Organized systems for providing comprehensive prepaid health care that have five basic attributes: (1) provide care in a defined geographic area; (2) provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; (3) provide care to a voluntarily enrolled group of persons; (4) require their enrollees to use the services of designated providers; and (5) receive reimbursement through a predetermined, fixed, periodic prepayment made by the enrollee without regard to the degree of services provided. (From Facts on File Dictionary of Health Care Management, 1988)
A partnership, corporation, association, or other legal entity that enters into an arrangement for the provision of services with persons who are licensed to practice medicine, osteopathy, and dentistry, and with other care personnel. Under an IPA arrangement, licensed professional persons provide services through the entity in accordance with a mutually accepted compensation arrangement, while retaining their private practices. Services under the IPA are marketed through a prepaid health plan. (From Facts on File Dictionary of Health Care Management, 1988)
Method of charging whereby a physician or other practitioner bills for each encounter or service rendered. In addition to physicians, other health care professionals are reimbursed via this mechanism. Fee-for-service plans contrast with salary, per capita, and prepayment systems, where the payment does not change with the number of services actually used or if none are used. (From Discursive Dictionary of Health Care, 1976)
A method of payment for health services in which an individual or institutional provider is paid a fixed, per capita amount without regard to the actual number or nature of services provided to each patient.
Arrangements negotiated between a third-party payer (often a self-insured company or union trust fund) and a group of health-care providers (hospitals and physicians) who furnish services at lower than usual fees, and, in return, receive prompt payment and an expectation of an increased volume of patients.
The effort of two or more parties to secure the business of a third party by offering, usually under fair or equitable rules of business practice, the most favorable terms.
Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.
Economic sector concerned with the provision, distribution, and consumption of health care services and related products.
The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed)
The containment, regulation, or restraint of costs. Costs are said to be contained when the value of resources committed to an activity is not considered excessive. This determination is frequently subjective and dependent upon the specific geographic area of the activity being measured. (From Dictionary of Health Services Management, 2d ed)
Adverse or favorable selection bias exhibited by insurers or enrollees resulting in disproportionate enrollment of certain groups of people.
Amounts charged to the patient as payer for medical services.
The combining of administrative and organizational resources of two or more health care facilities.
The geographic area of the northwestern region of the United States. The states usually included in this region are Idaho, Montana, Oregon, Washington, and Wyoming.
Health insurance plans for employees, and generally including their dependents, usually on a cost-sharing basis with the employer paying a percentage of the premium.
That portion of total HEALTH CARE COSTS borne by an individual's or group's employing organization.
The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.
Federal program, created by Public Law 89-97, Title XVIII-Health Insurance for the Aged, a 1965 amendment to the Social Security Act, that provides health insurance benefits to persons over the age of 65 and others eligible for Social Security benefits. It consists of two separate but coordinated programs: hospital insurance (MEDICARE PART A) and supplementary medical insurance (MEDICARE PART B). (Hospital Administration Terminology, AHA, 2d ed and A Discursive Dictionary of Health Care, US House of Representatives, 1976)
Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.
The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.
Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)
Provisions of an insurance policy that require the insured to pay some portion of covered expenses. Several forms of sharing are in use, e.g., deductibles, coinsurance, and copayments. Cost sharing does not refer to or include amounts paid in premiums for the coverage. (From Dictionary of Health Services Management, 2d ed)
An organized group of three or more full-time physicians rendering services for a fixed prepayment.
The concept concerned with all aspects of providing and distributing health services to a patient population.
Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.
Application of marketing principles and techniques to maximize the use of health care resources.
Alternative health care delivery mechanisms, such as PREFERRED PROVIDER ORGANIZATIONS or other health insurance services or prepaid plans (other than HEALTH MAINTENANCE ORGANIZATIONS), that meet Medicare qualifications for a risk-sharing contract. (From Facts on File Dictionary of Health Care Management, 1988)
The Balanced Budget Act (BBA) of 1997 establishes a Medicare+Choice program under part C of Title XVIII, Section 4001, of the Social Security Act. Under this program, an eligible individual may elect to receive Medicare benefits through enrollment in a Medicare+Choice plan. Beneficiaries may choose to use private pay options, establish medical savings accounts, use managed care plans, or join provider-sponsored plans.
Insurance providing benefits for the costs of care by a physician which can be comprehensive or limited to surgical expenses or for care provided only in the hospital. It is frequently called "regular medical expense" or "surgical expense".
An organized procedure carried out through committees to review admissions, duration of stay, professional services furnished, and to evaluate the medical necessity of those services and promote their most efficient use.
Federal program, created by Public Law 89-97, Title XIX, a 1965 amendment to the Social Security Act, administered by the states, that provides health care benefits to indigent and medically indigent persons.
The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (HEALTH CARE COSTS) and may or may not be shared among the patient, insurers, and/or employers.
Any system which allows payors to share some of the financial risk associated with a particular patient population with providers. Providers agree to adhere to fixed fee schedules in exchange for an increase in their payor base and a chance to benefit from cost containment measures. Common risk-sharing methods are prospective payment schedules (PROSPECTIVE PAYMENT SYSTEM), capitation (CAPITATION FEES), diagnosis-related fees (DIAGNOSIS-RELATED GROUPS), and pre-negotiated fees.
The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.
The controlling of access to health services, usually by primary care providers; often used in managed care settings to reduce utilization of expensive services and reduce referrals. (From BIOETHICS Thesaurus, 1999)
Compensatory plans designed to motivate physicians in relation to patient referral, physician recruitment, and efficient use of the health facility.
Any group of three or more full-time physicians organized in a legally recognized entity for the provision of health care services, sharing space, equipment, personnel and records for both patient care and business management, and who have a predetermined arrangement for the distribution of income.
Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.
Economic aspects of the field of medicine, the medical profession, and health care. It includes the economic and financial impact of disease in general on the patient, the physician, society, or government.
Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility.
Review of claims by insurance companies to determine liability and amount of payment for various services. The review may also include determination of eligibility of the claimant or beneficiary or of the provider of the benefit; determination that the benefit is covered or not payable under another policy; or determination that the service was necessary and of reasonable cost and quality.
Organizations which are not operated for a profit and may be supported by endowments or private contributions.
Payments or services provided under stated circumstances under the terms of an insurance policy. In prepayment programs, benefits are the services the programs will provide at defined locations and to the extent needed.
The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from HEALTH EXPENDITURES, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost.
Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level.
Generally refers to the amount of protection available and the kind of loss which would be paid for under an insurance contract with an insurer. (Slee & Slee, Health Care Terms, 2d ed)
Services designed for HEALTH PROMOTION and prevention of disease.
State plans prepared by the State Health Planning and Development Agencies which are made up from plans submitted by the Health Systems Agencies and subject to review and revision by the Statewide Health Coordinating Council.
Cost-sharing mechanisms that provide for payment by the insured of some portion of covered expenses. Deductibles are the amounts paid by the insured under a health insurance contract before benefits become payable; coinsurance is the provision under which the insured pays part of the medical bill, usually according to a fixed percentage, when benefits become payable.
The amount that a health care institution or organization pays for its drugs. It is one component of the final price that is charged to the consumer (FEES, PHARMACEUTICAL or PRESCRIPTION FEES).
Hospitals owned and operated by a corporation or an individual that operate on a for-profit basis, also referred to as investor-owned hospitals.
Payment by a third-party payer in a sum equal to the amount expended by a health care provider or facility for health services rendered to an insured or program beneficiary. (From Facts on File Dictionary of Health Care Management, 1988)
The remuneration paid or benefits granted to an employee.
Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).
Amounts charged to the patient as payer for health care services.
Services for the diagnosis and treatment of disease and the maintenance of health.
Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.
Management of the internal organization of the hospital.
Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.
Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care.
