Our non-traditional depression
management program has yielded measurable claims and productivity savings and
has enhanced the effectiveness of our current care management, pharmacy and
medical care programs. provides mental health, chemical
dependency and employee assistance services to covered members and maintains a
national network of behavioral health care practitioners .

managed audits

The uniform starter set comprises prevention measures for cancer screening
and vaccinations; measures for chronic conditions including coronary artery
disease, heart failure, diabetes, asthma , depression, and prenatal care; and,
two efficiency measures that address overuse and misuse. Our mission is to further health
care innovation, and the behavioral industry is making giant strides in its
contribution to more effective and affordable health care. Currently, more than 99 percent of PacifiCare's
commercial health plan members are enrolled in plans that have received
Excellent Accreditation by the National Committee for Quality Assurance
(NCQA).

urac compliance

com/cgi-bin/prnh/20040830/AHIPLOGO )
The AQA, initially convened by the American Academy of Family Physicians
(AAFP), the American College of Physicians (ACP), America's Health Insurance
Plans (AHIP), and the Agency for Healthcare Research and Quality (AHRQ),
consists of a large body of stakeholders that represents clinicians ,
consumers, purchasers, health plans and others.
"Attendees will learn about a revolutionary productivity calculator that
allows employers to quantify their behavioral benefits in terms of workplace
productivity and monetary return., Convention Center.com.

purchasers clinicians

The starter set of measures
may be incorporated into performance-based payments as early as next year.nmhcc.

managed acquired

, Convention Center.

concept stakeholders

D. PacifiCare
Behavioral Health has done an outstanding job of bringing together some of the
industry's most dynamic and invigorating presenters.

evaluate clinicians

(Logo: http://www.
This approach is similar to the Hospital Quality Alliance that has
involved a broad array of stakeholders with the goal of producing a
standardized set of measures for inpatient care., health benefits operations director of IBM
Corporation and one of the session presenters: "Reducing claims costs
associated with behavioral issues demands new approaches that identify, reach
out to and motivate employees in need.
The 17th Annual National Managed Health Care Congress will be held March 5-7,
at the Washington, D.

preferred utilization

Ambulatory Performance Measures 'Major Step' in Improving Quality of Health Care

efficiency managed

The starter set of measures is intended to provide
clinicians, consumers and purchasers with a set of quality indicators that may
be utilized for quality improvement, public reporting and pay for performance
programs.D.pbhi.

babicm clinicians

" A secondary aim of the AQA is
to promote uniformity in order to provide consumers and purchasers with
consistent information and to reduce the burden on providers. In addition, they will find out how non-
traditional behavioral solutions are increasing quality while controlling
costs."
According to Jane Barlow , M.C.com.

brain evaluate

, PBH's vice president
and chief clinical officer.

ncqa purchasers

newscom.

This category is for non-profit organizations, societies, and associations of professionals and firms working with the managed care industry.

evaluate clinicians

S. The starter set
represents an initial set of measures that physicians may use to collect the
data and report their performance.
The AQA intends to invite additional provider, purchaser and consumer
groups to join the Steering Committee. PacifiCare
Behavioral Health is a wholly owned subsidiary of PacifiCare Health Systems
(NYSE: PHS), with clients including health plans, union trust funds,
employers, school districts and public sector agencies.

About PacifiCare Health Systems
PacifiCare Health Systems is one of the nation's largest consumer health
organizations with more than 3 million health plan members and approximately
10 million specialty plan members nationwide.

assurance employers

pacificare.

ncqa managed

The full-day forum will feature presentations by a cross section of
employers, health plan executives and industry consultants who will reveal
their "out-of-the -box" strategies for measuring and increasing the
effectiveness of behavioral health programs. All PacifiCare
Behavioral Health service centers hold three-year, Full Accreditation from the
National Committee for Quality Assurance (NCQA), as well as URAC Health
Utilization Management and Case Management Accreditation. More information on
PacifiCare Behavioral Health can be obtained at http://www.

efficiency accreditation

Broad-based Coalition Reaches Consensus on 'Starter Set' for Physicians

WASHINGTON, In a major step toward improving the
quality of the U. The mission of the AQA is "to
improve health care quality and patient safety through a collaborative process
in which key stakeholders agree on a strategy for measuring, reporting and
improving performance at the physician level. "This forum provides a tremendous opportunity for
industry thought leaders to share their successful, breakthrough strategies
with attendees who are interested in putting creative solutions to work in
their own environments. PacifiCare's specialty operations include behavioral health, dental
and vision, and complete pharmacy benefit management through its wholly owned
subsidiary, Prescription Solutions .

utilization affiliate

concept accreditation

C. More information on PacifiCare Health
Systems is available at http://www.

brain stakeholders

(PBH), a national behavioral health care organization and subsidiary of
PacifiCare Health Systems, Inc.
"Today 's health care purchasers are increasingly looking at how behavioral
benefits can play a more important role in offsetting medical costs and
increasing workplace productivity," said Ed Jones, Ph."

About the National Managed Health Care Congress (NMHCC)
The National Managed Health Care Congress is the nation's largest managed
care event connecting teams across every segment of the managed care industry.

efficiency ncqa

PacifiCare Behavioral Health to Lead Discussion on Cost-Saving Benefit Management Strategies at the National Managed Health Care Congress

* Event will spotlight creative behavioral health programs that use
empirical clinical and economic data to define a measurable return on
health care spending

* Industry thought leaders to present new solutions that measure and
solve workplace productivity losses

SANTA ANA, Calif.

About PacifiCare Behavioral Health
PacifiCare Behavioral Health, Inc.

audits efficiency

The measures in the starter set will lead to a uniform set of measures for
ambulatory care that can focus quality efforts and give consumers data they
need to make more informed health care decisions. (NYSE: PHS ), will sponsor the Behavioral
Health Track on March 7 at the 2005 National Managed Health Care Congress
(NMHCC) at the Washington, D.com.

utilization babicm

Except for the two
efficiency metrics, the AQA limited its review to those measures that are
currently under review by the National Quality Forum., PacifiCare Behavioral Health,
Inc. For more information, go to
http://www.

committee affiliate

health care system, the Ambulatory care Quality Alliance
(AQA) has selected a "starter set" of 26 clinical performance measures for the
ambulatory care setting."
Conference Director Carina Kuhl said: "The behavioral forum adds a
valuable dimension to this year's NMHCC.

acquired periodic

clinicians evaluate

The AQA calls on employers and health
plans to endorse this effort and to utilize the starter set to improve quality
of care in the ambulatory setting . PacifiCare offers individuals,
employers and Medicare beneficiaries a variety of consumer-driven health care
and life insurance products.

employers babicm

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