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PubMed1952

HEALTH planning.

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Health Planning↗
PubMed1994

Beyond report cards: a health profile for HealthPartners Health Plan and the Business Health Care Action Group.

HealthPartners Health Plan and the "Business Health Care Action Group" (a buyer's coalition) operate in a market place increasingly concerned about accountability and quality improvement. Improving the population's health is a strategy that satisfies the mission and business purposes of employers and health care providers alike. Proposed quality measures and "report cards" have focused on clinical performance standards such as procedure rates or adherence to clinical practice guidelines. This paper describes a unique collaboration between an HMO and a purchasing coalition to assess member health status and health risks as a catalyst for increasing consumer involvement in health care.

Community Participation↗
PubMed2000

NaviMedix's NaviNet Web solution delivering measurable administrative simplification to neighborhood health plan.

Neighborhood Health Plan (NHP), a Boston-based not-for-profit health maintenance organization (HMO), is deploying NaviMedix's NaviNet to replace the tangle of phone calls, faxes, and paper forms with a single real-time Web solution that delivers online referral notification, eligibility verification, specialty notification, claims submission, and claims status inquiry to NHP providers. This real-time information exchange has measurably reduced costs for both NHP and its providers. At the first NHP provider site to implement NaviNet, the total cost of processing and managing referrals was reduced by 70 percent. NHP expects to save three dollars for every dollar it invests in NaviNet.

Ambulatory Care Information Systems↗
PubMed2002

Patient protection and risk selection: do primary care physicians encourage their patients to join or avoid capitated health plans according to the patient's health status?

BACKGROUND: Individual physicians who are paid prospectively, as in capitated health plans, might tend to encourage patients to avoid or to join these plans according to the patient's health status. Though insurance risk selection has been well documented among organizations paid on a prospective basis, such physician-level risk selection has not been studied. OBJECTIVE: To assess physician reports of risk selection in capitated health plans and explore potentially related factors. DESIGN AND PARTICIPANTS: National mailed survey of primary care physicians in 1997-1998, oversampling physicians in areas with more capitated health plans. RESULTS: The response rate was 63% (787 of 1,252 eligible recipients). Overall, 44% of physicians reported encouraging patients either to join or to avoid capitated health plans according to the patients' health status: 40% encouraged more complex and ill patients to avoid capitated plans and 23% encouraged healthier patients to join capitated plans. In multivariable models, physicians with negative perceptions of capitated plan quality, with more negative experiences in capitated plans, and those who knew at each patient encounter how they were being compensated had higher odds of encouraging sicker patients to avoid capitated plans (odds ratios, 2.0, 2.2, and 2.0; all confidence intervals >1). CONCLUSIONS: Many primary care physicians report encouraging patients to join or avoid capitated plans according to the patient's health status. Although these physicians' recommendations might be associated primarily with concerns about quality, they can have the effect of insulating certain health plans from covering sicker and more expensive patients.

Adult↗
PubMed2003

Sampling patients within physician practices and health plans: multistage cluster samples in health services research.

OBJECTIVE: To better inform study design decisions when sampling patients within health plans and physician practices with multiple analysis goals. STUDY SETTING: Chronic eye care patients within six health plans across the United States. STUDY DESIGN: We developed a simulation-based approach for designing multistage samples. We created a range of candidate designs, evaluated them with respect to multiple sampling goals, investigated their tradeoffs, and identified the design that is the best compromise among all goals. This approach recognizes that most data collection efforts have multiple competing goals. DATA COLLECTION: We constructed a sample frame from all diabetic patients in six health plans with evidence of chronic eye disease (glaucoma and retinopathy). PRINCIPAL FINDINGS: Simulations of different study designs can uncover efficiency gains as well as inform potential tradeoffs among study goals. Simulations enable us to quantify these efficiency gains and to draw tradeoff curves. CONCLUSIONS: When designing a complex multistage sample it is desirable to explore the tradeoffs between competing sampling goals via simulation. Simulations enable us to investigate a larger number of candidate designs and are therefore likely to identify more efficient designs.

Cluster Analysis↗