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  • Kaiser Family Fou
  • Employers continue to be true believers in wellness programs, according to a Kaiser Family Foundation study ( https://www.kff.org/private-insurance/report/2013-employer-health-benefits/ ), despite skepticism heard in some quarters. (managedcaremag.com)
  • In a 2004 poll by the Kaiser Family Foundation, a majority of those polled said they believed that managed care decreased the time doctors spend with patients, made it harder for people who are sick to see specialists, and had failed to produce significant health care savings. (wikipedia.org)
  • 2002
  • According to the company's 2004 Drug Trend Report, from December 2002 to January 2005, the number of members enrolled in a plan with at least one step-therapy program nearly tripled, going from 4.5 million to 13.2 million. (managedcaremag.com)
  • The average number of step-therapy modules per Express Scripts client using step-therapy programs increased from 2.5 to 7.2 between 2002 and 2005. (managedcaremag.com)
  • The CBO estimates that the national deficit will exceed $100 billion for 2002, and the Wall Street Journal reports that that could "squeeze money for the government's health care programs. (managedcaremag.com)
  • outcomes
  • There is a growing national consensus that the best indicators of quality of care are the results, or outcomes, of the interventions offered. (aacap.org)
  • In addition, the National Committee for Quality Assurance requires managed care companies to have a year of outcomes data to be certified. (managedcaremag.com)
  • Examine the effect of a prenatal program on birth outcomes, specifically birth weight, in a managed Medicaid pregnant population, and identify the potential barriers to obtaining the risk screening information required for successful interventions. (managedcaremag.com)
  • We demonstrate a statistically significant improvement in delivery outcomes in the women who participate in the pregnancy management program (NOP group) compared with those who do not (non-NOP group). (managedcaremag.com)
  • Participation in a pregnancy management program improves birth outcomes in women who are at risk of low-birth-weight deliveries. (managedcaremag.com)
  • She is quoted by the NHS Confederation as saying: "Measuring care and outcomes in mental health is often put in the 'too difficult' box yet capturing data on whether people have homes to live in, jobs to go to, appropriate medication, financial stability and social interactions are possible for other conditions so why not for people with mental health problems too. (wikipedia.org)
  • States that have tried implementing PCCM programs have encountered mostly positive results PCCM has been shown to improve patient outcomes. (wikipedia.org)
  • Disease management programs, a prominent part of many PCCM programs, have shown to improve health outcomes by increasing communication between the patient and his/her PCP. (wikipedia.org)
  • 1993
  • In 1993, Lovelace Healthcare Innovations, which is owned by the Lovelace Clinic Foundation in Albuquerque, N.M., joined Greenstone Healthcare Solutions, a subsidiary of Pharmacia and Upjohn, to create what is now one of the most established asthma management programs in the country. (managedcaremag.com)
  • In late 1993, in response to requirements in the DOD Appropriation Act for Fiscal Year 1994, the DoD announced plans for implementing a nationwide managed care program for the MHS that would be completely implemented by May 1997. (wikipedia.org)
  • Formed in 1993 as the Catholic Health Services Plan of Brooklyn and Queens, Inc., Fidelis Care has grown to provide services to more than 1,600,000 New York State residents. (wikipedia.org)
  • Fidelis Care was formed in 1993 under the auspices of the Catholic Medical Center of Brooklyn and Queens, Inc. and the Diocese of Brooklyn to serve the poor and medically underserved, initially operating only in a 14-zip code area Brooklyn. (wikipedia.org)
  • Insurers
  • Insurers that contract with the state to manage the care of low-income Medicaid patients are expected to save money, in part by negotiating lower prices with health providers. (bostonglobe.com)
  • While the company's straight ROI measure - what it didn't spend on visits to physician offices and hospitals - may appear to put the clinics in a competitive role with local health care providers, the company hopes physicians and insurers will keep an open mind. (managedcaremag.com)
  • Meanwhile, insurers responded to public demands and political pressure by beginning to offer other plan options with more comprehensive care networks-according to one analysis, between the years 1970 and 2005 the share of personal health expenditures paid directly out-of-pocket by U.S. consumers fell from about 40 percent to 15 percent. (wikipedia.org)
  • 1994
  • The program was launched January 1, 1994. (wikipedia.org)
