Health Plans Bear Down on Quality, HEDIS Scores Improve Dramatically

In past years, the National Committee for Quality Assurance has used the annual release of its "State of Managed Care Quality" report to goad health plans into better HEDIS performance. Plans that do well are stroked; minimal improvement is called not good enough; and those that do not participate in HEDIS, that are not accredited by NCQA, or that do not report their HEDIS data publicly are excoriated. But this year, NCQA abandoned the bully pulpit in favor of praising the HMO industry as a quality-improvement success story to be told. Here's part of that story.

Full text of this article (PDF)


Innovation ’19: Reverse Auctions for PBMs
By Joseph Burns
Innovation ’19: Blockchain
By Richard Mark Kirkner