Health Plans

Project Status: It’s Not Easy Staying Green

Is your project’s status report green….really?? Healthcare executives typically get color coded “cliff notes” on the status of their projects. These small cheat sheets, snippets of a status report, as…

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CMS Releases Proposed Policy Changes for 2020

On July 29, 2019, CMS released its proposed changes for Chronic Care Management  2020. Here’s IQVIA’s Healthcare Center of Excellence (COE) take on the changes. Overall there are some great new…

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What Do NCQA’s Five-Star Ratings Mean?

There are numerous rating systems these days: Rating the top movies, the best restaurants, or that little yellow full-or-half-star on popular e-commerce sites that indicate how satisfied customers were with…

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Configuration Issues Addressed after Critical System Failure

An East Coast health plan experienced one of the worst critical system failures and service issues imaginable. It struggled with getting members on individual health insurance products. The issues deteriorated…

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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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