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  • Children's Health
  • Prior to joining AHIP, he served as a Senior Director for Policy at the Pharmaceutical Research and Manufacturers of America (PhRMA) where he worked on developing and managing public policy issues related to comprehensive health care reform, health-system and delivery reforms, and public programs such as Medicaid and the Children's Health Insurance Program (CHIP). (ahip.org)
  • We conducted this study at Community Health Choice, Inc, which is a local nonprofit HMO plan that offers the Medicaid State of Texas Access Reform program, the Children's Health Insurance Program, and Health Insurance Marketplace Plans, with a network of 10,000 doctors and 70 hospitals. (ahdbonline.com)
  • parity
  • ANNAPOLIS, Md. , PRNewswire/ -- ClearHealth Quality Institute TM (CHQI), an independent health care accrediting body, is pleased to announce its new Online Parity Compliance Tool, the first and only comprehensive digital resource designed for health plans and other organizations to build, implement, and manage a parity compliance program that meets key regulatory and accreditation requirements. (biospace.com)
  • Health plans, employers, third-party administrators and others can soon access CHQI's interactive Online Parity Tool, which will offer a secure platform to help build and maintain mental health parity compliance programs. (biospace.com)
  • The tool will also serve as the online application portal for CHQI's new Mental Health and Substance Use Disorder MH/SUD Parity Accreditation Program for those entities prepared to apply. (biospace.com)
  • As a result, CHQI launched a two-year initiative to create the MH/SUD Parity Accreditation Program, with a primary purpose of filling regulatory gaps and implementing consistent national standards. (biospace.com)
  • In support of the accreditation program and implementation of effective compliance programs, the CHQI Online Parity Compliance Tool will serve as a roadmap for health plans to implement a successful parity compliance program. (biospace.com)
  • Through its new Mental Health and Substance Use Disorder MH/SUD Parity Accreditation Program, CHQI has combined the best of consulting, accreditation and technology solutions to help implement the Federal Parity Law in a meaningful and practical manner. (biospace.com)
  • The new Online Parity Tool will help companies to organize and automate how parity is achieved, benefiting health plans, consumers, providers, regulators and others alike. (biospace.com)
  • More than 50 parity-related legal claims and court cases have been filed or decided recently, along with a growing number of state regulatory audits looking at how health plans cover mental health and substance use disorder treatments. (biospace.com)
  • CHQI's Online Parity Tool will help health plans implement a proactive risk management program in anticipation of tighter regulatory and legal oversight. (biospace.com)
  • CHQI will soon offer demos of the new Online Parity Tool and the new MH/SUD Parity Accreditation Program to qualified health plans and potential clients. (biospace.com)
  • Evaluation of Parity in the Federal Employees Health Benefits (FEHB) Program: Final Report. (hhs.gov)
  • President Clinton directed the Office of Personnel Management to institute parity for mental health and substance abuse (MH/SA) coverage within the FEHB Program to serve explicitly as a model for both public and private health policy choices. (hhs.gov)
  • The purpose of this component of the study is to characterize the structure and process employed by each of the selected health plans to implement the FEHB Program parity requirements. (hhs.gov)
  • plan's
  • As illustrated below, there are relevant benefit design and provider reimbursement features that could be grouped under each priority area as a way to reinforce and implement a health plan's quality improvement strategies. (commonwealthfund.org)
  • A copy of the health plan's summary matrix will be given back to that plan for review and comment. (hhs.gov)
  • After the plan's contact person and RAND staff have discussed the Guide and identified the appropriate respondent to answer questions in each of the topical areas, we will customize the Guide for each plan to facilitate the interview process. (hhs.gov)
  • nation's
  • PHS is one of the nation's leading managed health care services companies. (bmj.com)
  • In an article published in November 3 edition of Journal of the American Medical Association (JAMA), Chad Boult, MD, MPH, MBA, professor of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, calls for key improvements to primary care in order to improve the health of the nation's most costly patientsolder adults with multiple chronic conditions. (bio-medicine.org)
  • hospitals
  • Almost two-thirds of the health and social care estate needs investment to modernise, with many hospitals aged over 50 years old. (agendani.com)
  • A total of £2.32 billion has been allocated for primary care, hospitals and public safety between 2011 and 2021: £851 million up to 2015 and £1.47 billion thereafter. (agendani.com)
  • Further ICT developments are planned, including allergy and current prescription information and electronic prescribing in hospitals. (agendani.com)
  • U.S. hospital chain Tenet Healthcare Corporation , and two of its subsidiaries in the Atlanta region, paid $513 million to resolve criminal and civil allegations that four of its hospitals engaged in a plan to defraud the government and pay kickbacks for patient referrals. (bricker.com)
  • screenings
  • PACE has been found to increase health screenings, reduce hospital admissions, increase nursing home stays, and reduce mortality among PACE participants at high risk of dying. (bio-medicine.org)
  • 2016