Formal programs for assessing drug prescription against some standard. Drug utilization review may consider clinical appropriateness, cost effectiveness, and, in some cases, outcomes. Review is usually retrospective, but some analysis may be done before drugs are dispensed (as in computer systems which advise physicians when prescriptions are entered). Drug utilization review is mandated for Medicaid programs beginning in 1993.
Health services required by a population or community as well as the health services that the population or community is able and willing to pay for.
Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer.
A traditional term for all the activities which a physician or other health care professional normally performs to insure the coordination of the medical services required by a patient. It also, when used in connection with managed care, covers all the activities of evaluating the patient, planning treatment, referral, and follow-up so that care is continuous and comprehensive and payment for the care is obtained. (From Slee & Slee, Health Care Terms, 2nd ed)
Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.
Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
Excessive, under or unnecessary utilization of health services by patients or physicians.
Organized services to provide health care for children.
An occupation limited in scope to a subsection of a broader field.
The art and science of studying, performing research on, preventing, diagnosing, and treating disease, as well as the maintenance of health.
Individuals licensed to practice medicine.
Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.
Processes or methods of reimbursement for services rendered or equipment.
Works about lists of drugs or collections of recipes, formulas, and prescriptions for the compounding of medicinal preparations. Formularies differ from PHARMACOPOEIAS in that they are less complete, lacking full descriptions of the drugs, their formulations, analytic composition, chemical properties, etc. In hospitals, formularies list all drugs commonly stocked in the hospital pharmacy.
Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.
The seeking and acceptance by patients of health service.
Directions written for the obtaining and use of DRUGS.
Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.
The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.
Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.
Social and economic factors that characterize the individual or group within the social structure.
Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.
Innovation and improvement of the health care system by reappraisal, amendment of services, and removal of faults and abuses in providing and distributing health services to patients. It includes a re-alignment of health services and health insurance to maximum demographic elements (the unemployed, indigent, uninsured, elderly, inner cities, rural areas) with reference to coverage, hospitalization, pricing and cost containment, insurers' and employers' costs, pre-existing medical conditions, prescribed drugs, equipment, and services.
Customer satisfaction or dissatisfaction with a benefit or service received.
Community or individual involvement in the decision-making process.
A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area.
Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.
The state wherein the person is well adjusted.
Organized periodic procedures performed on large groups of people for the purpose of detecting disease.
Public attitudes toward health, disease, and the medical care system.
Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.
Recording of pertinent information concerning patient's illness or illnesses.
The state of the organism when it functions optimally without evidence of disease.
Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural.
A heterogeneous group of disorders characterized by HYPERGLYCEMIA and GLUCOSE INTOLERANCE.
Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.
The confinement of a patient in a hospital.
A specialized agency of the United Nations designed as a coordinating authority on international health work; its aim is to promote the attainment of the highest possible level of health by all peoples.
Statistical interpretation and description of a population with reference to distribution, composition, or structure.
A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results.
Personal satisfaction relative to the work situation.
Insurance providing for payment of services rendered by the pharmacist. Services include the preparation and distribution of medical products.
Planning for needed health and/or welfare services and facilities.
Those physicians who have completed the education requirements specified by the American Academy of Family Physicians.
A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.
The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases.
The use of severity-of-illness measures, such as age, to estimate the risk (measurable or predictable chance of loss, injury or death) to which a patient is subject before receiving some health care intervention. This adjustment allows comparison of performance and quality across organizations, practitioners, and communities. (from JCAHO, Lexikon, 1994)
Studies in which a number of subjects are selected from all subjects in a defined population. Conclusions based on sample results may be attributed only to the population sampled.
Elements of limited time intervals, contributing to particular results or situations.
The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.
The concept pertaining to the health status of inhabitants of the world.
Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.
Studies designed to assess the efficacy of programs. They may include the evaluation of cost-effectiveness, the extent to which objectives are met, or impact.
The teaching or training of patients concerning their own health needs.
Voluntary cooperation of the patient in following a prescribed regimen.
Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL).
Conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes school admission or job interviews.
Radiographic examination of the breast.
Men and women working in the provision of health services, whether as individual practitioners or employees of health institutions and programs, whether or not professionally trained, and whether or not subject to public regulation. (From A Discursive Dictionary of Health Care, 1976)
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.
Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.
The utilization of drugs as reported in individual hospital studies, FDA studies, marketing, or consumption, etc. This includes drug stockpiling, and patient drug profiles.
Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis.
An infant during the first month after birth.
Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends.
Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.
Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.
A range of values for a variable of interest, e.g., a rate, constructed so that this range has a specified probability of including the true value of the variable.
The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease.
A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
Studies determining the effectiveness or value of processes, personnel, and equipment, or the material on conducting such studies. For drugs and devices, CLINICAL TRIALS AS TOPIC; DRUG EVALUATION; and DRUG EVALUATION, PRECLINICAL are available.
A shared service which combines the purchasing power of individual organizations or facilities in order to obtain lower prices for equipment and supplies. (From Health Care Terms, 2nd ed)
Management of public health organizations or agencies.
Computer-based systems for input, storage, display, retrieval, and printing of information contained in a patient's medical record.
Studies in which variables relating to an individual or group of individuals are assessed over a period of time.
Revenues or receipts accruing from business enterprise, labor, or invested capital.
Extensive collections, reputedly complete, of facts and data garnered from material of a specialized subject area and made available for analysis and application. The collection can be automated by various contemporary methods for retrieval. The concept should be differentiated from DATABASES, BIBLIOGRAPHIC which is restricted to collections of bibliographic references.
Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)
The probability that an event will occur. It encompasses a variety of measures of the probability of a generally unfavorable outcome.
The promotion and maintenance of physical and mental health in the work environment.
The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health.
Variation in rates of disease occurrence and disabilities between population groups defined by socioeconomic characteristics such as age, ethnicity, economic resources, or gender and populations identified geographically or similar measures.
The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.
A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.
Inhaling and exhaling the smoke of burning TOBACCO.
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.
Components of a national health care system which administer specific services, e.g., national health insurance.
A health care system which combines physicians, hospitals, and other medical services with a health plan to provide the complete spectrum of medical care for its customers. In a fully integrated system, the three key elements - physicians, hospital, and health plan membership - are in balance in terms of matching medical resources with the needs of purchasers and patients. (Coddington et al., Integrated Health Care: Reorganizing the Physician, Hospital and Health Plan Relationship, 1994, p7)
Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.
Planning for the equitable allocation, apportionment, or distribution of available health resources.
Preferentially rated health-related activities or functions to be used in establishing health planning goals. This may refer specifically to PL93-641.
The activities and endeavors of the public health services in a community on any level.
Organized services to provide mental health care.
A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.
Diagnostic, therapeutic and preventive health services provided for individuals in the community.
Tumors or cancer of the human BREAST.
A form of bronchial disorder with three distinct components: airway hyper-responsiveness (RESPIRATORY HYPERSENSITIVITY), airway INFLAMMATION, and intermittent AIRWAY OBSTRUCTION. It is characterized by spasmodic contraction of airway smooth muscle, WHEEZING, and dyspnea (DYSPNEA, PAROXYSMAL).

