Managed Care

 

Colorado Seeks Proof of Quality From Health Plans

MANAGED CARE December 1998. © MediMedia USA
State Initiatives

Colorado Seeks Proof of Quality From Health Plans

MANAGED CARE December 1998. ©1998 Stezzi Communications

New regulations taking effect in Colorado this month tighten reporting rules and seek to gain greater proof that health plans are delivering quality care.

The regulations require plans to have written quality assurance programs to evaluate their services. The plans must detail the treatments and conditions that will be reviewed, and conduct research to improve services and health outcomes. Plans must also demonstrate that they are providing adequate access to care and are also educating members about wellness and chronic-disease management.

Colorado's Cross-Disabilities Coalition criticized the new rules as inadequate, noting that HMOs will not be required to make their quality assurance plans available to the public, and that the rules do not address home-health care services.

Colorado's Department of Public Health and Environment developed the rules and will administer them jointly with the Division of Insurance and the Department of Health Care Policy and Financing, which regulates Medicaid in the state. The final version of the regulations is available at http://www.cdphe.state.co.us/.

Meetings

4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014
HealthIMPACT Southeast Tampa, FL January 23, 2015