Quality Improvement & Outcomes

Latest Headlines

Latest Headlines

Highmark P4P program requires hospitals to lower readmissions

Highmark wants to reduce hospital readmissions to help chip away at the $25 billion they cost the healthcare system, requiring hospitals participating in its pay-for-performance program, called Quality Blue, to track and curb readmissions.

Can the reform law replicate success in Massachusetts?

Massachusetts now boasts the country's highest rate of residents with health insurance (98 percent), decreased emergency room visits (down 4 percent) and more preventive care visits (up 5.9 percent).

Screen for risky providers to root out fraud

To fundamentally change how healthcare fraud is rooted out, health insurance companies should conduct robust screening of providers in their network.

In wake of reform ruling, costs, collaboration top of payers' minds

In the wake of yesterday's U.S. Supreme Court ruling, insurance companies large and small responded to the high court's decision to uphold the Affordable Care Act--and almost every one focused on reducing costs and collaborating with lawmakers.

Aetna partners with Inova in narrow network plan

Aetna has partnered with Northern Virginia's Inova Health System to create the perfect win-win solution to providing and paying for healthcare services in the region, at least according to officials from both companies.

Federally recommended obesity counseling could expand coverage

A federal health advisory panel's new recommendations could lead to a surge in insurance coverage for obesity-related counseling, treatments and services.

Reform, in some way or another, is here to stay

Broad trends and discussions pre-date the reform law and will continue post-Supreme Court ruling, according to experts at AHIP Institute 2012.

Payers, providers collaborate in triple-aim approach, P4P

Two health insurers--HealthPartners and Blue Cross Blue Shield of Michigan--have focused their attention on collaborating with providers to improve health outcomes. One key to successful...

'Secret sauce' to payment reform is provider collaboration

To successfully reform payment methods, payers must engage in meaningful collaborations with providers that move beyond simply altering payment structures to incorporate care coordination, the right information and better incentives for providers.

Payer CEOs outline 3 keys to high-value, low-cost healthcare

Better integrated care, improved population health and enhanced consumer engagement are the three keys to a high-value, low-cost healthcare system, three chief executives from major insurers said Thursday during the AHIP Institute 2012 in Salt Lake City.