Use of out-of-plan services by Medicare members of HIP. (1/1026)

Use of out-of-plan services in 1972 by Medicare members of the Health Insurance Plan of Greater New York (HIP) is examined in terms of the demographic and enrollment characteristics of out-of-plan users, types of services received outside the plan, and the relationship of out-of-plan to in-plan use. Users of services outside the plan tended to be more seriously ill and more frequently hospitalized than those receiving all of their services within the plan. The costs to the SSA of providing medical care to HIP enrollees are compared with analogous costs for non-HIP beneficiaries, and the implications for the organization and financing of health services for the aged are discussed.  (+info)

Hypertension, antihypertensive medication use, and risk of renal cell carcinoma. (2/1026)

To investigate whether diuretic medication use increases risk of renal cell carcinoma (RCC), the authors conducted a case-control study of health maintenance organization members in western Washington State. Cases (n = 238) diagnosed between January 1980 and June 1995 were compared with controls (n = 616) selected from health maintenance organization membership files. The computerized health maintenance organization pharmacy database provided information on medications prescribed after March 1977. Additional exposure information was collected from medical records. For women, use of diuretics was associated with increased risk of RCC (odds ratio (OR) = 1.8, 95% confidence interval (CI) 1.0-3.1), but the association was not independent of a diagnosis of hypertension (adjusted for hypertension, OR = 1.1, 95% CI 0.5-2.1). Similarly, nondiuretic antihypertensive use was associated with increased risk, but only when unadjusted for hypertension. For men, neither diuretic nor nondiuretic antihypertensive use was associated with risk of RCC. A diagnosis of hypertension was clearly associated with RCC risk for women (OR = 2.5, 95% CI 1.2-5.1), but not men (OR = 1.3, 95% CI 0.7-2.5). High systolic and diastolic blood pressures were associated with increased risk in both sexes. These results do not support the hypothesis that use of diuretic medication increases RCC risk; they are more consistent with an association between RCC and high blood pressure.  (+info)

The changing elderly population and future health care needs. (3/1026)

The impending growth of the elderly population requires both fiscal and substantive changes in Medicare and Medicaid that are responsive to cost issues and to changing patterns of need. More emphasis is required on chronic disease management, on meaningful integration between acute and long-term care services, and on improved coordination between Medicare and Medicaid initiatives. This paper reviews various trends, including the growth in managed-care approaches, experience with social health maintenance organizations and Program of All-Inclusive Care for the Elderly demonstrations, and the need for a coherent long-term care policy. Such policies, however, transcend health care and require a broad range of community initiatives.  (+info)

Raising the bar: the use of performance guarantees by the Pacific Business Group on Health. (4/1026)

In 1996 the Pacific Business Group on Health (PBGH) negotiated more than two dozen performance guarantees with thirteen of California's largest health maintenance organizations (HMOs) on behalf the seventeen large employers in its Negotiating Alliance. The negotiations put more than $8 million at risk for meeting performance targets with the goal of improving the performance of all health plans. Nearly $2 million, or 23 percent of the premium at risk, was refunded to the PBGH by the HMOs for missed targets. The majority of plans met their targets for satisfaction with the health plan and physicians, as well as cesarean section, mammography, Pap smear, and prenatal care rates. However, eight of the thirteen plans missed their targets for childhood immunizations, refunding 86 percent of the premium at risk.  (+info)

Financial incentives and drug spending in managed care. (5/1026)

This study estimates the impact of patient financial incentives on the use and cost of prescription drugs in the context of differing physician payment mechanisms. A large data set was developed that covers persons in managed care who pay varying levels of cost sharing and whose physicians are compensated under two different models: independent practice association (IPA)-model and network-model health maintenance organizations (HMOs). Our results indicate that higher patient copayments for prescription drugs are associated with lower drug spending in IPA models (in which physicians are not at risk for drug costs) but have little effect in network models (in which physicians bear financial risk for all prescribing behavior).  (+info)

Waking the health plan giant: Group Health Cooperative stops counting sheep and starts counting key tobacco indicators. (6/1026)

Implementing a comprehensive approach to decreasing tobacco use in a large health plan requires hard work and commitment on the part of many individuals. We found that major organisational change can be accomplished and sustained. Keys to our success included our decision to remove access barriers to our cessation programmes (including cost); obtaining top leadership buy-in; identifying accountable individuals who owned responsibility for change; measuring key processes and outcomes; and finally keeping at it tenaciously through multiple cycles of improvement.  (+info)

Health maintenance organizations in developing countries: what can we expect? (7/1026)

Health maintenance organizations (HMOs) are a relatively new and alternative means of providing health care, combining a risk-sharing (insurance) function with health service provision. Their potential for lowering costs has attracted great interest in the USA and elsewhere, and has raised questions regarding their applicability to other settings. Little attention, however, has been given to critically reviewing the experience with HMOs in other countries, particularly concerning their introduction to settings other than the USA. This paper first reviews the current experience of HMOs in low- and middle-income countries, including Argentina, Bolivia, Brazil, Colombia, Ecuador, Uruguay, Chile and Indonesia. Secondly, the paper reviews the USA experience with HMOs: prerequisites for the establishment of HMOs in the USA are identified and discussed, followed by a review of the performance of HMOs in terms of cost containment, integration of care and quality of care for the elderly and poor. The analysis concludes that difficulties may arise when implementing HMOs in developing countries, and that potential adverse effects on the overall health care delivery system may occur. These should be avoided by careful analyses of a nation's health care system.  (+info)

The corporate practice of health care ... a panel discussion. (8/1026)

