Colorado Seeks Proof of Quality From Health Plans


New regulations taking effect in Colorado this month tighten reporting rules and seek to gain greater proof that health plans are delivering quality care.

The regulations require plans to have written quality assurance programs to evaluate their services. The plans must detail the treatments and conditions that will be reviewed, and conduct research to improve services and health outcomes. Plans must also demonstrate that they are providing adequate access to care and are also educating members about wellness and chronic-disease management.

Colorado's Cross-Disabilities Coalition criticized the new rules as inadequate, noting that HMOs will not be required to make their quality assurance plans available to the public, and that the rules do not address home-health care services.

Colorado's Department of Public Health and Environment developed the rules and will administer them jointly with the Division of Insurance and the Department of Health Care Policy and Financing, which regulates Medicaid in the state. The final version of the regulations is available at http://www.cdphe.state.co.us/.

Career Opportunities

HAP, a subsidiary of Henry Ford Health System, is a nonprofit health plan providing coverage to individuals, companies and organizations. This executive develops strategies to meet membership and revenue targets through products, pricing, market segmentation and advertising.  Aligns business among Business Development, Commercial Sales, Medicare and Public Sector Programs and Product Development. Seeks to enhance and be responsible for business development and expansion through the development of an effective product portfolio, strong interpersonal relationships and service excellence.

Apply via email to jfedder1@hfhs.org or online at http://p.rfer.us/HENRYFORDlXqAJA

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