  • The DOJ reported that it has recovered $19.3 billion in health care fraud claims since 2009 and that 2016 marks the seventh consecutive year that it has recovered at least $2 billion as a result of health care fraud. (bricker.com)
  • broader
  • This study provides insight into how communications regarding the Compensation Plan in Alberta, Canada positioned pharmacists' changing roles in the broader context of changes to primary health care delivery. (beds.ac.uk)
  • HealthPartners
  • In response, HealthPartners has developed summary measures that align with the recommendations of the For the Public's Health series of reports from the Institute of Medicine. (cdc.gov)
  • HealthPartners will use the summary measures to identify and address conditions and factors that have the greatest impact on the health and well-being of its patients, members, and community. (cdc.gov)
  • Founded in 1957, HealthPartners is the largest consumer-governed, nonprofit health care organization in the nation. (cdc.gov)
  • employer
  • Both employer group health plans, including self-insured plans, individual market plans, and qualified health plans sold through the insurance exchanges are required to submit such reports (Appendix B). (commonwealthfund.org)
  • AHIP's members provide health and supplemental benefits to more than 200 million Americans through employer-sponsored coverage, the individual insurance market, and public programs such as Medicare and Medicaid. (ahip.org)
  • Primary operations include managed care products for employer groups and Medicare beneficiaries in nine states and Guam serving approximately 3.6 million members. (bmj.com)
  • The absence of consistent coverage of benefits under the ACA is on full display with the law's fractured regulation of employer sponsored small group plans. (amazonaws.com)
  • You're 65 or older and covered by a group health plan through your current employer or the current employer of a spouse of any age. (amazonaws.com)
  • Program
  • In recent years, we have witnessed the consolidation of a CPG program in both the Basque Country and the Spanish National Health System and this has led to the GuiaSalud Program. (biomedcentral.com)
  • And just 7.8 percent (1,107 persons) of medical students participating in the National Resident Matching Program selected primary care residencies, down from 8.1 percent (1,132) in 2006. (managedcaremag.com)
  • Alwyn Cohall , MD, Sociomedical Sciences, and Erica Chin, PhD, Psychiatry, will receive $1,198,613 over five years from the New York State Department of Health for "Youth Access Program (YAP) for YMSM: Transgender and Other Hisk-Risk Adolescents/Young Adults. (columbia.edu)
  • Plan and scope Departmental program review. (health.gov.au)
  • Full time Staff: Opportunity to join the Australia Awards program and contribute to health, safety and security for program operations 12 month contract, with the possibility of extension Based in Port Moresby. (eldis.org)
  • and identify the factors that promote and inhibit community involvement in PHC program development and implementation. (jhsph.edu)
  • In addition to providing health benefits to federal workers, the FEHB Program serves as a model for national health policy in areas ranging from managed care to the design of prescription drug benefits. (hhs.gov)
  • A lead contact person at each of the selected health plans has been designated by OPM and the plans to coordinate FEHB Program evaluation activities for the plan. (hhs.gov)
  • Population
  • Lynn Freedman , JD, and Shanon McNab, Population & Family Health, will receive $901,730 over one year from Merck for "Globalizing the Quest for Maternal Health - D&A in the USA. (columbia.edu)
  • Helena Duch , PsyD, Population & Family Health, will receive $554,774 over one year from the Heising-Simons Foundation for "Getting Ready for School: An Integrated Approach to School Readiness" in a competitive renewal. (columbia.edu)
  • Lynn Freedman , JD, and Marta Schaaf, MIA, MPH, Population & Family Health, will receive $500,000 over two years from the John D. & Catherine T. MacArthur Foundation for "For Maternal Health Accountability at the Frontlines. (columbia.edu)
  • In considering a framework to meet reporting requirements outlined in the Affordable Care Act, there are significant opportunities to align with the National Quality Strategy (NQS) in pursuit of improving population health, improving care experiences, and controlling per capita costs. (commonwealthfund.org)
  • They lack, however, a summary measure of the third leg of the Triple Aim, population health. (cdc.gov)
  • Draft population plans and the strategic implementation plan were completed in June and have subsequently been subject to a quality assurance review. (agendani.com)
  • Each state or territory office considers Indigenous population figures, analyses OATSIH regional planning data and takes into account current funding levels, with particular emphasis on the 29 priority communities identified in COAG's National Partnership Agreement on Remote Service Delivery (RSD NP). (health.gov.au)
  • increasingly
  • While the numbers vary and are sometimes disputed, health plan medical directors and top executives are increasingly coming to the conclusion that a shortage is imminent - and that they will have to take action to mitigate its effects on their businesses. (managedcaremag.com)
  • providers
  • In addition, some health plans use their contracts with providers to encourage high-quality, high-value care. (commonwealthfund.org)
  • PacifiCare Health Systems, Inc (PHS) addresses key health issues through the research and development of health improvement strategies designed to complement the care provided by a robust network of dedicated health care providers. (bmj.com)
  • Additionally, the prevalence of whistleblower cases, and their resulting successes, highlights the continued need for health care providers and companies to continue to focus on developing policies and procedures to ensure compliance. (bricker.com)
