Health insurance plans are advancing and supporting strategies that promote a safe, effective, patient-centered, timely, efficient and equitable health care system. These initiatives focus on: implementing systems to provide high quality and coordinated care, empowering patients with the information they can use to make informed health care decisions, promoting transparency throughout the health care system, disclosing and rewarding physicians for quality-based medical practice, and using evidence-based decision making. This webpage provides resources and information for health insurance plans, consumers, employers, and other interested parties that address these important issues.
Last updated: March 27, 2009
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Measuring Provider Performance
The Institute of Medicine (Crossing the Quality Chasm, 2001) and a recent study by RAND (McGlynn, etal., 2003) have found that individuals in the United States routinely do not receive recommended care and both studies highlighted a critical need in this country to improve the quality of care. Measuring provider performance on clinical quality and efficiency is a key strategy that is being used by health insurance plans and employers to improve quality and enhance transparency. By notifying providers of their performance on quality and efficiency measures, they can better compare themselves to other providers, national benchmarks and improve their practice patterns. Consumers will use the data to make more informed health care decisions. In this section, recent activities surrounding this issue will be reported. -
The Tools and Techniques of Improved Medication Use
The Tools and Techniques of Improved Medication Use initiative seeks to translate research findings into practice by presenting detailed descriptions of intervention strategies, resources and results that can be replicated in multiple settings. On this webpage, you will find nearly fifty scientific studies that focus on improved medication use and patient compliance, through varied intervention strategies - implementing disease management approaches, educating patients and providers, and monitoring and providing feedback about target populations. -
Clinical Trials
Two publications entitled Should I Enter a Clinical Trial? A Patient Reference Guide for Adults with a Serious or Life-Threatening Illness (a full-length and executive summary ) offer information and resources for adult patients who are thinking about enrolling in a clinical trial. These tools assist patients in making informed decisions about whether to enter a clinical trial. -
Pharmacy Programs: Focusing on Patient Safety and Quality
(.pdf - 555 KB)
The report entitled Health Plan Pharmacy Programs: A Focus on Patient Safety, Quality, and Access, provides information on health insurance plan programs that promote safety and effectiveness in the use of prescription drugs. -
Evidence-based Clinical Practice Guideline Resources
Global Resources and Information from Specialty Society Websites
