Quality Improvement & Outcomes

Latest Headlines

Latest Headlines

Group Health aims to put medical research into practice faster

Group Health wants to ensure that medical innovations aren't tossed by the wayside simply because of lag time between ideas created and implemented in doctors' offices.

HMO Group Health, Providence Health launch single delivery network

Seattle-based HMO Group Health is joining forces with 32-hospital system Providence Health & Services to create what they hope will be more efficient, coordinated healthcare through a new medical limited liability corporation.

Aetna-provider plan offers price guarantees to stay competitive

Aetna is partnering with the nation's 10th largest provider group to sell new health plans that offer price guarantees for employers and limits members' premium increases.

Don't leave money on the table: Improve your Medicare Advantage quality rating

Not improving your Medicare Advantage star quality rating is like leaving money on the table and walking away; it just doesn't make sense.

Insurers share claims data with HHS to fight fraud

Hoping to clamp down on healthcare fraud, private payers like UnitedHealth and WellPoint are partnering with the U.S. Department of Health & Human Services to share more claims information and fraud prevention best practices.

HHS dedicates $275M to state testing of payment models

The U.S. Department of Health & Human Services will award a total of $275 million to states either to test existing models or to provide technical assistance to determine the best payment model in the market. 

Weight loss surgery doesn't shed long-term costs

Insurers aren't saving much money by covering weight loss operations like gastric bypass surgery because patients undergoing the procedure don't see fewer healthcare expenses afterward.

Aetna, Cigna, Blues unveil new ACOs

Several health insurers made moves this week to launch accountable care organizations (ACOs), further demonstrating the industry's hope that ACOs can help defray rising costs. Cigna is joining forces with the Palo Alto Medical Foundation to create the payer's first ACO in California.

Consumer engagement: Helping members help themselves

As insurers continue to grapple with rising healthcare costs, they're faced with an increasingly unhealthy member population. So payers have started taking matters into their own hands to engage members into becoming stewards of their own health and wellnes.

Insurers avoid C-sections to save costs, cut risk

Many insurers now are working to decrease the amount of cesarean surgeries to help defray the rising healthcare costs and risks associated with the most common surgery in the country.