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.
Medical "Extensivists" Care for High-Acuity Patients Across Settings, Leading to Reduced Hospital Use
A Medicare Advantage plan uses employed "extensivists" who perform traditional hospitalist functions for a smaller-than-average caseload of patients, and then continue to follow and care for these patients after discharge until their condition becomes stabilized, leading to low length of stay and fewer readmissions.
Health Plan's Multifaceted Strategy Involving Care Coordination, Disease Management and Physician Incentives Leads to Better Outcomes and Reduced Costs for Medicare Advantage Enrollees
HealthSpring's Partnership for Quality program offers bonuses to physician practices and onsite care coordination and disease management support, leading to significantly better outcomes and reduced costs for Medicare Advantage enrollees.
Statewide Measurement and Reporting System Stimulates Quality Improvement in Targeted Clinical Areas, Becomes Standard for Local and National Pay-for-Performance Programs
A statewide measurement and reporting system serves as a single, comprehensive, credible source of information on provider performance, leading to significant improvements in performance over time and to adoption and use of the system by local and national payers and other organizations.
Individualized, In-Home Program Identifies and Addresses Environmental Problems That Can Worsen Asthma Control
A health plan's individualized, in-home, environmental asthma intervention program targets all pediatric members with confirmed allergies to indoor allergens and symptomatic asthma. During multiple in-home visits, trained asthma counselors provide education, perform an environmental assessment, demonstrate intervention equipment, devise a written care plan, and assess and address psychosocial issues.
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Theory and Reality of Value-Based Purchasing: Lessons from the Pioneers
This report summary provides early lessons on the scope, patterns, barriers, and possibilities of value-based purchasing.
Designing and Implementing Medicaid Care Management Programs: A User’s Guide
The Medicaid Care Management Guide helps States design, implement, and evaluate care management programs for the chronically ill.
Evaluating the Impact of Value-Based Purchasing: A Guide for Purchasers
This guide was developed to be an evaluation tool for purchasers, particularly employers, in assessing their value-based purchasing (VBP) activities.
Medicare Prescription Drug Plan Finder
This tool will help Medicare beneficiaries learn more about the new Medicare prescription drug coverage and enable them to find and compare prescription drug plans that meet their personal needs.
Improving Outcomes for Children in Child Welfare: A Medicaid Managed Care Toolkit
This toolkit, developed by the Center for Health Care Strategies (CHCS), can help guide efforts to improve care for children in the child welfare system.