Who We Are
community, health plans are working to improve the health of more than 200
million Americans, while providing peace of mind and financial protection from
the high cost of medical care. Health plans
employ or contract with tens of thousands of physicians, hospitals, laboratories
and other health care providers to offer Americans wide choice and access to
partner or interact with every other part of the system, health plans are best able
to see how the system is performing from the ground up. This gives health plans
a unique view across the entire system – what works and what needs improvement.
Here are just a few real-world examples of
how health plans are making a difference.
- Giving consumers more information to make
better decisions about their health. Health plans are providing understandable
information and user-friendly tools – such as information on the safety records
of medical devices and the costs of various medical products and procedures –
that help patients and doctors make the most informed choices, while also
assisting patients in navigating the complex health care system.
- Supporting innovations that facilitate
patient-centered care. Health plans play a pivotal role in helping
doctors, nurses and others meet their patients’ needs by providing an
infrastructure that facilitates outreach to patients in need of medical services,
highlights health risks in different patient populations, coordinates care
among providers, and tracks outcomes.
- Helping patients to stay on their treatment
plans. Patients with chronic conditions may find it
overwhelming to follow complex treatment regimens and make the necessary
lifestyle changes to improve their health. Health plans are helping by
designing and implementing innovative programs that are improving patient
adherence and patient self-management.
patient safety and patient-centered use of medical services.
Health plans’ infrastructure and information technologies are reducing
risks to patients through targeted initiatives that focus on reducing medical
errors, preventing health care acquired infections, preventing avoidable
hospital readmissions, and addressing the problems of underuse, misuse and
overuse of medical services.
- Changing financial incentives to promote
better health. Working together with physicians and
hospitals, health plans are changing reimbursement models to improve patient
safety and the quality of care while promoting accountability to patients
throughout the system. By rewarding physicians and hospitals for the quality of
care provided—rather than the volume of services provided—health plans are
helping ensure that patients receive care that best meets their individual
- Collaborating on quality improvement. Researchers
agree that the quality of patient care varies widely based on location. To address geographic and other variations in
care, health plans are participating in coalitions with private and public
health care stakeholders to improve provider performance and drive quality improvement.
- Addressing disparities in health care.
The U.S. health care
system faces new challenges and opportunities in its efforts to better serve
the needs of its increasingly diverse population. Health plans are assessing
and reducing these “gaps” in health care with linguistically appropriate and
culturally sensitive programs targeting preventive services, health and
wellness, access to qualified providers, and specific efforts focused on
chronic conditions that disproportionately impact disadvantaged or underserved
America’s Health Insurance Plans
601 Pennsylvania Avenue, NW
Washington, DC 20004
(202) 331-7487 fax