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  1. www.ahrq.gov/talkingquality/about/index.html
    August 01, 2016 - to consumers on the quality of care provided by health care organizations (e.g., hospitals, health plans … quite a challenge to sum up and present in an objective way what’s known about the quality of health plans
  2. www.ahrq.gov/cahps/news-and-events/events/20150317/webcast_03_17_15video.html
    July 01, 2018 - Webcast: March 17, 2015 Excelling on CAHPS: Lessons from Top-Performing Medicaid and CHIP Health Plans
  3. www.ahrq.gov/patient-safety/resources/index.html
    December 01, 2022 - medical errors and promoting patient safety, measuring health care quality, consumer assessment of health plans … Health Literacy Universal Precautions Toolkit Pharmacy Health Literacy Center   National Action Plans … National Action Plans are developed with expert input to provide a framework for collaboration among
  4. www.ahrq.gov/policymakers/chipra/overview/background/next-steps.html
    December 01, 2009 - Lower scoring plans reported an average receipt rate of 67 percent, and higher reporting plans reported … an average rate of 92 percent, suggesting considerable variation across plans. … The measure is currently reported to NCQA by 163 MMC health plans in 32 States. … Plans in the Northeast region of the United States have reported higher rates than plans in the South … The current reporting specifications are for health plans and providers.
  5. www.ahrq.gov/sites/default/files/wysiwyg/pqmp/lessons/lessons-using-pqms.pdf
    January 01, 2016 - • In another study, the authors found that health plans have an effect on HEDIS® scores that is … For a pilot program, the state had health plans create a patient-level data flag linking patients … Stakeholder interactions •NCINQ asked participating health plans to categorize key data elements of … ◦ While health plans relied on rules or requirements (such as prior authorization) and feedback … Do health plans influence quality of care?.
  6. www.ahrq.gov/talkingquality/explain/share-info/highlight.html
    September 01, 2019 - If you are rating health plans, for example, it will be important to stress member’s rights to appeal … the organizations in your State or community that take responsibility for complaints about the health plans … your State or locality if you have problems with your Medicare benefits, including Medicare Advantage plans
  7. www.ahrq.gov/prevention/guidelines/tobacco/decisionmakers/index.html
    August 01, 2020 - specific strategies that health care administrators, managed care organizations, and purchasers of health plans
  8. www.ahrq.gov/pqmp/implementation-qi/toolkit/antipsychotic/about.html
    September 01, 2021 - The measures were tested using data from 17 Medicaid managed care plans in a large, mid-Atlantic state … , as well as data from 73 commercial plans nationwide. … Updated specifications are published annually in HEDIS Volume 2: Technical Specifications for Health Plans … Retirement of the Use of Multiple Concurrent Antipsychotics in Children and Adolescents Measure for Health Plans … While this measure is no longer used in reporting programs, it remains important for plans to continue
  9. www.ahrq.gov/workingforquality/events/webinar-federal-agency-alignment-to-the-six-priorities.html
    November 01, 2016 - We give broad choices: members choose from plans currently offered in their area. … We set some boundaries to our plans, what plans must cover, and in general you'll see those in the gray … All of our plans have free preventive care. … I'll share a little bit about the measure set we use for all health plans. … We've also included the links to the 2016 Agency Specific Plans here, and there are additional plans
  10. www.ahrq.gov/patient-safety/settings/long-term-care/resource/quality.html
    July 01, 2018 - Healthy Through Education and Prevention (STEP): Implementation Guide and Coaching Sessions Lesson Plans
  11. www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide185.html
    October 01, 2014 - dependence treatments (both medication and counseling) as a paid or covered benefit by health insurance plans … effective in the Guideline should be included as covered services in public and private health benefit plans
  12. www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-overview/slide36.html
    October 01, 2014 - dependence treatments (both medication and counseling) as a paid or covered benefit by health insurance plans … effective in the Guideline should be included as covered services in public and private health benefit plans
  13. www.ahrq.gov/hai/cusp/toolkit/daily-goals.html
    December 01, 2012 - CUSP Toolkit Effective communication is particularly important in the unit if complicated care plans … Effective communication is particularly important in the unit if complicated care plans are to be effectively
  14. www.ahrq.gov/research/findings/final-reports/diabetesnetwork/diabnet4.html
    October 01, 2014 - What are the plans and likelihood of regional/national spread of what has been learned? … Clinic B completed most Action Plans, with almost all involving DEd. … Not available (Clinic has since implemented electronic medical record [EMR]; plans to evaluate impact … Copies of Action Plans were not placed in medical records to allow followup by clinicians. … Every clinic had a few Action Plans without a comfort level noted.
  15. www.ahrq.gov/pqmp/implementation-qi/toolkit/tcd/qi-strategies.html
    August 01, 2021 - Health Plan Incentives to Promote TCD Screening & Follow Up Financially incentivize Medicaid health plans … increasing TCD screening rates Provide measure performance feedback to Medicaid and CHIP health plans … on regularly scheduled basis Establish processes for health plans to share best practices for … List of state Medicaid health plans may be obtained from state Department of Health and Human Services … The state plans to use its financial incentives “lever” to encourage an environment for plans within
  16. www.ahrq.gov/cahps/about-cahps/index.html
    June 01, 2025 - range of interactions that patients have with the healthcare system, including their care from health plans … develop surveys that ask consumers and patients to report on and evaluate their experiences with health plans … professionals, public and private purchasers of healthcare, healthcare accreditation organizations, health plans
  17. www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/chipra_1415-p011-1-ef_0.pdf
    March 01, 2015 - The measures are intended for children enrolled in commercial health plans and/or Medicaid, with particular … data from States participating in the MEDNET project, Medicaid claims data from about 20 managed care plans … in one State, and data from about 70 commercial plans. … Testing indicated States and plans can collect and report the measures. … and provider Federal programs and have been adopted for reporting by Medicaid and commercial health plans
  18. www.ahrq.gov/talkingquality/distribute/media/printed-report.html
    September 01, 2019 - EXAMPLE: A Brochure for Medicaid Beneficiaries Title: A Guide to Michigan Medicaid Health Plans: Quality … Michigan Department of Health and Human Services publishes a brochure with summary scores for Medicaid plans … process is automatic (i.e., if consumers do not have to take any action to re-enroll in their current plans
  19. www.ahrq.gov/faqs/index.html?page=1
    June 12, 2025 - Quality (AHRQ) to develop surveys of patients' experiences with the healthcare they receive from health plans … The CAHPS program also houses a database for voluntarily submitted survey data from health plans and … Database contains respondent-level survey data, characteristics of entities surveyed (e.g., health plans … The CAHPS® Ambulatory Care Improvement Guide is a comprehensive resource for health plans, medical
  20. www.ahrq.gov/practiceimprovement/delivery-initiative/casalino/paper/idkeydsrapb.html
    February 01, 2014 - Market structures: Market concentration vs. fragmentation (e.g., among hospitals, health insurance plans … Examples of External Incentives Payment methods from payors (primarily commercial health insurance plans … benefits to organizations that have it, e.g.: Is negotiating leverage between health insurance plans

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