The pros and cons of treating health care as a profit-making business got a lively airing in Boston May 16, when the Harvard School of Public Health's "Second Conference on Strategic Alliances in the Evolving Health Care Market" presented what was billed as a "Socratic panel." The moderator was Charles R. Nesson, J.D., a Harvard Law School professor of 30 years' standing whose knack for guiding lively discussions is well known to viewers of such Public Broadcasting Service series as "The Constitution: That Delicate Balance. "As one panelist mentioned, Boston was an interesting place for this conversation. With a large and eminent medical establishment consisting mostly of traditionally not-for-profit institutions, the metropolis of the only state carried in 1972 by liberal Presidential candidate George McGovern is in one sense a skeptical holdout against the wave of aggressive investment capitalism that has been sweeping the health care industry since the 1994 failure of the Clinton health plan. In another sense, though, managed care-heavy Boston is an innovative crucible of change, just like its dominant HMO, the not-for-profit but merger-minded Harvard Pilgrim Health Care. Both of these facets of Beantown's health care psychology could be discerned in the comments heard during the panel discussion. With the permission of the Harvard School of Public Health--and asking due indulgence for the limitations of tape-recording technology in a room often buzzing with amateur comment--MANAGED CARE is pleased to present selections from the discussion in the hope that they will shed light on the business of health care.  (+info)

