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An initiative that assigns ownership of HEDIS®* measures to various staff members has resulted in improved HEDIS scores and national acclaim for Keystone Health Plan Central, a wholly owned subsidiary of Capital BlueCross, independent licensees of the Blue Cross Blue Shield Association.
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Prices in the commercial insurance industry, which declined steadily in 2004 in the first yearlong soft market since 1998, may be showing signs of a rebound, according to a new survey.
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When Blue Shield of California conducted a pilot project paying physicians for Internet-based consultations for nonurgent conditions, the San Francisco-based health plan found the initiative reduced office visit claims by $1.92 per member per month and total health care costs by $3.69 per member per month.
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One in three (33%) U.S. adults who have been prescribed drugs to take on a regular basis reported that they often or very often are noncompliant with the treatment regimen, according to a recent Harris Interactive on-line survey.
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Employees who are injured or ill return to work full time more quickly and experience a shorter period of disability when the health care components and disability components of an insurance company work together, a CIGNA study of 60,000 short-term disability claims has shown.
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Quality improvement organizations (QIOs) have gone a long way toward erasing the previously adversarial and punitive roles of their predecessors, the peer review organizations, according to a new study in the bimonthly journal Health Services Research.
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Suspecting that a colleague might be impaired by drugs or alcohol is difficult; knowing what to do with those suspicions is even harder.
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At CIGNA, disability nurse case managers often partner with nurse case managers from the health care side of the company to facilitate getting an injured worker back on the job.
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Gaps in the system are costing you money: the injury that isnt reported right away; the employee who doesnt keep a doctors appointment; and the supervisor who doesnt make an effort to find a position for an employee with temporary restrictions.
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Horizon Blue Cross and Blue Shield of New Jersey is taking physician pay for performance to a new level, embarking on a plan to pay a higher standard fee to specialists who outperform their peers.