Managed Care On-Line™: Data Report Cards

Managed-care organizations cited by HCFA for best practices

HCFA recently surveyed managed-care organizations who are operating most efficiently in terms of quality of care provided and controlling of costs. While there is still, and always will be, room for improvement, HCFA has identified the following eight managed-care organizations as best at balancing the quality of care needs with financial needs. Also listed is each plan's best practice.

Blue Cross and Blue Shield of Minnesota, St. Paul

Physician profiling, outcomes measurement, utilization management

Blue Cross and Blue Shield of Rochester (N.Y.) Area

Case management, case-mix severity adjustment

Cigna HealthCare of Arizona, Phoenix

Screening and prevention

Harvard Community Health Plan, Brookline, Mass.

Continuous quality improvement, physician profiling, outcomes measurement,

technology assessment

HealthAmerica of Pittsburgh

Continuous quality improvement, protocol applications

Health Partners, Minneapolis

Protocol applications, special population care coordination

Prudential Insurance Co., Roseland, N.J.

Technology assessment

United HealthCare Corp., Minneapolis

Performance measurement, provider communication, utilization management

Data Source: HCFA

This file has been provided for MCOL members only.