Below are links to various organizations and websites relevant to the health insurance and managed health care industry. They are divided into seven loose categories, but not otherwise sorted within a category.
The Medicare Payment Advisory Commission (MedPAC), an independent Congressional agency established to advise the U.S. Congress on issues affecting the Medicare program, and payment policies in particular.
The Medicaid and CHIP Payment and Access Commission (MACPAC) is tasked with reviewing state and federal Medicaid and SCHIP access and payment policies and making recommendations to Congress, the Secretary of Health and Human Services (HHS), and the states on a wide range of issues affecting Medicaid and SCHIP populations, including health care reform.
The DOL Employee Benefits Administration website, which provides information on employee benefits rights under ERISA and several other laws, including appeal rights and new rights under the ACA.
Government Health IT, a governmental site focusing on IT issues, including standards, the EMR, a national IT network, and so forth.
The Office of the Inspector General (OIG) at The Department of Health and Human Services (DHHS), the agency that audits health organizations for such things as defrauding the government or violations of laws and regulations.
The Data Bank (Formerly known ast The National Practitioner Databank and The Healthcare Integrity and Protection Databank), focusing on maintaining provider data related to adverse actions, malpractice, fraud, etc. (Access to actual data is restricted).
The CMS Innovation Center (formerly the Center for Medicare & Medicaid Innovation or CMMI), a new branch of CMS created under the ACA to focus on identifying, testing and ultimately spreading new ways of delivering and paying for care in Medicare and Medicaid.
The Center for Consumer Information and Insurance Oversight (CCIIO) within CMS, responsible for ensuring compliance with ACA market rules, oversight of medical loss ratio rules, assistance to states in reviewing insurance rates, providing guidance and oversight for the state-based insurance exchanges, and compiling and maintaining data on insurance.
Healthcare.gov, the federal website portal for consumers to help them access and choose health insurance.
HealthFinder, a site maintained by HHS to provide health-related information to consumers.
Data.Medicare.Gov, a site that provides access to a huge array of Medicare data in an interactive format, for use primarily by health policy researchers and the media.
The Agency for Healthcare Research and Quality (AHRQ), a site containing a wealth of information around health care including quality issues, evidence-based clinical care, and various standardized consumer studies such as CAHPS.
U.S. Preventive Services Task Force (USPSTF), an independent panel of experts in prevention composed of primary care physicians, OB/Gyns, nurses, and behavioral health specialists. It keeps recommendations for preventive services up to date based on evidence-based medicine.
The National Association of Drug Diversion Investigators (NADDI), a non-profit organization that facilitates cooperation between law enforcement, healthcare professionals, state regulatory agencies and pharmaceutical manufacturers in the prevention and investigation of prescription drug diversion.
The Henry J. Kaiser Family Foundation, an especially rich resource for data on trends for both private and public health issues. Examples of specific areas of focus at KFF include:
Academy Health, a health policy research organization (most material free, some accessible only to members).
The Health Care Cost Institute (HCCI), a non-profit research institute that uses de-identified data from commercial payers to perform independent research and analysis on rising health spending.
Mathematica Policy Research, Inc., a commercial think tank that analyzes a large variety of policy-related issues, including health care.
The Integrated Healthcare Association (IHA), a California organization focusing on collaboration between health plans, providers, employers and government to promote data transparency, pay-for-performance, and public health improvements.
National Quality Forum (NQF), a nonprofit organization that works to build consensus on national priorities and goals for performance improvement; endorses national consensus standards for measuring and publicly reporting on performance; and promotes education and outreach programs.
CAQH (formerly the Council for Affordable Quality Healthcare), a nonprofit organization made up of payer companies and trade associations focusing on the information and administrative interactions between payers and providers, including physician credentialing.
The Leapfrog Group, an employer-sponsored organization focusing on improving quality and aligning financial incentives, with a special focus on safety.
The National Committee for Quality Assurance (NCQA), the organization that is responsible for HEDIS, as well as a major accreditation agency for health plans, credentialing organizations, specialty managers, and many others.
URAC, an accreditation agency working with health plans, employers, and others involved in managed health care and care management.
Managed Care Online (MCOL), a commercial resource for information about managed care. (Has both free and paid types of membership).
Managed Care Magazine by MediMedia ManagedMarkets, a free magazine with general managed care topics and interviews with some emphasis on managed care and pharmaceuticals.
Atlantic Information Services, a commercial site featuring publications and information about managed health care and other health care sectors (Some free content, most content requires payment).
Healthcare Intelligence Network, a commercial site featuring publications and information about managed health care and other health care sectors (Some free content, most content requires payment).
Managed Healthcare Executive, providing short articles and profiles in managed health care, with an emphasis on pharmaceutical issues.
Unless otherwise noted, all material copyright P.R.Kongstvedt Company, LLC
