Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Healthcare Quality

NCQA Seeks Comment on Proposed Updates to HEDIS Quality Measures

February 13, 2019 - The National Committee for Quality Assurance (NCQA) is seeking comments from health plans, purchasers, consumers, and other stakeholders on proposed updates to the Healthcare Effectiveness Data and Information Set (HEDIS) measures. “When clinical guidelines change, or new evidence becomes available in the scientific literature, NCQA reviews HEDIS measures to determine whether...


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Humana, Aledade Bring Value-Based Care to Medicare Advantage Members

by Jessica Kent

Humana and Aledade have announced a value-based care agreement that will increase access to value-based care for Medicare Advantage members. The partnership will enable physicians in Aledade’s accountable care organizations (ACOs)...

Patient-Centered Methods Help Health Plans Boost Cancer Care

by Jessica Kent

Employers and payers should ensure their health plans use patient-centered methods and provider performance measurement strategies to reduce costs and improve cancer care, a report from the National Alliance of Healthcare Purchaser...

Steward Health Care Joins Mission to Expand Generic Drug Access

by Jessica Kent

Steward Health Care has become a founding member of Civica Rx, a collaborative, non-profit drug company with the mission to reduce drug costs and increase the supply of life-saving generic medicines. Approximately 800 US hospitals have...

Patient-Centered Medical Home Model Saved BCBS of MI $626M

by Thomas Beaton

BlueCross BlueShield of Michigan has reduced expected spending by $626 million over a nine-year period through a patient-centered medical home (PCMH) model that emphasizes personalized care. The payer found that the PCMH increased rates...

Medicaid Coverage Creates Significant Healthcare Opportunities

by Thomas Beaton

Medicaid coverage led to significant healthcare opportunities that rivaled commercial health insurance care quality, according to a new study from AHIP. Nearly 74 million adults and children who receive Medicaid were found to have...

Top Commercial Payers Offering Medigap, MA, and Medicaid Plans

by Thomas Beaton

The top payers with the highest enrollment numbers for Medigap, Medicaid, and Medicare Advantage (MA) are a unique mix of some of the largest commercial payers as well as smaller to mid-size insurers, a new report from AHIP reveals. These...

Misalignment of Healthcare Quality Measures Impacts Payers

by Vera Gruessner

In the healthcare industry’s move toward value-based care reimbursement, public and private payers create healthcare quality measures meant to align with how providers are paid and what type of financial penalties will be instituted...

Payers Could Boost HEDIS Quality Measures by Exchanging Data

by Vera Gruessner

HEDIS quality measures are managed by the National Committee for Quality Assurance (NCQA), which allows consumers to compare the quality of health plans among more than 90 percent of health payers around the country. HEDIS quality measures...

Best Practices to Drive HEDIS Success in 2017

by Brian Drozdowicz of Verisk Health

Achieving success requires plans to adhere to annual changes from the National Committee for Quality Assurance (NCQA) related to HEDIS measurement, reporting requirements, and timelines. In addition, health plans can better position...

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