Health Plan & Provider Report Index Summary

QUALITY OF CARE

– Comparative effectiveness research

– Consumer-directed plans, employer savings and improved quality, Aetna study, 320
– Cost management measures

– – Streamlining administrative options, UnitedHealth says system could save $332 billion over decade, report, 805
– – UnitedHealth says federal government could save $540 billion over 10 years, report, 643

– Disparities among states shows need for health care reform, report says, 1194
– Hospitals

– – Fla. website updated, In Brief, 682
– – Information technology, increased use improves outcomes and saves money, study, 133
– – Insurer rewards, innovative payment models, report, 536
– – Mergers and acquisitions, FTC to focus on quality improvement potential, meeting, 177
– – Telemedicine, Prince Frederick, Md., facility and Wilmington, Del., tertiary care facility linked, 682

– Infrastructure to measure, Brookings Inst. publication outlines 3-year plan, briefing, 946
– Medical home pilot program, CIGNA partners with Tex. clinic, 1075
– Medicare Advantage

– – Comparable performance measures versus traditional Medicare, MedPAC meeting discusses, 1123; data collection requirements expansion considered, 1177
– – Consumer ratings of plans, CMS seeks to raise, forum, 151

– Minn. care delivery improvement, Medica and Fairview Health Sys. collaborative agreement, 898
– NCQA

See NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA)

– N.Y. health insurance, state public plans exceed national averages, report, 652
– Organized health care delivery systems, improvement strategies described, report, 834
– Pa. improvement, new law, 777
– Physicians

– – Insurer rewards, innovative payment models, report, 536
– – Pay-for-performance programs

See PAY-FOR-PERFORMANCE PROGRAMS

– – Ratings, Tex. BCBS to stop using cost-based system, 435

– Provider information

– – Aetna expands website, 320
– – Data, errors and remedies described, BNA Analysis, 135

– Regional organizations' information exchanges, liability insurance key issue, study, 894

QUI TAM SUITS

– Attorneys' fees, litigant who filed frivolous Medicare cases must pay (E.D. Tenn.), 69
– Medicare Secondary Payer Act

– – Hospitals, sanctions imposed on individual who did not receive benefits and therefore lacked standing to sue (U.S., rev sought), 70
– – Insurer acceptance of payment was allegedly improper, no claim for patient (2d Cir.), 925
– – State Farm's motion to dismiss properly granted where insurer did not avoid legal obligation to repay hospital after accident (D. Idaho), 1005

– PBM Caremark, state immunity from counterclaims in FCA suit at issue (5th Cir.), 893