Definition of Health Maintenance Organizations in the Financial Dictionary - by Free online English dictionary and encyclopedia. What is Health Maintenance Organizations? Meaning of Health Maintenance Organizations as a finance term. What does Health Maintenance Organizations mean in finance?
Rev. 5/25/2016 8:48:59 AM--2015]. CHAPTER 695C - HEALTH MAINTENANCE ORGANIZATIONS. GENERAL PROVISIONS. NRS 695C.010 Short title. NRS 695C.020 Legislative declaration.. NRS 695C.030 Definitions.. NRS 695C.050 Applicability of certain provisions.. NRS 695C.055 Applicability of certain other provisions.. NRS 695C.057 Applicability of certain provisions concerning portability and availability of health insurance.. NRS 695C.060 Establishment of organization.. NRS 695C.070 Certificate of authority: Application.. NRS 695C.080 Certificate of authority: Evaluation of application.. NRS 695C.090 Certificate of authority: Issuance.. NRS 695C.100 Certificate of authority: Denial.. NRS 695C.110 Governing body: Composition; participation by enrollees.. NRS 695C.120 Powers of organization.. NRS 695C.123 Contracts with certain federally qualified health centers.. NRS 695C.125 Contract between health maintenance organization and provider of health care: Form to obtain information on provider of health care; ...
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Despite clear principles regarding antibiotic use in patients with upper respiratory infections (URIs), this practice is still widespread. Gonzales and colleagues conducted a prospective cohort study to determine which clinical characteristics in patients cause physicians to prescribe antibiotics for non-antibiotic responsive conditions (i.e., URIs).. Patients enrolled in a group-model health maintenance organization were included in the study if they had symptoms involving the chest, throat, ears or nasal passage. Each visit was documented in a standardized fashion, and adult patients with a final diagnosis of URI were included for analysis. Patients with diagnoses of pneumonia, acute bronchitis, otitis media, sinusitis or pharyngitis were excluded. (Even though acute bronchitis is not an indication for antibiotics, many physicians continue to prescribe antibiotics for this condition.). The clinical manifestations most often reported by the 451 patients diagnosed with URI were cough, sore ...
A Health Maintenance Organization (HMO) provides a wide range of benefits that cover the entire health care spectrum, from preventive care and education to physician care, surgery and hospitalization. Health care is typically managed by primary care physicians, specialists, hospitals and labs inside the provider network, with premiums and co-payment for certain services or prescriptions.. Since contracting discounts from a network of providers is one of the primary ways an HMO maintains cost effectiveness, treatment received outside the network is usually not covered. While an HMO is more restrictive than other plans, doctor visits and health care can be simple, easy and reliable. If there is a need to see a specialist, the doctor will recommend appropriate resources and often make the scheduled appointment on the patients behalf.1. ...
62D.12 Prohibited practices. Subdivision 1. False representations. No health maintenance organization or representative thereof may cause or knowingly permit the use of advertising or solicitation which is untrue or misleading, or any form of evidence of coverage which is deceptive. Each health maintenance organization shall be subject to sections 72A.17 to 72A.32, relating to the regulation of trade practices, except (a) to the extent that the nature of a health maintenance organization renders such sections clearly inappropriate and (b) that enforcement shall be by the commissioner of health and not by the commissioner of commerce. Every health maintenance organization shall be subject to sections 8.31 and 325F.69. Subd. 1a. Swing-out products. Notwithstanding subdivision 1, nothing in sections 62A.049, 62A.60, and 72A.201, subdivision 4a, applies to a commercial health policy issued under this chapter as a companion to a health maintenance contract. Subd. 2. Coverage cancellation; nonrenewal. ...
OBJECTIVE: To assess adherence to prescribing guidelines, continuation rates, population effects on glycemic control, and occurrence of lactic acidosis during the first 20 months of the availability of metformin in a large health maintenance organization. RESEARCH DESIGN AND METHODS: A retrospective cohort study was performed in the 90,000-member diabetes registry of Kaiser Permanente, northern California. Principal study measures were the proportions of patients started on metformin who met prescribing guidelines (previously on sulfonylureas, HbA1c, obesity, creatinine), the change in HbA1c at 6 months after starting metformin, and hospitalization rates for lactic acidosis. RESULTS: A total of 9,875 patients received metformin during this interval. At least 74% were previously treated with sulfonylureas alone, 81% had baseline HbA1c , or = 8.5%, 71% were obese, and 99% had a serum creatinine , or = 1.5 mg/dl. Among patients on sulfonylureas at baseline, those starting metformin had ...
Minnesota lays claim to the idea of prepaid health plans-health services operated and administered by medical doctors and professional staff, and managed by health maintenance organizations (HMOs) -a design formulated in the early 1960s by Dr. Paul M. Ellwood, then executive director of the American Rehabilitation Foundation and the Sister Kenny Institute of Minneapolis. To Dr. Ellwood and his associates, the passage of Medicare legislation in 1965 seemed to portend a slide toward socialized medicine, unwelcome involvement of government in American medicine and patient care.. In proposing his concept of managed care, Dr. Ellwood intended it to act as a bulwark against a looming threat to the quality of medical care. In cooperation with the Park Nicollet Clinic in Minneapolis, Dr. Ellwood conducted a pilot program in 1972, testing the concept. The pilot program involved 5000 patients from General Mills, the Dayton Company, and other local corporations who were enrolled in this ...
Services of facilities licensed as general hospitals under chapter 4640 (general hospital services) shall be provided through contracts between the health maintenance organization and hospitals. These services shall be available and accessible, on a timely basis consistent with generally accepted practice parameters, 24 hours per day, seven days per week within the health maintenance organizations service area. Services of facilities licensed as specialized hospitals under chapter 4640 (specialized hospital services), including chemical dependency and mental health services, shall be provided through contracts between the health maintenance organization or its contracted providers and hospitals, either within or outside the health maintenance organizations service area. These services shall be available during normal business hours consistent with generally accepted practice parameters.. ...
Daily Camera reviews for health maintenance organizations in Boulder, CO - Helping Hands Health Education, Herb Research Foundation, Longmont Athletic Club West, Longmont Athletic Club,
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Trends in overweight from 1980 through 2001 among preschool-aged children enrolled in a health maintenance organization. Obesity (Silver Spring). 2006 Jul; 14(7):1107-12 ...
32 kandeel and koussa figure 1 human sexuality. Nevertheless, it is unlikely that any are forthcoming in the treatment of patients presenting with a large health maintenance organization with more frequency in cases of prostate cancer. Figure 1 investigation of female sexual arousal, defined as the rossello or mooreville will prevent uncontrolled tearing of the issues from a rare urologic condition that causes narrowing. Genitourin med 1986; 344(25):16571674. Nitric oxide donors linsidomine. In men, trazodone can lead to undesirable and significant prostate cancer is between 1 and are less than 50 seconds, and about 10% to 28%, which may, in fact, be the bridge between testosterone withdrawal and decreased testosterone in combination with congenital qt prolongation and those who received 50 mg 1 mg phentolamine mixture. Notably, many of the relationship between androgens and may result in erectile function. Paul reported that his connectedness with his wife. Study of the european imaginationa ...
We identified a 20% sample of all Medicare beneficiaries who died between the ages of 66 and 99 years during the period 2003-07. Data for 2010-12 are based on a 100% sample of claims. We excluded beneficiaries without continuous Part A and Part B coverage in the last six months of life or who were enrolled in Medicare health maintenance organizations (i.e., Medicare Advantage). From these decedents, we identified those with poor prognosis cancer diagnoses on at least one hospital claim or at least two clinician visits in the last six months of life. We then categorized decedents into one of 26 cancer types based on their predominant cancer diagnosis using a modified Clinical Classification Software (CCS) approach; please see the Methods of our cancer report for details. ...
Group Health Cooperative, a large, membersnip staff model health maintenance organization HMO, has designed a comprehensive influenza campaign for identifying, recruiting and vaccinating enrollees at increased risk for influenza-related complications. The Cooperative s Centre for Health Promotion is responsible for the overall planning,...
Doctors and other health care providers are paid a fixed monthly fee for each HMO member under their care, rather than for each In fee-for-service plans, the annual expenses the patient must pay before the insurer will begin reimbursement for additional expenses. in which patients pay doctors, hospitals, and other providers for services and then request reimbursement from private insurers providing a broad range of basic health services, assuring financial administered by the Health Care Financing Administration, Department Who offers worthy alternative therapies? receive medical care from a group physician unless a referral -- Health maintenance organization (HMO): HMOs offer prepaid, comprehensive health coverage for both hospital and physician services. An HMO contracts with health care providers, including doctors, hospitals and others. Members must use participating providers for all health services. -- Preferred provider organization (PPO): A health care arrangement between purchasers
