What insurers know about your hospital ... and how they are using it.
Insurers are using their purchasing power and their enormous stores of claims data to push hospitals to improve quality. Health plans are able to parse the data according to such quality indicators as cost, length of stay and outcomes. Hospitals are wary of the trend, but some welcome it, especially if insurers use the so-called pay-for-performance model.
Scalise
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D019985:Benchmarking; D054598:Blue Cross Blue Shield Insurance Plans; D032982:Contracts; D016208:Databases, Factual; D017721:Hospital Costs; D017052:Hospital Mortality; D006761:Hospitals / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007343:Insurance Carriers; D007350:Insurance, Hospitalization / Q000592:standards*; D016344:Medicare Part A; D009017:Morbidity; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D019984:Quality Indicators, Health Care; D012052:Reimbursement, Incentive; D014481:United States / Q000453:epidemiology