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Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
The Anthem medical data breach was a medical data breach of information held by Elevance Health, known at that time as Anthem Inc. On February 4, 2015, Anthem, Inc. disclosed that criminal hackers had broken into its servers and had potentially stolen over 37.5 million records that contain personally identifiable information from its servers. [ 1 ]
Founded in 1948, [26] Arkansas Blue Cross Blue Shield (ABCBS) [27] is an independent licensee of the Blue Cross Blue Shield Association, and the largest healthcare provider in the state. [28] It donated $1.98 million to The Walton College of Business toward founding its Robert L. Shoptaw Master of Healthcare Business Analytics Program. [ 29 ]
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In August 1997, Anthem acquired Blue Cross and Blue Shield of Connecticut. [18] It also sold Acordia to management. [19] In 1999, Anthem acquired Blue Cross and Blue Shield of New Hampshire and Blue Cross and Blue Shield of Colorado and Nevada. The acquisitions made since 1996 added 850,000 policy holders.
[4]: 2 In the period between 1910 and 1940, early healthcare plans formed into two models: a capitated plan (essentially an HMO), and a plan which paid service providers, such as the Blue Cross and Blue Shield Plans. [4]: 2 One of the earliest examples is a 1910 "prepaid group plan" in Tacoma, Washington for lumber mills.
As a result of the passage of Proposition 103 in 1988, the elected office of the California Insurance Commissioner was created in 1991. Previously, the position was held by a person appointed by the Governor.
L.A. Care Health Plan (Local Initiative Health Authority for Los Angeles County) was created in 1997 by the State of California to provide health care services for Medi-Cal managed care beneficiaries, uninsured children and other vulnerable populations in Los Angeles County.