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While Orlando Health utilizes a variety of sources of information in checking the accuracy of the data reported, we cannot be sure that all of the information on this profile is correct, complete, or up-to-date, and cannot be responsible for any information that is wrong or has been left out. Please contact the physicians practice office directly to verify insurances accepted and the physicians status as an in-network or out-of-network provider of a specific health plan before requesting services. Healthcare practitioners who provide services in the hospital may or may not participate with the same health insurers or health maintenance organizations as the hospital. It is recommended to confirm/ contact the healthcare practitioner who will provide services in the hospital to determine which health insurers and health maintenance organizations the practitioner participates in as either a network provider or preferred provider. For a list of insurance plans accepted by Orlando Health, visit the ...
While Orlando Health utilizes a variety of sources of information in checking the accuracy of the data reported, we cannot be sure that all of the information on this profile is correct, complete, or up-to-date, and cannot be responsible for any information that is wrong or has been left out. Please contact the physicians practice office directly to verify insurances accepted and the physicians status as an in-network or out-of-network provider of a specific health plan before requesting services. Healthcare practitioners who provide services in the hospital may or may not participate with the same health insurers or health maintenance organizations as the hospital. It is recommended to confirm/ contact the healthcare practitioner who will provide services in the hospital to determine which health insurers and health maintenance organizations the practitioner participates in as either a network provider or preferred provider. For a list of insurance plans accepted by Orlando Health, visit the ...
While Orlando Health utilizes a variety of sources of information in checking the accuracy of the data reported, we cannot be sure that all of the information on this profile is correct, complete, or up-to-date, and cannot be responsible for any information that is wrong or has been left out. Please contact the physicians practice office directly to verify insurances accepted and the physicians status as an in-network or out-of-network provider of a specific health plan before requesting services. Healthcare practitioners who provide services in the hospital may or may not participate with the same health insurers or health maintenance organizations as the hospital. It is recommended to confirm/ contact the healthcare practitioner who will provide services in the hospital to determine which health insurers and health maintenance organizations the practitioner participates in as either a network provider or preferred provider. For a list of insurance plans accepted by Orlando Health, visit the ...
Mode of Data Collection: face-to-face interview Data Source: personal interviews. Restrictions: In preparing the data tape(s) for this collection, the National Center for Health Statistics (NCHS) has removed direct identifiers and characteristics that might lead to identification of data subjects. As an additional precaution, NCHS requires, under section 308(d) of the Public Health Service Act (42 U.S.C. 242m), that data collected by NCHS not be used for any purpose other than statistical analysis and reporting. NCHS further requires that analysts not use the data to learn the identity of any persons or establishments and that the director of NCHS be notified if any identities are inadvertently discovered. ICPSR member institutions and other users ordering data from ICPSR are expected to adhere to these restrictions.. ...
I could not get the rigth answer for this question, this came up in a kaplan exam. I also dont understand the explanation. Could someone ...
Washington, D.C.] : U.S. Dept. of Health & Human Services, Public Health Service, Health Resources and Services Administration, Bureau of Health Maintenance Organizations and Resources Development, Office of Health Planning, 1984-), by United States. Bureau of Health Maintenance Organizations and Resources Development. Office of Health Planning (page images at HathiTrust ...
1Note.-As created by s. 33, ch. 96-199. As created by s. 9, ch. 96-223, s. 641.513(4) and (5) read:. (4) A subscriber may be charged a reasonable copayment, as provided in s. 641.31(12), for the use of an emergency room, except for Medicaid recipients. Nothing in this section is intended to prohibit or limit application of a nominal copayment as provided in s. 409.9081 for the use of an emergency room for services other than emergency services and care.. (5) Reimbursement for services under this section provided to subscribers who are not Medicaid recipients by a provider for whom no contract exists between the provider and the health maintenance organization shall be the lesser of:. (a) The providers charges;. (b) The usual and customary provider charges for similar services in the community where the services were provided; or. (c) The charge mutually agreed to by the health maintenance organization and the provider within 60 days after the submittal of the claim.. Such reimbursement shall be ...
Health Insurance Alert: Out-of-Network Rip-Offs [ez_date] Much has been made in the health insurance debate surrounding Obamacare of the growing reliance by health insurers on narrow networks of doctors and hospitals willing to accept their discounted payments as a means of keeping healthcare costs under control. This trend preceded Obamacare, but has accelerated as insurers […]. ...
Sec. 843.336. DEFINITION. (a) In this subchapter, clean claim means a claim that complies with this section.. (b) A nonelectronic claim by a physician or provider, other than an institutional provider, is a clean claim if the claim is submitted using the Centers for Medicare and Medicaid Services Form 1500 or, if adopted by the commissioner by rule, a successor to that form developed by the National Uniform Claim Committee or its successor. An electronic claim by a physician or provider, other than an institutional provider, is a clean claim if the claim is submitted using the Professional 837 (ASC X12N 837) format or, if adopted by the commissioner by rule, a successor to that format adopted by the Centers for Medicare and Medicaid Services or its successor.. (c) A nonelectronic claim by an institutional provider is a clean claim if the claim is submitted using the Centers for Medicare and Medicaid Services Form UB-92 or, if adopted by the commissioner by rule, a successor to that form ...
Most recently I have written, with my colleagues, a review of Sustainability and Transformation Plans. I have also prepared a review of plans in Huddersfield as a precursor to a legal challenge in West Yorkshire. Ive worked on some of the largest PFI developments in the country, witnessed at close hand the NHS IT project, and even set up a Health Maintenance Organisation in the private sector, in the mid-1990s. I have a lot of experience of the claims of the transformation industry.. And I do work for a living so if anyone wants to pay me, then do come and see meet me afterwards.. So turning to Accountable Care Organisations.. First the commercial perspective. They derive from the American model of Health Maintenance Organisations.. These are defined as a medical insurance group that provides health services for a fixed annual fee. It is an organisation that provides or arranges managed care for health insurance, self-funded health care benefits plans, individuals, or other entities, acting ...
Further study is needed to elucidate whether parents who smoke underutilize health services for their children or use services differently from nonsmoking parents and whether these differences have cost implications.
641.3915 Health maintenance organization anti-fraud plans and investigative units.-Each authorized health maintenance organization and applicant for a certificate of authority shall comply with the provisions of ss. 626.989 and 626.9891 as though such organization or applicant were an authorized insurer. For purposes of this section, the reference to the year 1996 in s. 626.9891 means the year 2000 and the reference to the year 1995 means the year 1999. ...
Creating a health care business is definitely an fascinating action to take when you are up for any challenge. There are various several types of firms that one
The objective of this study is to estimate the effects of competition for both Medicare and HMO patients on the quality decisions of hospitals in Southern California. We use discharge data from the State of California for the period 1989-1993. The outcome variables are the risk-adjusted hospital mortality rates for pneumonia (estimated by the authors) and acute myocardial infarction (reported by the state of California). Measures of competition are constructed for each hospital and payer type. The competition measures are formulated to mitigate the possibility of endogeneity bias. The study finds that increases in the degree of competition for HMO patients decrease risk-adjusted hospital mortality rates. Conversely, increases in competition for Medicare enrollees are associated with increases in risk-adjusted mortality rates for hospitals. In conjunction with previous research, the estimates indicate that increasing competition for HMO patients appears to reduce prices and save lives and hence ...
he study did not find evidence of differences between HMOs and other types of insurance in hospital use, emergency room visits or surgeries. In addition, reports of unmet need or delayed care, important indicators of access to care, differ little between HMO enrollees and people with other types of insurance. Hospital, Surgery and Emergency Room Use. Comparing use of costly services in HMOs with that in other forms of insurance is important because of the interest in controlling health care costs and concern about access to these services. The study did not find evidence of reduced use of three important services under HMOs. The difference between HMO enrollees hospital use and that of people with other types of insurance is small and not statistically significant (see Figure 1). Overall use of surgery does not differ significantly, nor is there evidence of greater reliance on outpatient over inpatient surgery in HMOs (see Figure 2). We also found no evidence that HMO enrollees use emergency ...
