Anthem Blue Cross and Blue Shield focus on helping members get healthy and stay healthy. They serve you in the best way they can, each year they look closely at the medical care and programs that is best for you. They measure their quality and safety. The process of figuring out how to improve your care is called Quality Improvement programs. Anthem cares about the member’s satisfaction with their medical care, delivery of care, their doctors, health plan and service they deliver. https:\www.anthem.com
GOALS OF ANTHEM
Anthem goals are:
• All our members get quality health care service
• We understand all our members’ cultures and languages
• We work to improve the health of our members
Meta-data provides support in order to deliver key
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The type of data is created and used by tools and applications that create, manage, and use data. Technical metadata includes database systems names, table and column names and sizes, data types and allowed value, and structural information such as foreign key attributes. Alex Berson and Larry Dubov; The benefits of metadata and implementing a metadata management strategy; www.techtarget.com
Operational metadata contains information that is available in operational systems and run-time environments. It contains data file size, data and time of last load, updates, backup’s names of operational procedures and scripts.
Metadata is not bad it just misunderstood. It is essential in making a file parable, without it, we would not know where on our compute a file is stored, its filename, or other necessary information. Metadata can be found in WordPerfect, PDF, and image and video files that you create with a GPS enable device such as a smartphone. Donna Payne; Metadata: The Good, the Bad, and the Misunderstood; vol. 30 No. 2.
GATHERING METADATA
Metadata is used by the government to know all your secrets like emails, mobile phone, Facebook, and web browsers. Metadata is a software the government uses to identify what you are doing. I don’t think it is such a bad idea for the government to track your every moment. It’s not like they are following you around on foot and spying on you. It is just a control software they use to identify certain security features people use every
As we know the IN HHW/ Anthem BCBS plan will go live as of 01/01/2017. As we all know this is one of many new plans and I just wanted to point out some key points. When you are looking for benefits before the official ORM is posted please refer to KQ. They will be listed as
Anthem Inc, a leading health insurance company that provides health insurance for personal, business and government entities across the States. Anthem is a prosperous company, ranking within the Fortune 50 list, with total assets equaling $61.7 Billion. They have over 52,000 associates to serve over 39.8 million members. The company has presence in 14 States and continues to offer its services in growing markets (“Stats and Facts”).
TRICARE Health Plans is the replacement for CHAMPUS which was the provider of health care services for military dependents. TRICARE not only replaced CHAMPUS but its purpose was also to facilitate members with access to better health care. Unfortunately, TRICARE has gone through many changes and upheavals since its inception in 1997. First, they began by dividing the company into regions. Each member was placed into a region based on where the military member was stationed. If the member was stationed in Maryland then his family belonged to the East Region. Unfortunately, there were many problems with this plan. First, some military members and their families did not live in the same regions. Therefore, the families either had to travel
By partnering with Providers and implementing Payment Innovation Models, Anthem as part of its Enhance Personal Health Care Program is empowering them with tools, information, resources and choices. This allows the providers to focus on the most important aspect– “overall health of the patients”.
The ABC Company, a premier managed care health insurance provider was faced with the recent health care reform that enforced major changes in the health care industry. ABC had to take initiatives to stay competitive in the industry. The health care reform and market changes demanded ABC to rethink their business model and how they delivered their services. For companies to stay in business it was important to understand their consumers’ perception of the company’s cost of health care and ample access to quality (Bhaskar & Vo, 2012). With the new legislation consumers are hyper aware of the options in health care insurance products available. ABC had to adapt to new market realities: “consumers wanted a company that they perceived had a lower cost than competition and that provided an ample access to quality health care” (Bhaskar & Vo, p.19, 2012). Due to the high elasticity of health insurance people are extremely sensitive to the cost they need to pay. Improvements in medical technology explains high rise in healthcare costs (The Hasting Center, 2015).The CIO of ABC wanted to take advantage of the new environment using information technology based solutions integrated with new processes. The objective for the new systems was to track, influence, and maintain the consumer perception of the company’s efforts addressing these challenges (Bhaskar & Vo, 2012). The ultimate objective of the project was to create infrastructure and business functions to change the opinion of the
I took away valuable insights on how the inventive program works and function for the company Arkansas Blue Cross Blue Shield. On that agree on the fact of ABCBS wanting to stay ahead in the insurance field with incentives. On the other hand, other company's may not be able to afford, if not some of the incentives offered by BCBS, such as tuition reimbursement, Club Blue a free gyms offered at multiple ABCBS locations to encourage exercise and convenient employee health clinic as ABCBS does.
