Health plan (HMO, PPO, etc.)

Innovations

Statewide Managed Care Plan for Foster Care Children Features Care Coordination and a Central Database, Leading to Improved Access and Mental Health Treatment 10/31/14

The Texas STAR (State of Texas Access Reform) Health Program is a statewide managed care plan for children and young adults in foster care and young adults who have aged out of the foster care...

Countywide, Public–Private Consortium Conducts Outreach and Provides Enrollment Assistance, Enhancing Access to Coverage for Low-Income and Uninsured Residents 09/18/14

A jointly governed consortium of more than 100 local organizations, the Milwaukee Enrollment Network helps county residents (particularly low-income and uninsured individuals) learn about and...

Daily Text Messages and Nurse Followup Improve Self-Management Behaviors in Patients with Diabetes, Leading to Better Glycemic Control and Lower Costs 04/28/14

University of Chicago Medicine (a large academic medical center) developed and implemented a program called CareSmarts in which patients with diabetes received several text messages each day...

Managed Care Entity Funded By Public Agencies Reduces Institutionalization and Recidivism, and Improves School Attendance and Functional Ability Among Emotionally Disturbed Youth 03/30/14

Funded by and receiving referrals from the various public systems serving at-risk youth, Wraparound Milwaukee is a managed care entity that pays for and supports the provision of coordinated...

Reference-Pricing Policy for Hip/Knee Replacements Generates Significant Savings by Encouraging Enrollees To Choose High-Value Facilities 12/18/13

In collaboration with Anthem Blue Cross, the California Public Employees' Retirement System (more commonly referred to as CalPERS) changed the benefit design for its self-funded preferred provider...

QualityTools

HospitalBillHelp.org 05/08/14

This Web site helps uninsured and underinsured consumers in California navigate the application process for discounted care from hospitals. It also provides information about health insurance plans and pricing to protect against medical debt and...

FAIR Health Consumer Cost Lookup 05/08/14

FAIR Health Consumer Cost Lookup is a free tool that consumers can use to get an estimate of how much health care providers charge for medical and dental services in their area. It will also inform consumers how much of that cost they can expect...

MONAHRQ® 4.0 09/18/12

My Own Network, powered by AHRQ (MONAHRQ), is a free software product that enables organizations—such as State and local data organizations, chartered value exchanges, hospital systems, and health plans—to input their own hospital administrative...

Improving Outcomes for Children in Child Welfare: A Medicaid Managed Care Toolkit 04/25/12

This toolkit, developed by the Center for Health Care Strategies (CHCS), can help guide efforts to improve care for children in the child welfare system. The toolkit presents the work of 9 managed care organizations that participated in a 3-year...

Improving Asthma Care for Children Toolkit: Best Practices in Medicaid Managed Care 03/30/10

This toolkit provides strategies to improve asthma care tested by a diverse group of health plans serving Medicaid consumers. The inventive methods, targeted for children with asthma, can also be used for adults. The toolkit suggests the need...

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