The Adverse Childhood Experiences Study (ACE study) confirmed the linkage between exposure to adversity in childhood and the risk of chronic disease and poor health outcomes as an adult.. Dr. Vincent Felitti, from Kaiser Permanentes Health Appraisal Clinic in San Diego and Dr. Robert Anda, from the Centers for Disease Control and Prevention (CDC)were the principle investigators in the study. More than 17,000 Health Maintenance Organization (HMO) members were included in the study (CDC).Most of the study participants were well educated, middle class, and white and consisted of a near equal percent of men and women.. Each participant underwent a thorough physical exam and gave a detailed history of any exposure in childhood to stressful or traumatic experiences. The ACE Study specifically looked at ten categories of abuse, neglect, and family dysfunction.. Each category is worth one point. Exposure to any of the ACEs before the age of 18, regardless of how often it occurred, or how long it ...
N.B.: The data have been collected from the national canine organisations member of the FCI. Blank cells in the table mean either no answer from the national canine organisation member of the FCI or data not available. ...
Fingerprint Dive into the research topics where Институт педагогики is active. These topic labels come from the works of this organisations members. Together they form a unique fingerprint. ...
Kaiser Permanente, the biggest U.S. health maintenance organization, said it is using Gilead Sciences new hepatitis C drug, Sovaldi, even though its $84,000 treatment price is outrageous.
Health maintenance organization, or HMO -- Broadly speaking, there are two types of HMOs: those that have their own doctors and medical facilities, and those that dont. Locally, Kaiser Permanente
Soliciting or accepting new or renewal health maintenance contracts by insolvent or impaired health maintenance organization prohibited; penalty ...
FAQs on HMO plans to help you understand what they are, types of HMO plans, why its needed and the benefits of having a comprehensive HMO plan.
On the afternoon of April 6, updates were made to the adult pneumococcal Health Maintenance Topics, Plans, and Best Practice Advisories (BPA) in [email protected] Early this morning an issue was identified with the Health Maintenance Topics not appropriately recognizing past vaccinations, which may cause Health Maintenance to indicate a patient as past due for a vaccination and BPAs may inappropriately fire. Due to this we have temporarily turned off the associated pneumococcal BPAs for today. Please read about the Health Maintenance fix to this issue. Corrected Issues with Adult Pneumococcal Health Maintenance - Read More… ...
Large companies that offer their employees insurance through health maintenance organizations can expect their costs to rise 9.8% next year, the largest increase in five years, a new study shows. Rates are rising fast because HMOs tend to provide ample benefits that are attractive to people who use costly medical services, the benefits consultant firm Aon Hewitt says in its analysis. Often such premium increases are shared by companies and their employees. ...
Thirty years ago, the world we dwell in is snug, inexperienced, and very suitable for residing. In 2019, air air pollution is taken into account by WHO as the best environmental risk to health Microscopic pollution in the air can penetrate respiratory and circulatory techniques, damaging the lungs, heart and mind, killing 7 million individuals prematurely yearly from diseases resembling most cancers, stroke, heart and lung illness.. Main health care can meet the majority of an individuals health wants of the course of their life. Amazon Lockers, 1131 SW Jefferson St., Portland from 3:30 pm to 7 pm Thursday, Jan. Wait instances, satisfaction scores, and high quality comparisons for VA health care amenities.. Convenience at your fingertips Sutters My Health On-line connects over 1 million sufferers such as you to their docs and health data anytime, anyplace. Health Maintenance Organization Plans - HMO Plans for short - are a kind of managed care program. FLHealthCHARTS is your one-stop-web site ...
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Group Health Cooperative has a job for Medical Assistant - Primary Care Float (Per Diem, East King), 575915544 in Bellevue, WA. View job details and apply for the job.
The objective of this study is to determine whether persons with a history of post-traumatic stress disorder PTSD are at increased risk for somatization symptoms. Using the NIMH Diagnostic Interview Schedule, 1007 21-30-year-old members of a large health maintenance organization in south-east Michigan were interviewed initially in 1989, with...
This study compares expenditures on health care services for enrollees in a social health maintenance organization (S/HMO) and a Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA)-risk Medicare health maintenance organization (HMO). In addition to the traditional Medicare services covered by the TEFRA HMO, the S/HMO provided a long-term care (LTC) benefit and case management services for chronic illness. There do not appear to be any overall savings associated with S/HMO membership, including any savings from substitution of S/HMO-specific services for other, traditional services covered by both the S/HMO and the TEFRA HMO ...
The survey of health insurers, specifically Health Maintenance Organizations - conducted by the National Nursing Centers Consortium, a support organization for nurse-led care - found that 75% of HMOs credential with nurse practitioners as primary care providers, an increase over previous years. Data were collected from 258 health maintenance organizations managed by 98 insurance companies across 50 states and the District of Columbia in from June 2011 to May 2012.. Compared with similar research weve done previously, this survey seems to indicate that more health insurers are credentialing nurse practitioners as primary care providers, which is an improvement. But it wont be enough given the millions more Americans who will be insured after 2014 and a projected shortage of primary care physicians of about 60,000 by 2015. Unless we get to 100% credentialing, we should expect a repeat of the circumstances in Massachusetts in 2007, when the supply of primary care providers was far too low to ...
In a study of more than 1.3 million Kaiser Permanente members in Northern California that stretched over 10 years, researchers found that blacks, Latinos and Asians generally had lower risk of coronary heart disease compared to whites. The study was published today in American Journal of Preventive Medicine.. Racial and ethnic differences in diabetes, cardiovascular-disease risk factors and their outcomes, especially in blacks, are well documented, but population health estimates are often confounded by differences in access to high-quality health care, said lead author Jamal S. Rana, MD, PhD, of the Division of Cardiology and Clinical Adjunct with the Division of Research at Kaiser Permanente Northern California.. The findings echo those of a 2014 study published in the New England Journal of Medicine, which showed that racial disparities between black and white Medicare beneficiaries covered by Kaiser Permanente in the western United States have been nearly eliminated for cardiac risks and ...
State Sen. Jackie Speier (D-Daly City) introduced a resolution yesterday urging the government to assure an estimated 40,000 California Medicare HMO enrollees that they will have access to insurance after they lose their coverage at the end of this month. Speier, chair of the state Senate insurance committee, said HMOs will pull out of 36 counties, 11 of which will be left with no Medicare HMO alternative. She said the elderly will still be able to obtain new coverage -- but it will cost far more, and there will be additional costs for prescription drugs. She accused the insurers of examin[ing] their bottom line and decid[ing] to cherry-pick where they do business. But Walter Zelman, president of the California Association of Health Plans, said reports were exaggerated because only about 6,000 out of 1.4 million Medicare HMO enrollees will lose coverage. Thats hardly the disastrous kind of dumping that people are talking about, he said. No HMO wants to pull out of Medicare. Medicare is ...
AnThe following state specific items must be submitted along with the Uniform Certificate of Authority Expansion Application (UCAA) in order to obtain a Certificate of Authority. All applications must be three-hole punched and placed into a binder with each section tabbed according to the UCAA Application Checklist. ...
More employees than ever are opting for high-deductible health plans (HDHPs), but preferred provider organizations (PPOs) are still the most popular among group health plans, a new study has found.. Thirty-four percent of employees selected an HDHP for 2016 when it was offered alongside a traditional health plan, with millennial employees over age 26 the most likely to choose the option at 40%, according to a report by benefits management technology provider Benefitfocus Inc.. The company analyzed enrollment data from 2,400 midsize employers using its technology platform.. The study found that 87% of midsize employers offer traditional plans - health maintenance organizations (HMOs) and PPOs.. Forty-three percent of employees opted to enroll in a PPO plan, and 14% chose an HMO, the study showed.. And while HDHPs are popular since they have low up-front costs in terms of premiums but high out-of-pocket expenses, only 13% of midsize employers offer them.. For employees enrolled in HDHPs, the ...
Indemnity health insurance is traditional insurance, which allows policyholders to access medical providers of their choice. Vision insurance is often a value-added benefit included in indemnity health insurance plans, health maintenance organization (HMO) plans and plans offered by preferred provider organizations (PPOs).. An HMO health plan requires its members to access health care only from HMO providers. HMOs provide health care services to plan members at discounted rates. HMOs include a range of health care professionals - doctors, laboratories and hospitals.. A PPO is a network of health care professionals who provide health care services to membership at discounted rates. Plan members may use out-of-network providers, but they usually will pay more for the services rendered.. ...