  • In 1994, Fidelis Care expanded its services throughout Brooklyn and Queens. (wikipedia.org)
  • citation needed] In 1994, the eight bishops of the Catholic Dioceses, led by John Cardinal O'Connor, sought to extend the Fidelis Care license across the State, receiving final approval in 1996. (wikipedia.org)
  • physician
  • In the most recent report, "2011 Physician Compensation Survey," the group says that these programs decreased slightly from their highest reported usage of 69 percent in 2010 to 64 percent in 2011. (managedcaremag.com)
  • The clinics, staffed by nurse practitioners and physician assistants, will have the dual responsibility of taking care of on-the-job injuries when appropriate and developing and running wellness programs. (managedcaremag.com)
  • Most of the care the clinics provide is episodic, routine care that would not likely be very competitive with a practicing physician who has a busy practice," she says. (managedcaremag.com)
  • Physician practices that exceed the national 90th percentile performance on at least 8 of 10 preventive and chronic care HEDIS measures are named to the plan's physician group honor roll, generating good publicity for the doctors and an invitation to an awards ceremony in their honor. (managedcaremag.com)
  • To encourage physician practices to improve the quality of care they deliver, Harvard Pilgrim annually awards grants to support initiatives that help manage chronic diseases, increase the use of health information technology to improve patient care, or reduce disparities in patient care. (managedcaremag.com)
  • 2017
  • On September 12, 2017, it was announced that Centene Corp. would acquire Fidelis Care for US $3.75 billion. (wikipedia.org)
  • On June 23, 2017, Fidelis Care introduced their Every Child Covered campaign, a new marketing, advertising, and communications campaign to raise awareness for the 100,000 children who are still uninsured in New York State, and to highlight the availability of quality, affordable coverage for kids under 19. (wikipedia.org)
  • company's
  • The Express Scripts report notes that although "some research has touted large savings from retrospective dose consolidation (using prescription claims to identify dose-consolidation opportunities after the prescription has been filled)," the company's research shows that savings of only two cents to three cents per member per month are achieved for a retrospective program. (managedcaremag.com)
  • Also in 2004, the company's training program-CareSource University opened to educate employees and keep service standards high. (wikipedia.org)
  • plan
  • Burnell says OhioCare's managed Medicaid plan payments were cut because they were higher than Medicaid fee-for-service rates on a per-member, per-month basis - a phenomenon inconsistent with federal regulations. (managedcaremag.com)
  • That's what Harvard Pilgrim Health Care (HPHC), a not-for-profit plan covering more than 1 million members in Massachusetts, New Hampshire, and Maine, has focused on for most of this decade - and with good effect. (managedcaremag.com)
  • Through its Healthy Returns worksite program, Harvard Pilgrim sends nurses and health educators to offices and factories to help plan members lose weight, stop smoking, and lower their blood pressure. (managedcaremag.com)
  • Retrospective propensity-adjusted comparison of pregnant women in a managed Medicaid plan enrolled in a prenatal program and pregnant women who were not enrolled. (managedcaremag.com)
  • Work with companies to help boost their Star Ratings by closing health plan care gaps through a review program. (wikipedia.org)
  • The New York State Catholic Health Plan, d/b/a Fidelis Care, d/b/a Fidelis Care New York provides health insurance coverage to people of all ages in New York State. (wikipedia.org)
  • citation needed] After becoming a subsidiary of Fidelis Care in 2005, CenterCare, a New York City-based Medicaid managed care plan, was formally acquired by Fidelis Care in 2008. (wikipedia.org)
  • That same year, Fidelis Care was approved to be a Qualified Health Plan, offering products through NY State of Health: The Official Health Plan Marketplace. (wikipedia.org)
  • On May 13, 2014, Fidelis Care became the Official Health Plan Partner of the New York Liberty WNBA Basketball team for their 2014 season. (wikipedia.org)
  • CareSource is a nonprofit that began as a managed health care plan serving Medicaid members in Ohio. (wikipedia.org)
  • practice
  • The decline this year is surprising," says Jim Otto, senior principal in the Hay Group's health care practice. (managedcaremag.com)
  • The American Society of Health-System Pharmacists (ASHP) Commission on Credentialing approved a full six-year accreditation for the postgraduate year one Health Net Managed Care Pharmacy Practice Residency Program. (webwire.com)
