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Showing results for "plans".

1. Comparative Reports on Health Plans | Agency for Healthcare Research and Quality
   www.qualitymeasures.ahrq.gov/talkingquality/resources/comparative-reports/health-plans.html
   December 01, 2022 - The following reports are examples of comparative information on the quality of health plans … Report Title: Health Plan Report Card Website: https://reportcards.ncqa.org/health-plans . … Additional topics are included in the rating for plans that cover prescription drugs. … The scores for patient experience with health plans use CAHPS rating and composite measures. … , as well as reports to learn more about the overall performance of Maryland health plans.

2. CAHPS Health Plan Survey | Agency for Healthcare Research and Quality
   www.qualitymeasures.ahrq.gov/cahps/surveys-guidance/hp/index.html
   April 01, 2024 - For over two decades, health plans, public and private purchasers, and other organizations have been … plans for high-quality care. … To support consumers in assessing the quality of health plans and choosing the plans that best meet their … To identify the strengths and weaknesses of health plans and target areas for improvement. … Plans, and the fee-for-service program.

3. How Will You Gain the Trust of Health Care Providers or Plans? | Agency for Healthcare Research and Quality
   www.qualitymeasures.ahrq.gov/talkingquality/plan/gain-trust.html
   November 01, 2018 - About TalkingQuality How Will You Gain the Trust of Health Care Providers or Plans … View Health Care Organizations as an Audience Start by regarding the providers and plans as one of … While you may be designing it for consumers, the reality is that providers and plans are typically the … Research on report card use demonstrates that not only do providers and plans pay attention to the data … Keep them informed about your objectives and plans, including methods, schedule, progress, and issues

4. Planning Culturally and Linguistically Appropriate Services | Agency for Healthcare Research and Quality
   www.qualitymeasures.ahrq.gov/ncepcr/tools/cultural-competence/planclas.html
   July 01, 2019 - Plans and their providers are subject to major cost constraints, so they are understandably concerned … In addition, plans may feel that their current approach to the provision of services is adequate and … What Does This Mean for Plans and CLAS? … In sum, there are multiple reasons for plans to undertake improvements in CLAS. … Many of these plans have benefited from working collaboratively with other managed care plans to develop

5. Using CAHPS Health Plan Survey Data | Agency for Healthcare Research and Quality
   www.qualitymeasures.ahrq.gov/cahps/surveys-guidance/hp/improve/index.html
   July 01, 2022 - To inform consumers about enrollee experience with health plans. … and different kinds of health plans. … Improve Enrollee Experience Many health plans use their Health Plan Survey results to identify strengths … Several resources are available to support health plans in this effort. … Survey Scores Webcast: Excelling on CAHPS: Lessons from Top-Performing Medicaid and CHIP Health Plans

6. Excelling on CAHPS: Lessons from Top-Performing Medicaid and CHIP Health Plans (Webcast) | Agency for Healthcare Research and Quality
   www.qualitymeasures.ahrq.gov/cahps/news-and-events/events/20150317/webcast_03_17_15.html
   July 01, 2018 - CAHPS Excelling on CAHPS: Lessons from Top-Performing Medicaid and CHIP Health Plans … Two top-performing health plans shared how they have achieved high patient experience scores in the areas … ) Listen to the Webcast Excelling on CAHPS: Lessons from Top-Performing Medicaid and CHIP Health Plans … Health Plan Survey Database Chartbook: What Consumers Say About Their Experiences with Their Health Plans … Internet Citation: Excelling on CAHPS: Lessons from Top-Performing Medicaid and CHIP Health Plans

7. Major Health Plan Quality Measurement Sets | Agency for Healthcare Research and Quality
   www.qualitymeasures.ahrq.gov/talkingquality/measures/setting/health-plan/measurement-sets.html
   December 01, 2022 - More than 90 percent of health plans—HMOs, POS plans, and PPOs—use HEDIS to measure performance. … HEDIS is one component of NCQA's accreditation process, although some plans submit HEDIS data without … HEDIS enables consumers and purchasers to compare health plan performance to other plans and to national … Data source: You can obtain HEDIS results directly from health plans or by purchasing access to NCQA … employees, beneficiaries); however, sponsors typically get this information directly from the health plans

8. The IHA Bundled Episode Payment and Gainsharing Demonstration | Agency for Healthcare Research and Quality
   www.qualitymeasures.ahrq.gov/practiceimprovement/delivery-initiative/bozicstudysnapshots/index.html
   August 01, 2018 - Under this approach, a group of providers receives a fixed payment from participating health plans. … Ultimately, only three of the six health plans and two of the five hospitals signed contracts, as did … clinical care redesign (by providers) and automated claims processing (by health plans). … Lack of trust, driven by competing interests: Participating health plans, hospitals, and physicians … Mistrust manifested in significant disagreement about pricing, with health plans expecting reductions

9. How Will You Pay for a Health Care Quality Report? | Agency for Healthcare Research and Quality
   www.qualitymeasures.ahrq.gov/talkingquality/plan/pay.html
   November 01, 2018 - Possible sources include: Local health plans and providers. … Sharing Costs With Health Plans and Providers The most common strategy is to ask the health plans or … However, competitive forces and multiple demands in the health care industry are making some health plans … Read about strategies for addressing this response in How Will You Gain the Trust of Providers or Plans … Through this arrangement, health plans bear the cost of collecting data on their quality; the plans also

10. Improvement Data | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/pqmp/implementation-qi/toolkit/tcd/improvement-data.html
    July 01, 2021 - As such, plans will have to work together to achieve overall improvement in the region to receive the … and future plans for improving care has been developed and is ready for implementation. … Barriers Baseline information was to be collected by the State from Michigan Medicaid health plans … through 2018, increases were seen in the performance rates for two collaborating health plans, Plan … Rates for all health plans decreased in 2019.

