 'fluid' market despite profit growth

As WellPoint announced its unexpectedly high fourth-quarter earnings, the insurer remained cautious about its future this year, yet hopeful about 2014.

Highmark expands medical home after care costs drop

Highmark is expanding its patient-centered medical home (PCMH) through which it pays participating doctors more money for providing quality care, Pennsylvania's largest insurer said Wednesday.

Can narrow networks boost exchange coverage?

As insurers prepare to sell plans through health insurance exchanges, they're hoping narrow network plans will appeal to a large number of new consumers.

Texas Blues forms ACO focused on IT, data sharing

Blue Cross Blue Shield of Texas has formed one of the largest accountable care organizations in the country, partnering with healthcare provider Texas Health Resources to improve quality and decrease costs.