Navigation Links
Unique Program Means Better Care for Highmark Members
Date:12/3/2007

NCQA program targets those with chronic conditions

PITTSBURGH, Dec. 3 /PRNewswire/ -- As part of its ongoing effort to ensure quality care for its members, Highmark Inc. is encouraging physicians to pursue National Committee on Quality Assurance (NCQA) certification during a pilot program. Highmark's support of the physician recognition program certification is unique as Highmark is one of the few health insurers in the country offering a program of this kind to motivate physicians to earn the certification.

In a survey of participating physicians conducted by Highmark, 69 percent agreed that their patients had improved outcomes as a result of the program. Also, 95 percent said it was a worthwhile activity for their practice.

The program began in January with 538 physicians participating. Physicians could work toward one of three NCQA certifications. The three programs include:
-- Physician Practice Connections, which recognizes physician practices

that use enhanced management of information to improve the quality of

patient care;

-- Diabetes Physician Recognition Program, which recognizes physicians who

demonstrate they provide high-quality care to patients with diabetes;

-- Heart/Stroke Recognition Program, a program where physicians

demonstrate they provide high-quality care to patients with cardiac

conditions or who have had a stroke.

"These designations are important because they require physicians to demonstrate that they are following national quality guidelines for treating patients with chronic conditions such as diabetes and heart disease," said Michael Madden, M.D., medical director of medical performance management at Highmark. "We know that a disproportionate amount of health care spending is for patients with chronic conditions, so we are hoping over time this program will prove to be beneficial for patients as well as the physicians who are earning this recognition."

The program has several levels for the physician to work through. In the first phase, Highmark offered the physicians a pre-survey allowing them to examine their practice patterns and how they manage the care of patients with chronic conditions.

After the survey was completed, Highmark's medical management consultants reviewed the results with the physicians to develop strategies to correct any gaps that were identified to help ensure the providers satisfy the NCQA standards.

In the second phase, a physician completed the NCQA application and workbook or survey tool based on the practice patterns for all the physicians' patients. In the final level, the physician received financial reimbursement from Highmark when the certification was awarded to the provider.

"This initiative provides an excellent framework for physicians, staff, and patients to work together to improve the health of patients with diabetes. We feel strongly that this ongoing collaborative effort has improved the care of our patients," said Gregory Walker, M.D., Internal Medicine Specialists, Aliquippa.

The 433 network physicians that have completed the program have the potential of improving care for about 55,000 Highmark members with chronic conditions from the practices that participated.

Highmark launched the certification pilot program in January 2007 and during the next two years Highmark will evaluate the program's effectiveness in improving care and reducing costs.

About Highmark Inc.

As one of the leading health insurers in Pennsylvania, Highmark Inc.'s mission is to provide access to affordable, quality health care enabling individuals to live longer, healthier lives. Based in Pittsburgh, Highmark serves 4.6 million people through the company's health care benefits business.

Highmark contributes millions of dollars to help keep quality health care programs affordable and to support community-based programs that work to improve people's health. Highmark exerts an enormous economic impact throughout Pennsylvania. A recent study states that Highmark's positive impact exceeded $2.5 billion. The company provides the resources to give its members a greater hand in their health.


'/>"/>
SOURCE Highmark Inc.
Copyright©2007 PR Newswire.
All rights reserved

Related medicine news :

1. Unique role for blood formation gene identified
2. New Seminar Series from Activator Methods Teaches Doctors a Unique Approach to Improving Nations Chiropractic Care: Focus on the Patients
3. Blue Cross and Blue Shield Association Nationally Recognized by BusinessWeek and AARP for Creating a Unique Workplace Environment for New and Mature Employees
4. Frutarom Acquires Gewurzmuller, a Company Specializing in Unique Savory Flavors
5. Video: Trinity Mother Frances Neurosurgeon First in Region to Remove Brain Tumor Using Unique Surgical Procedure
6. Graduates of Unique New Labor/Management Healthcare Workforce Training Program Honored Today in Oakland
7. Deep Breeze Ltd. Launches Unique Non-Invasive, Radiation-Free Pulmonary Imaging System in the U.S.
8. Micromets BiTE(R) Antibodies Reveal Unique Mode of Action
9. The Lilly MDR-TB Partnership Provides Unique Model for Fight Against Multidrug-Resistant Tuberculosis in South Africa
10. Franco e Rizzi Offers Low-Cost Weight Loss Surgery (WLS) With Unique Price Guarantee
11. S*BIO Expands Pipeline With the Development of a Unique Flt3 -CDK Inhibitor as a Targeted Therapy for Acute Leukemias
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:8/21/2017)... ... August 21, 2017 , ... Marathon running has surged ... country. , Outdoor running increases exposure to ultraviolet radiation, a carcinogen that promotes ... melanoma, and only half may be adequately protecting themselves with proper clothing and ...
(Date:8/21/2017)... ... August 21, 2017 , ... The experts have spoken. Prolonged ... supposed to get things done in a healthy way these days? FlexiSpot, one of ... crowdfunding campaign on August 28 to introduce Deskcise Pro™– the world’s first sit-stand-cycle desk ...
(Date:8/21/2017)... ... ... The American Hospital Association (AHA) has elected Claire Zangerle, Chief Nurse Executive at ... Trustees for a three-year term beginning January 1, 2018. , The AHA ... committed to the improvement of health in their communities. Founded in 1898, the AHA ...
(Date:8/21/2017)... ... August 21, 2017 , ... ... of UnitedHealth Group (NYSE: UNH), has made a multi-million dollar partnership commitment ... post-traumatic stress disorder (PTSD) and traumatic brain injuries (TBI) over the next year. ...
(Date:8/20/2017)... ... August 20, 2017 , ... A total solar eclipse will occur across the U.S. ... the moon moves between the sun and Earth. This rare event will be magnificent to ... help keep you safe on the road during the total eclipse of the sun. , ...
Breaking Medicine News(10 mins):
(Date:8/7/2017)... -- Endo International plc (NASDAQ: ENDP ) today ... known U.S. mesh product liability claims and that it ... U.S. claims at reasonable values. Under the agreements, Endo ... of 2017 and continuing through the fourth quarter of ... the Company intends to increase its mesh product liability ...
(Date:8/3/2017)... 3, 2017  Opioid addiction and other drugs of ... costs and threatening outcomes, were problems taken on directly ... industry that support them, met this week. This according ... that drugs of abuse, procalcitonin and acute kidney injury ... organization,s 69th meeting in San Diego, CA. ...
(Date:8/2/2017)... -- Life Flight Network and PeaceHealth Oregon Network announced they renewed ... operational efficiency for patients at hospitals in Eugene ... Grove , and Florence, Oregon , ... Network work collaboratively to move patients who require the highest ... sensitive emergency exists. ...
Breaking Medicine Technology: