A program in which case managers coordinate the care of members with complex medical conditions and those who are at high risk for chronic diseases has paid off for Care Choices HMO of Farmington Hills, MI.
A depression management program has resulted in better scores on Health Plan Employer Data Information Set (HEDIS) measures and a reduction in depression screening scores for Fallon Community Health Plan, with headquarters in Worcester, MA.
Great-West Healthcares disease management approach won the Denver-based company the award of best disease management program in a national PPO for 2002-2003 from the Disease Management Association of America (DMAA).
A predictive modeling program is just the first step in identifying members for a comprehensive disease management program, says Michael Cousins, PhD, manager of health informatics for Health Management Corp. (HMC), based in Richmond, VA.
When it comes to accepting cash payments from providers in exchange for referrals, there is no question: It is expressly forbidden. But what happens with noncash items, such as the seemingly innocuous gifts that show up around the holidays or the New Year. What are the rules?
