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Massachusetts hospitals rate health plan performance

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A new report from the Massachusetts Hospital Association compares the state‚Äôs health plans on the cost, effectiveness and efficiency of their administrative practices (AHA News). Based on a survey of hospital executives, the report rates the performance of 12 health plans in areas such as claims payment, member education, authorization processes and utilization management. Among other recommendations, it concludes that the plans could improve their radiology management programs and claims adjudication, regularly update and disseminate evidence-based clinical guidelines, give providers more opportunity to review and verify the information used in their “tiering” programs, and better educate plan members about their benefits and obligations.

Report: Health Plan Scorecard – Hospitals Rate Health Plans: A Critical Look at Performance Variation

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