  • It has subsequently spread to describe an approach to decision-making that is used at virtually every level of health care as well as other fields (evidence-based practice). (wikipedia.org)
  • citation needed
  • citation needed] During this time, states increasingly turned to health plans already serving the public coverage programs such as Medicaid and SCHIP to operationalize expansions of coverage to uninsured populations. (wikipedia.org)
  • citation needed] So although consumers faced rising health insurance premiums over the period, lower out-of-pocket costs likely[citation needed] encouraged consumers to use more health care. (wikipedia.org)
  • citation needed] Changes in the perception of health care after World War II and an assessment of medical services provided to dependents caused Congress to re-evaluate the dependent health care benefit in the late 1950s. (wikipedia.org)
  • citation needed] On December 8, 2010, Fidelis Care opened a new Community Office in Patchogue, New York. (wikipedia.org)
  • citation needed] In the first half of 2014, Fidelis Care announced it would add over 100 new jobs to its Upstate New York offices. (wikipedia.org)
  • citation needed] On March 26, 2014, Fidelis Care opened a new Community Office in Gouverneur, New York. (wikipedia.org)
  • 2016
  • On September 14, 2016, Fidelis Care opened a new Regional office in Fairport, New York. (wikipedia.org)
  • On November 16, 2016, Fidelis Care opened its first Welcome Center at 95-25 Queens Boulevard in Rego Park, New York. (wikipedia.org)
  • On December 7, 2016, Fidelis Care opened a new Community Office in Utica, New York. (wikipedia.org)
  • On October 4, 2016, Fidelis Care, in partnership with television personality and lifestyle expert Evette Rios, launched a new initiative, Lunchology: The Basics of Healthy School Lunches. (wikipedia.org)
  • providers
  • One of the important contributions of the systems of care perspective is that it has allowed families to join with mental health providers as equal partners in creating innovative service systems that can be responsive to the needs of children, families, and communities. (aacap.org)
  • It is thus imperative that the purchasers, providers, and consumers of care take a leadership role in developing a process for holding managed care Medicaid programs accountable for the quality of the care that they provide. (aacap.org)
  • Health plans and providers in Ohio's beleaguered Medicaid managed care program, OhioCare, welcomed its per-member, per-month payment increases of more than 25 percent over the last two years. (managedcaremag.com)
  • The costs of treating the uninsured must often be absorbed by providers as charity care, passed on to the insured via cost-shifting and higher health insurance premiums, or paid by taxpayers through higher taxes. (wikipedia.org)
  • Managed care plans are widely credited with subduing medical cost inflation in the late 1980s by reducing unnecessary hospitalizations, forcing providers to discount their rates, and causing the health care industry to become more efficient and competitive. (wikipedia.org)
  • The company does not directly deliver mental health care, but attempts to act as an "integrator", coordinating mental health services from different health and social care providers to ensure care effectively meets the needs of each person with mental health conditions. (wikipedia.org)
  • These acts allowed the Secretary of Defense to contract with civilian health care providers. (wikipedia.org)
  • In return, the PCP is responsible for providing primary care and for prior authorizations to hospitals and specialty care providers. (wikipedia.org)
  • disease
  • The portion of the U.S. population with a chronic disease is forecast to increase from 47 percent in 2010 to 49.2 percent in 2030, putting a further strain on health care budgets," says the survey "Pharmaceutical Key Trends 2011 Overview" by Datamonitor, a business information and analysis company. (managedcaremag.com)
  • One of the goals of the clinics, Kasiarz says, is to establish ties with the local medical community in order to launch disease management and wellness programs, as well as to set up referral capabilities for the clinics. (managedcaremag.com)
  • Lydia Bernstein, the plan's director of clinical programs, discussed the programs that are helping Harvard Pilgrim brandish a sword against heart disease and stroke. (managedcaremag.com)
  • Harvard Pilgrim's cardiac disease management program targets members with cardiac diagnoses who are identified through insurance claims. (managedcaremag.com)
  • Firms offering health benefits continue to offer wellness and health promotion programs, 24% offer employee health risk assessments, and 57% offer at least one disease management program. (managedcaremag.com)
  • Examples of such programs include smoking cessation programs and screenings for high blood pressure or other cardiovascular disease related risk factors. (wikipedia.org)