11. Strategy 6K: Cultivating Cultural Competence | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/cahps/quality-improvement/improvement-guide/6-strategies-for-improving/communication/strategy6kculturalcompetence.html
    March 01, 2020 - Interventions The variety of strategies available to help health plans reduce linguistic, cultural, … At a minimum, health plans should collect information on race, ethnicity, and preferred language through … As part of the Healthcare Effectiveness Data and Information Set (HEDIS), plans routinely report on the … To go beyond tracking, innovative plans put in place programs to match members with providers who can … Health plans can also reward providers for contributing to the linguistic diversity of their networks

12. Measures To Assess the Safe and Judicious Use of Antipsychotics in Children and Adolescents Field Test Summary (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-148-testing-summary.pdf
    February 22, 2019 - 1 MEDNET state • Health plan analyses o 2009 claims data from 17 New York State Medicaid health plans … o 2013 claims data from 73 commercial health plans nationwide Study Population Our study population … Commercial plans had lower denominator sizes (Table 2c). … Among commercial plans, rates were slightly lower (i.e. better). … We focused on health plans, as there were low numbers of observations for states.

13. The Effects of Out-of-Pocket Costs on Enrollees' Experiences With Health Plans: Implications for Consumer Reporting (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/podcasts/effects-costs-enrollees-vonglahn-20120101-transcript.pdf
    January 23, 2012 - The Effects of Out-of-Pocket Costs on Enrollees' Experiences With Health Plans: Implications for Consumer … www.talkingquality.ahrq.gov The Effects of Out-of-Pocket Costs on Enrollees’ Experiences With Health Plans … and their respective products, the HMO and PPO products offered by the plans. … And part of what we’re finding in these results is the plans are coming up short in that regard. … plans, or platinum plans, or gold plans -- plans that are categorized by the benefit design and the

14. Section 6: Strategies for Improving Patient Experience with Ambulatory Care | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/cahps/quality-improvement/improvement-guide/6-strategies-for-improving/index.html
    March 01, 2023 - How Health Plans Can Drive Improvements at the Medical Group Level References Download Section … For some strategies, both health plans and provider groups have a role to play, even if one is more " … Health plans, for example, can equip providers with the skills, tools, and information systems they can … Appendix 6b discusses three ways in which health plans can harness reporting and purchasing strategies … Health plans that own physician practices and/or employ physicians, and those that have an exclusive

15. Considerations When Partnering with Health Care Organizations | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/talkingquality/plan/partners/healthcare-org.html
    July 01, 2011 - Health Care Organizations To help decide whether and how to collaborate with providers or plans … If, on the other hand, you wish to report on members’ experiences with health plans, you can get that … While you may still want to invite the health plans to participate in the development of the report, … For example, if you wish to report on the quality of medical groups, you may find that health plans are … Because of their contractual relationships, health plans can also help to exert pressure on providers

16. Providing Oral Linguistic Services | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/ncepcr/tools/cultural-competence/oralling.html
    July 01, 2019 - What Does This Mean for Plans and CLAS? … In sum, there are multiple reasons for plans to undertake improvements in linguistic competence. … Purpose of This Guide This guide helps plans address shifting demographic trends by: Offering an … Step 3: Identify Points of Contact for Members of Managed Care Plans. … parts of the planning process, while other plans will be new to linguistic competency and may choose

17. Quality Improvement Strategies | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/pqmp/implementation-qi/toolkit/antipsychotic/qi-strategies.html
    July 01, 2021 - Plans also tested strategies to engage youth and family in their QI work. … Worked individually with the plans participating in the collaborative to compare baseline performance … The Multiple Concurrent Antipsychotics measure performance was already very good for most plans with … only one of the plans was able to realize an improvement in performance. … participating in the collaborative, other plans in NY, and plans reporting nationally.

18. Using the CAHPS Database to Compare, Report, and Improve Organizational Performance (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/events/20140115_DB/3_Deborah_Kilstein_slides_29-40.pdf
    January 15, 2014 - Growing role of health plans What is a sponsor report? … How do the ACAP Plans utilize the ACAP sponsor report? … ACAP’s 58 Plans are in 25 States 31 Medicaid Managed Care and Traditional Enrollment 1999 - 2011 … operate SNPs  10 ACAP plans operate Managed Long-Term Care Plans  18 ACAP plans will participate … are doing as a group  Also allows individual health plans to benchmark against other plans and national

19. Provider-Offered Medicare Advantage Plans Among U.S. Health Systems, 2016 (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/chsp/ma-plans.pdf
    March 01, 2019 - Provider-Offered Medicare Advantage Plans Among U.S. … 2016 1 Comparative Health System Performance Initiative Provider-Offered Medicare Advantage Plans … HMO plans are most common, followed by PACE. 12% of systems (N=626) Program of All-Inclusive Care … Across systems of all sizes, HMO plans are more common than PACE or other plans. … In our work, we used all plans in the MA Plan Directory.

20. Key Driver Diagram | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/pqmp/implementation-qi/toolkit/tcd/key-driver.html
    September 01, 2021 - Health plans had systems in place for using care management to improve care for chronic diseases, but … Clinic performance data was shared and improvement plans were developed. … Health Plan Insights Health plans have many competing priorities. … This means incentives are provided to the health plans to focus improvement efforts on those specific … The state will use financial incentives to create an environment for plans within a specific Medicaid