Health Plans Agree to Create Health Care Provider Database

August 25, 2006 (PLANSPONSOR.com) - Seven health plans have agreed to participate in an initiative to create a database of information on the performance of physicians and hospitals across the country.

Care Focused Purchasing, Inc. (CFP), an employer industry coalition advocating the quality and efficiency of providers as the basis for purchasing health care benefits, has announced it has finalized contracts with the seven plans and will begin aggregating claims data, Business Insurance reports. The participating plans include Aetna Inc.; CIGNA Corp.; Fiserv Health; Humana Inc.; Preferred Care; Regence Blue Shield; and WellPoint Inc. (Anthem Blue Cross & Blue Shield).

The initiative was introduced in 2003 by Mercer Human Resource Consulting, according to Business Insurance. Under the initiative, a database will be created to combine participating insurers’ data on claims for more than 18 million members, including claims data from the 50 participating self-insured employers that collectively provide coverage to more than two million employees and dependents.

Individual providers and facilities will be identified and measured in the database and reports will be delivered to the partner carriers in early 2007. The partner carriers will then use the information to develop tiered networks, share it with plan members or use it in strategies to improve provider performance.

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