  • Tertiary health programs address existing health problems, and aim to help control or reduce symptoms, or to help slow the progression of a disease or condition. (wikipedia.org)
  • Accreditation
  • As a result of their hard work we earned full accreditation our first time out, which ASHP gave to only 26 percent of all new pharmacy residency programs it reviewed this accreditation cycle. (webwire.com)
  • ASHP accreditation surveyors performed a two-day onsite review of the residency program. (webwire.com)
  • retirees
  • After World War II and the Korean War, especially with the growth in the standing forces of the U.S. military due to the Cold War, access to care in military facilities became increasingly unavailable for military retirees and the dependents of both active duty and retired military personnel due to resource constraints and growing demands on the system. (wikipedia.org)
  • Tricare Standard provides a similar benefit to the original CHAMPUS program and is available to retirees from the Active Component, retirees from the Reserve Component age 60 or older, and their eligible family members. (wikipedia.org)
  • The MHS also provides, where space is available, health care to dependents of active duty service members, to retirees and their dependents, and to some former spouses. (wikipedia.org)
  • The actual cost of having a government-run health care system for the military is higher because the wages and benefits paid for military personnel who work for the MHS and the retirees who formerly worked for it, is not included in the budget. (wikipedia.org)
  • Management
  • As part of its Drug Quantity Management program, the company offers what it calls "concurrent dose consolidation," which recommends a single unit of one drug strength in place of two units at half that strength when the price for different strengths is similar. (managedcaremag.com)
  • Mark V. Pauly, PhD, professor of insurance and risk management at the Wharton School of Business, says that it might be possible to reduce the prevalence of obesity with "some effective wellness programs" but he doesn't know of any. (managedcaremag.com)
  • and the intensive management of high-cost health care cases. (ucdenver.edu)
  • In 2010, MAXIMUS acquired DeltaWare, a developer of health administration management systems for the Canadian government health care market. (wikipedia.org)
  • Before 1 October 2013, it was managed by the Tricare Management Activity (TMA) under the authority of the Assistant Secretary of Defense (Health Affairs). (wikipedia.org)
  • Known as 'corporate wellbeing' outside the US, workplace wellness often comprises activities such as health education, medical screenings, weight management programs, on-site fitness programs or facilities. (wikipedia.org)
  • Example of primary prevention programs include stress management, and exercise and healthy eating promotion. (wikipedia.org)
  • 1956
  • To address this problem, Congress passed the Dependents Medical Care Act of 1956 and the Military Medical Benefits Amendments of 1966. (wikipedia.org)
  • Congress responded by passing the Dependents Medical Care Act of 1956 and the Military Medical Benefits Amendments of 1966. (wikipedia.org)
  • patient's
  • Hospice care in the United States is a type and philosophy of end-of-life care which focuses on the palliation of a terminally ill patient's symptoms. (wikipedia.org)
  • But hospice care may be authorized for more than six months given a patient's condition. (wikipedia.org)
  • Care may be provided in a patient's home or in a designated facility, such as a nursing home, hospital unit or freestanding hospice, with level of care and sometimes location based upon frequent evaluation of the patient's needs. (wikipedia.org)
  • physicians
  • There are fewer annual incentive programs being offered to physicians, according to a new report from the Hay Group, a global consulting company. (managedcaremag.com)
  • Although Lovelace created a small freestanding pediatric asthma clinic, the vast majority of cases are managed by primary care physicians. (managedcaremag.com)
  • Historically, health care for military personnel and their dependents was provided in military medical facilities as promised by the military, and through a referral system, by civilian medical personnel where military physicians were not available in a certain specialty, or when and where overcrowding of a military medical facility occurred. (wikipedia.org)
  • company
  • In many instances, there are several drugs that are therapeutically equivalent, meaning they are equally safe and equally effective," says Earl Steinberg, MD, president of Resolution Health, a health care data analysis company. (managedcaremag.com)
  • visits
  • The program, in which more than 90 percent of eligible members participate, is responsible for Harvard Pilgrim's success in reducing ER visits and inpatient stays related to cardiac emergencies, Bernstein says. (managedcaremag.com)