  • administrators
  • We will work closely with that contact person to identify the appropriate health plan administrators to interview, to schedule the site visit, and to collect any needed documentation. (hhs.gov)
  • Policy
  • For the Public's Health: Investing in a Healthier Future, For the Public's Health: Revitalizing Law and Policy to Meet New Challenges, and For the Public's Health: The Role of Measurement in Action and Accountability . (cdc.gov)
  • Mr. Gierer has over 15 years of experience with health care policy and analysis. (ahip.org)
  • He previously served as a Senior Policy Consultant at the Blue Cross and Blue Shield Association (BCBSA) and a Policy Analyst at America's Health Insurance Plans (AHIP). (ahip.org)
  • This weekly series explores breaking news and developments in the U.S. health care industry, examines key issues facing life sciences and health care companies and provides updates and insights on policy, regulatory and legislative changes. (deloitte.com)
  • Regulation
  • The federal government's role in health care regulation has grown over time, especially since the inception of Medicare and Medicaid in the 1960s. (amazonaws.com)
  • Americans
  • When aggregated across health plans, the measures would be applicable regionally and nationally, because nearly 90% of Americans are now registered with a health plan (4). (cdc.gov)
  • AHIP advocates for public policies that expand access to affordable health care coverage for all Americans through a competitive marketplace that fosters choice, quality, and innovation. (ahip.org)
  • access
  • In America, there are plenty of people that do not have adequate access to primary care, and there are some locations where it is difficult to hire certain doctors. (managedcaremag.com)
  • Get access to 16,000 woodworking plans, Download 50 FREE Plans. (slideshare.net)
  • Throughout the 2012 Presidential campaign, Republican contenders criticized the Affordable Care Act (ACA) as a "federal take-over of health care" for its promotion of national uniformity in health coverage and access. (amazonaws.com)
  • Allergy
  • Wafaa M. El-Sadr , MD, and Jessica Justman , MD, ICAP, will receive $1,421,810 over one year from the National Institute of Allergy and Infectious Diseases for "HPTN083 Protocol Funding- Implementation Costs Bronx CRS. (columbia.edu)
  • Accountability
  • If individual health plans were to collect and report a uniform set of summary measures of health and well-being, they would make a significant contribution to implementing the recommendations made in the 2011 report For the Public's Health: The Role of Measurement in Action and Accountability . (cdc.gov)
  • roles
  • The objective of this study is to examine the positioning of pharmacists' roles in documents used to communicate the Compensation Plan to Albertan pharmacists and other audiences. (beds.ac.uk)
  • Discourse analysis was performed using social positioning theory to explore how pharmacists' roles were constructed in communications about the Compensation Plan. (beds.ac.uk)
  • Pharmacists' changing roles were positioned in alignment with the aims of primary health care. (beds.ac.uk)
  • As implementation unfolds, however, the ACA's impact on the roles of federal, state, and private actors is uncertain. (amazonaws.com)
  • data
  • would serve as a marker of the progress of the nation and its communities in improving health, it is important that it be implemented in data collection and public communication efforts at the federal, state, and local levels" (3). (cdc.gov)
  • insurance
  • AHIP is the national trade association representing the health insurance industry. (ahip.org)
  • America's Health Insurance Plans. (ahip.org)
  • We are beginning to see health plans try new ways (e.g., lower insurance premiums for those who do not smoke) to financially incentivize people into changing their behavior. (deloitte.com)
  • The ACA seeks to preserve and even enhances the states' traditional role in regulating health insurance through newly created state health insurance exchanges to assist individuals and small employers to obtain coverage. (amazonaws.com)
  • Traditionally, many states have required health insurance policies to cover certain benefits over and above standard offerings, although the additionally mandated benefits will vary from state to state. (amazonaws.com)
  • The ACA provides that small group and individual insurance policies, offered both inside and outside of the exchanges, must cover a core set of "essential health benefits" (EHBs). (amazonaws.com)
  • Yes, Please see Medicare Publication 02179 for an explanation of how Medicare Co-Ordinates with Group Health Insurance, Workers Compensation, etc. (amazonaws.com)
  • Sciences
  • Alwyn Cohall , MD, Patrick Wilson , PhD, and Renee Cohall, Sociomedical Sciences, will receive $1,027,198 over five years from the National Institute on Drug Abuse for "Health and Justice: A Continuum of Care for HIV and SU for Justice-Involved Youth. (columbia.edu)
  • Jeffrey Shaman , PhD, and Kim Knowlton , DrPH, Environmental Health Sciences, will receive $270,274 over one year from the Rockefeller Foundation for "Global Consortium on Climate and Health Education. (columbia.edu)
  • Andrea Baccarelli , MD, PhD, Environmental Health Sciences, will receive $437,821 over two years from the National Institute of Environmental Health Sciences for "Early Exposure to Persistent Organic Pollutants, Breast Milk Extracellular Vesicles, and Abnormal Cardiometabolic Programming. (columbia.edu)
  • Susan Ridgely, a health attorney at RAND, will lead the site visits at each of the eight plans and a pool of three health economists from Harvard and RAND, as well as ROW Sciences' senior research staff, will be available to participate as the second site visitor. (hhs.gov)