Insurer Provides Financial Incentives, Infrastructure, and Other Support To Stimulate Provider Participation in Quality Improvement Collaborations
A large insurer offers financial incentives and other support to provider-led quality improvement collaborations, leading to high levels of provider participation, higher quality, lower costs, and a positive return on investment.
Medicaid Managed Care Plan Provides Reports, Guidelines, and Education Materials to Physicians, Reducing Inappropriate Prescribing of Antibiotics to Children and Adolescents
As part of a collaborative, a California health plan provides quarterly provider performance reports, educational materials, and other support to physicians and parents, leading to a reduction in inappropriate prescribing of antibiotics to children, adolescents, and adults with an upper respiratory infection or acute bronchitis enrolled in the insurer's Medi-Cal managed care plan.
Separate Teen and Parent Group Classes Combined With Pediatrician Support Reduce Body Mass Index and Improve Self-Image of Overweight Girls
In combination with training and support for pediatric providers, a large health maintenance organization offered separate parent and teen group meetings in primary care clinics to promote behavior changes in overweight and obese teenage girls, leading to improvements in eating habits, body mass index, and psychosocial outcomes.
Daily Text Messages and Nurse Followup Improve Self-Management Behaviors in Patients with Diabetes, Leading to Better Glycemic Control and Lower Costs
Daily automated text messages combined with nurse followup improved self-management behaviors among patients with diabetes, leading to significant
improvements in glycemic control, fewer doctor visits, lower costs, and high patient satisfaction.
Electronic Specialist Consultations Reduce Unnecessary Referrals and Wait Times for Specialty Appointments for Uninsured and Underinsured Patients
A public health plan developed a Web-based software platform that enables primary care physicians in federally qualified health centers to consult electronically with "specialist reviewers" before referring the patient to a specialist, leading to fewer unnecessary referrals and shorter wait times for patients who need to see a specialist.
Show Innovation Attempts
Show Policy Profiles
Improving Asthma Care for Children Toolkit: Best Practices in Medicaid Managed Care
This toolkit provides strategies to improve asthma care tested by a diverse group of health plans serving Medicaid consumers.
FAIR Health Consumer Cost Lookup
FAIR Health Consumer Cost Lookup is a free tool that consumers can use to get an estimate of how much health care providers charge for medical and dental services in their area.
This Web site helps uninsured and underinsured consumers in California navigate the application process for discounted care from hospitals.
New York Regional Health Care Report Card
This online report allows health care consumers to compare the cost and quality of commercial health insurance plans by county in New York and New Jersey.
Health Insurer Pandemic Influenza Planning Checklist
The Health Insurer Pandemic Influenza Planning identifies important, targeted activities health insurers can do now to prepare for a pandemic. This checklist is organized according to business-related, employee-related, and communications-related activities.