Anthem Blue Cross And Blue Shield

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,

2. San Diego Business Journal  Best Places to work and HR Professional Of The Year Awards Supplement, August 20, 2012 v33 i34 pS29(1)

Healthcare is often driven by consumers and insurance companies; there is strong pushes for insurance companies to start paying better through Patient Care Medical Homes (PCMH) or Accountable Care Organizations (ACO) rather than paying at a per-visit basis (Hamlin, 2015). With PCMH or ACOs payment is made on a continuum of care, encouraging the provider to be involved in all aspects affecting health of the patient (Derksen, & Whelan,

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

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

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”.

legislation is firmly in place, it may not always prevent misuse, unethical use, or objective

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”).

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

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.

Today’s market demands organizations to have a strategic plan. The purpose of the strategic plan describes where the organization wants their organization to go. A strategic plan is a document used to communicate goals, and the actions needed to achieve those goals. In order to remain competitive every organization needs to innovate to stay ahead of the competition. They need to develop new products and services with increasing frequency. The design of these new products and services must meet, or exceed, customer expectations and at the same time, they must generate an acceptable financial return for the organization. However, any business that does not realize the importance of developing new products will not last very long as a consequence

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).

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

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