Health plan data governance plays a key role in overcoming barriers related to industry-wide adoption of value-based reimbursement, according to a two-year study conducted by CAQH CORE.
Health...
Health plan performance, and how to improve it, is always an issue at the forefront of payers’ minds. While payers have engaged in several strategies in the past aimed at improving clinical...
NCQA is seeking health plan, provider, and related stakeholder public comments to weigh in on updated HEDIS measures and the implementation of new measures related to chronic disease management.
NCQA...
The top performing commercial health plans in the US for 2017-18 exceeded expectations for customer satisfaction, preventive care, and outcomes of their beneficiaries, according to the National...
For payers, an effective member engagement strategy can lead to better member health, lower claims cost, and improved product loyalty.
To achieve these goals, payers should start by identifying...
When attempting to improve provider performance on HEDIS quality scores, healthcare payers may need to pick and choose the quality measures that could be realistically raised. For example, childhood...
Last week, Humana announced in a company press release the development of a Clinical Quality Metrics Alignment (CQMA) program meant to simplify and regulate healthcare quality measures. The new...
