Health Plans

How One Health Plan Helps Others Achieve Scalability, Efficiencies

A health plan with solid roots in the south west United States is taking a unique approach to caring for its members by leveraging its knowledge and expertise in creating…

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Why Achieve Accreditation? Understanding accreditation and the new NCQA standards

Accreditation programs demonstrate the quality of a health plan to consumers and employers. For health plans achieving a high accreditation rating means they have programs that are fully developed, implemented,…

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Moving forward: How one health plan overcame a myriad of technology challenges and is now thriving

A core claims and adjudication system that was no longer delivering on its promise, was the main reason a large East Coast health plan decided to replace its technology in…

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Vendor Selection Best Practices

There are many reasons that a health plan will decide to go through the process of selecting a new care management vendor. It could be due to a change in…

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Medecision’s acquisition of AxisPoint Health: What you need to do now

Medecision’s acquisition of AxisPoint Health brings 58 VITALS and CCMS solution clients under the Medecision umbrella. These organizations have been aware of plans to sunset CCMS and VITALS since before…

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HighPoint Vendor Evaluations

Co-authors: Norita Wilson and Becky Jones In our previous blog A Closer Look at Population Health/Care Management Solution Vendors , we looked at Gartner’s March 2018 “Market Guide for Healthcare…

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A Closer Look at Population Health/Care Management Solution Vendors

Co-authors: Norita Wilson and Becky Jones

How to Prepare for Accreditation

Co-authored by: Suzanne Kunze, Norita Wilson, and Lori Harris In our previous blog, you learned about the strengths of both NCQA and URAC accreditation. Now we’ll look at how you…

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A Closer Look at Accrediting Organizations; the Strengths of NCQA, URAC

Co-authored by: Suzanne Kunze, Norita Wilson, and Lori Harris Health plans will look to two prominent and nationally recognized organizations, NCQA or URAC, when they are seeking accreditation. Accreditation provides…

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Open Enrollment 2017: Preparing for the Madness

When open enrollment 2016 closed for the Health Insurance Marketplace, U.S. consumers made nearly 13 million plan selections in which they were either first-time enrollees or they adjusted their plans….

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