  • Factors Associated With Adherence to Blood Pressure Measurement Recommendations at Pediatric Primary Care Visits, Minnesota and Colorado, 2007-2010. (ucdenver.edu)
  • States hoped to save money by eliminating unnecessary or inappropriate emergency room (ER) and specialist visits, lab tests, and other high-cost care. (wikipedia.org)
  • clinical
  • Sign up for Insight Alerts highlighting editor-chosen studies with the greatest impact on clinical care. (aappublications.org)
  • I am proud of how well our program leaders have built a process that gives pharmacy residents an opportunity to gain valuable clinical and business experience as they complete their education and consider a variety of options to launch their careers, Sivori added. (webwire.com)
  • Guided by 15 Health Net preceptors or instructors, the resident must complete three concurrent yearlong rotations in drug information, clinical programs and pharmacy operations, plus 12 consecutive four-week rotations. (webwire.com)
  • Comparing clinical effectiveness and drug toxicity with hydrochlorothiazide and chlorthalidone using two potency ratios in a managed care population. (ucdenver.edu)
  • initiatives
  • This recognition led to initiatives throughout the country to establish organized systems of care. (aacap.org)
  • system
  • While the document is written from the "system of care" perspective, it is not meant to diminish the fundamental role of the individual practitioner within the system of care. (aacap.org)
  • The system of care perspective represents a paradigm shift resulting from the recognition in the early 1980's that children with serious emotional disorders were receiving care in a fragmented treatment system. (aacap.org)
  • Currently, managed care is the most common health care delivery system in Medicaid. (wikipedia.org)
  • The introduction of AHLTA, previously known as the Composite Health Care System II, ushered in a significant new era in health care for the MHS and the nation. (wikipedia.org)
  • The Military Health System is the enterprise within the United States Department of Defense that provides health care to active duty and retired U.S. Military personnel and their dependents. (wikipedia.org)
  • While attempts were made to establish a centralized medical system, care provision was largely local and limited. (wikipedia.org)
  • costs
  • Unfortunately, current efforts to contain costs increase the risk of compromises in the quality of care. (aacap.org)
  • More than 12 million Americans suffer from it, and treatment accounts for 1 percent ($6.1 billion) of America's sky-high health care costs. (managedcaremag.com)
  • States used health plans as a platform for expansions and reforms because of their track record of controlling costs in public coverage programs while improving the quality of and access to care. (wikipedia.org)
  • Managed care is now nearly ubiquitous in the U.S, but has attracted controversy because it has had mixed results in its overall goal of controlling medical costs. (wikipedia.org)
  • medical
  • Managed Care Programs" is a descriptor in the National Library of Medicine's controlled vocabulary thesaurus, MeSH (Medical Subject Headings) . (ucdenver.edu)
  • In the United States, health insurance is any program that helps pay for medical expenses, whether through privately purchased insurance, social insurance or a social welfare program funded by the government. (wikipedia.org)
  • In addition to medical expense insurance, "health insurance" may also refer to insurance covering disability or long-term nursing or custodial care needs. (wikipedia.org)
  • Since people who lack health insurance are unable to obtain timely medical care, they have a 40% higher risk of death in any given year than those with health insurance, according to a study published in the American Journal of Public Health. (wikipedia.org)
  • Active duty military personnel always have priority for care in military medical facilities. (wikipedia.org)
  • Before the Civil War, medical care in the military was provided largely by the regimental surgeon and surgeons' mates. (wikipedia.org)
  • Care began on the battlefield and was then transferred to successively better levels of medical capability. (wikipedia.org)
  • In 2009, Fidelis Care launched Fidelis Medical Advantage Plus (HMO), a managed long term care product for individuals 18 years of age or older who have a chronic illness or disability. (wikipedia.org)
  • It promotes programs to teach the methods to medical students, practitioners, and policy makers. (wikipedia.org)
  • reduce
  • McCrory said he would sign a revised version of the bill, which also included provisions that end same-day voter registration, reduce early voting, and end a program that allowed high school students to register to vote before their 18th birthdays. (wikipedia.org)