The mission of UnitedHealthcare Group is to “help people live healthier lives” with access, quality and affordability. They are committed to continual improvement and the delivery of quality care by investing approximately $3 billion in business process improvements, research development, and technology within the past five years. In addition to reinvesting the revenues in innovative technologies, research and other improvements to better serves its consumers, UnitedHealthcare Group is also committed to social responsibility through employee involvement,
Kaiser Permanente offers a holistic health care system by combining a nonprofit insurance plan with its own hospitals and clinics. Additionally, since the plan pays a fixed amount for medical care per member, there is a considerable financial incentive to keep people healthy and out of the hospital. Kaiser oversees, administers and provides a comprehensive care for patients, ranging from providing screening and diagnosis to filling a prescription to running a hospital where the patients undergo surgery. This strategy of integration is at least 10 percent less expensive than other providers’ services (Abelson, 2013).
In the past few years the American health care system has changed in many ways. First there was the passage of the Affordable Care Act, which is a law that is giving Americans the opportunity to obtain health care. Under this new law, in 2011, the Department of Health and Human Services decided to create Accountable Care Organizations (ACO) to help doctors, hospitals and other providers better coordinate care (AthenaHealth.com). The first idea of an Accountable Care Organization was brought up in 2006 by Elliot Fisher, MD, and now there are over 400 in the United States (Healthcatalyst.com). An ACO’s primary job is to improve health care delivery, performance, and payment. This is done through physicians and
legislation is firmly in place, it may not always prevent misuse, unethical use, or objective
Blue cross was founded in 1929 by Justin Ford Kimball, a vice president of Baylor University health care facility in Dallas who introduced the plan to provide hospital care services. Justin Kimball first plan was to guarantee teachers 21 days of hospital care for $6 dollars a year. The plan became popular it was extended to other groups nationally, and other employees started using it throughout the United States. In 1939 blue shield was founded in California by a group of employers providing medical care to their employees by providing a monthly fee, which help pay for physician services. Later in 1980s both company merged, and became successful since providing the best health care service at a low cost nationwide.
Blue Cross Blue Shield of Tennessee faced another lawsuit against them filed by the Harrogate Family Practice owned by Amanda Brown. The plaintiffs, Harrogate Family Practice and owner, Amanda Brown, filed a complaint on the grounds of seeking injunctive and declaratory relief under ERISA (Employment Retirement Income Security Act of 1974). The defendant, Blue Cross Blue Shield of Tennessee, had sent five letters over the course of January, February, and March of 2014, notifying the plaintiffs of the overpayments that were discovered during an audit in November 2013 and requested recoupment. The Harrogate Family Practice and Amanda Brown’s counsel responded on April 3, 2013 stating that the recoupments violated ERISA. After a breakdown in
Amidst the information age, the Australian public faces perhaps the defining societal challenge of the 21st Century, the unprecedented governmental surveillance of metadata. Metadata surveillance refers to the recent legislation passed in March of this year, which sees compulsory retention of information by Australian telecommunication corporations, the individualised communications data of each Australian citizen.
Once the results of metadata discovery are presented to the end users, the metadata records need to be retrieved and accessed by them. The next section gives a brief overview of the retrieval and access step of the
Government organizations, as revealed by Edward Snowden, are routinely recording the metadata of its patrons and international communications. Metadata is the accumulation of mass information most likely done by intelligence agencies which collect raw data about all individuals in an indiscriminate manner. The agencies must use algorithms or social sorting techniques to filter the patterns of information into meaningful data. Social sorting is the review of data for desirable and undesirable characteristics. It is a filtration aimed to collect information that can be used for finding desirable and undesirable information. Further, the NSA utilized a system called PRISM which enabled them to decrypt communication information for their