Programs

We offer medical management programs designed to support our members at any stage of their health care journey. Our member programs are enhancements to our members’ total benefit package. They help our members lead healthier lives, and our programs reinforce and support your treatment plans.

Medical management

Our programs include case management, diabetes and disease management, palliative care, radiology, and physical and sleep medicine.

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Image: Smiling pharmacist checking medications to dispense
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Image: Pharmacist counting medication to dispense

Pharmacy

Explore our members’ prescription benefits and other medication information. Learn more about special member programs, pharmacy pre-authorization and our formularies.

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LabCorp

Laboratory Corp. of America is our lab of choice. We encourage you to refer patients to LabCorp for outpatient lab and pathology services.

Cost and quality

When you share cost and quality data with our members—your patients—they can make more informed health care decisions. Read about our quality program, how to respond to patient reviews, using our cost estimator and our participation in community collaboratives.

Risk adjustment

Risk adjustment encourages us to compete with other insurers on quality and efficiency, preserving consumer choice and improving quality of care. Risk scores are calculated differently for Medicare and commercial members, but both require the same types of information.

Medicare programs

Medicare Quality Incentive Program

Earn incentives when you address and close care and diagnosis gaps for Medicare Advantage members. Learn about member gap reports, calculating incentives and receiving payment.

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Medicare Star Ratings

The Centers for Medicare & Medicaid Services (CMS) uses a five-star rating system to assign quality ratings to Medicare Advantage plans each year. Learn how your work influences Star ratings.

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We're here for you

We're here for you

Our Provider Contact Center and Provider Relations teams are here to support you.

LabCorp is a separate and independent company that provides outpatient lab and pathology services for Regence members.