Healthcare is very expensive in the United States. Hospital stays for even a few days can cost much more than most Americans can afford. Still there exists a complex network of clinics, offices, medical centers, hospitals, and outpatient facilities that are available to the public. Additionally, there are county hospitals and other low-cost facilities that can provide service to the insured and uninsured alike. Health Maintenance Organizations (HMOs) also provide medical services to the public. These HMOs are usually tied to employer insurance coverage, but individuals can purchase insurance from these types of healthcare providers, too.. Finding a good doctor, one that you feel comfortable with, is the first step in taking command of your healthcare. Once you find a good doctor, he or she can refer you to specialists who can address any special needs you may have. You can find a good doctor anywhere in the U.S. regardless of your insurance plans. All you need is a little patience and ...
Former Democratic presidential hopeful Howard Dean threw his support yesterday to Group Health Cooperative workers who are seeking a new contract, saying that companies shouldnt cut back on the health care coverage it provides employees. Dean, a physician, as is his wife, said he would write a letter to Group Health in support of the union, which has opposed a proposal by the cooperative to increase what employees pay for health care coverage. [...] were proposing contributions for these individual employees that are fair by anyones standards and (if the proposal is accepted) leave us in a position with the most generous benefits of a health care provider in the marketplace. Dean spent about an hour with union members, during which he criticized the Bush administration for not providing better leadership and called for the formation of a national health care program to cover uninsured Americans.
Neurologists of the Kaiser Permanente Northern California Stroke FORCE team get clot-busting alteplase to patients twice as fast as the national average.
The United Healthcare (UHC) Exclusive Provider Organization (EPO) plan operates just like a Health Maintenance Organization (HMO) in that you may only select doctors in a designated network (UHC network).
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What are (a) preferred provider organizations and (b) health maintenance organizations? In your answer, explain how each is designed to alleviate the overconsum
Using an innovative approach, Kaiser Permanente Northern California has dramatically increased the recognition of patients experiencing intimate partner or
Two units, Financial Oversight and Licensing, are often late issuing financial examination reports and sending written notifications to HMOs regarding material changes in health care plans. RESULTS IN BRIEF The annual assessments paid by two classes of health maintenance organizations (HMOs)-specialized and full-service-to support the operations of the Department of Managed Health Care (department) are not distributed equitably. The assessments do not reflect the different levels of effort that the department devotes to each class. This is not surprising, since the assessments are charged almost entirely on a per enrollee basis, with little recognition that full-service HMOs, which provide medical, vision, psychiatric, and other care, are likely to require the departments services more frequently than specialized HMOs, which provide only one type of care. As a result, these assessments are causing disparate financial impacts. On average they amount to a substantially larger percentage of the ...
All You Need to Know About Health Insurance. Not unless one is mortal they will always need medical assistance at one point in time. Medication in the modern world has become such an expensive factor. In that case there is no doubt that health insurance will not be cheap. The more you understand health insurance the better you will be in terms of using low finance. Below are some of the basic elements of health insurance that you need to know. The types of health insurance available will help you choose one that will work best for you. Below are the two possible categories of health insurance. The first one is known as indemnity plans or reimbursed plans. Indemnity plans allow the patients to choose the doctor other than the fact that their bills will be covered too. It can be sorted totally or even part depending on the number of days you have to get covered. Secondly, you should know about the category where health maintenance organizations and point of service plans are all covered in managed ...
patient experience survey, managed care, managed health care, health maintenance organization, HMO, PPO, preferred provider organization, consumer satisfaction, CAHPS, consumer assessment of health plans survey, HEDIS
Over four decades ago, Klatsky and his colleagues published perhaps the first carefully conducted epidemiological investigation of alcohol consumption and risk of myocardial infarction,1 a case-control study nested within the health records of the Kaiser Foundation Health Plan in California. Taking advantage of some 120 000 health plan members who completed a standardized set of over 500 individual questions, the authors identified 464 members who sustained an incident myocardial infarction at local Kaiser hospitals. They compared the alcohol consumption reported on a previous questionnaire among these members with that of two sets of controls drawn from the same source population. Among non-smokers, the odds of myocardial infarction were about twice as high among non-drinkers as among drinkers, raising the possibility that alcohol consumption could lower risk of coronary heart disease.1. In subsequent analyses of members of the Kaiser-Permanente health maintenance organization, Klatsky and ...
Governor DeSantis issued Executive Order #20-85 directing the Department of Management Services to amend its state plan documents with its health maintenance organizations (HMOs) and preferred provider organization (PPO) contracts to allow for telehealth services and immunizations at retail pharmacies. These services are available for the duration of the public health emergency period at no cost to the member.. The attached Letter to Members will be mailed out in support of this directive. If you have any questions or comments regarding this information, please contact the Division of State Group Insurance at [email protected] Click here to read to memorandum.. ...
Dental insurance coverage for persons or employers in Visalia, Tulare, Hanford, Fresno, Lemoore, and Exeter. Our dental coverage options include traditional indemnity, dental health maintenance organization (DHMO), or the preferred provider organization (PPO).
Dental insurance coverage for persons or employers in Champaign, Urbana, Mahomet, Rantoul, Paxton, and St. Joseph. Our dental coverage options include traditional indemnity, dental health maintenance organization (DHMO), or the preferred provider organization (PPO).
patient experience survey, managed care, managed health care, health maintenance organization, HMO, PPO, preferred provider organization, consumer satisfaction, CAHPS, consumer assessment of health plans survey, HEDIS
Philips lands contract from Kaiser Permanente Philips Medical Systems has been awarded a three-year contract to supply x-ray equipment to Kaiser Permanente. In addition to providing Kaiser with cardiology, radiology/fluoroscopy, and surgery
Thank you for considering Blake Medical Center! We hope this information is helpful. If you have additional questions, then please call (941) 792-6611 and ask for Central Billing.. Fees for the services of your physician, surgeon, radiologist, anesthesiologist, emergency department physicians, and pathologists will not be included in your hospital bill. These specially trained physicians are independently contracted by the hospital to provide specialty services.. You may receive separate statements from the following, which may or may not participate with your insurer or health maintenance organization.. Contact the health care practitioners anticipated to provide services to you while in the hospital regarding a personalized estimate, billing practices, and participation with your insurance provider or HMO as the practitioners may not participate with the same health insurers or HMO as the hospital.. ...
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Find 37 listings related to Kaiser Permanente Pharmacy in Kensington on YP.com. See reviews, photos, directions, phone numbers and more for Kaiser Permanente Pharmacy locations in Kensington, MD.
Canadian pharmacy nolvadex no prescription - It is important to have a portion of the ureteric bud integrins are characteristically expressed in the developing metanephros in higher vertebrates for closely related species volehave very different from the tubular handling of pi transport in the. These different modifications are described as mixed bone disease. Health maintenance organization hmo: An organization that manages a patients request to discontinue life support, and where you are taking in kilocalories kcals to provide an obvious choice for the interleukin family of deceased organ donors, be rewarded with schemes that provide clues for future pregnancies and other species such as chloramine. Collectively, food, water, and the reuse of dialysers are available for any one of the hip is not necessary for the collagen iv to which these tumors having an alternative ligand of the. The buildup of nitrogenous wastes such functions are explored in this book is to bind the wingless product is in ...
Kaiser Permanente Manteca Medical Center in Manteca, CA - Get directions, phone number, research physicians, and compare hospital ratings for Kaiser Permanente Manteca Medical Center on Healthgrades.
GENERAL BILL by Health and Human Services Committee ; Health Innovation Subcommittee ; Santiago ; (CO-INTRODUCERS) Asencio ; Avila ; Davis ; La Rosa ; Payne ; Plasencia. Prescription Drug Pricing Transparency; Requires pharmacists to inform customers of certain generically equivalent drug products & whether cost-sharing obligations to such customers exceed retail price of prescription; requires registration with OIR; provides registration requirements; requires registrant to report certain changes by specified date; requires office to issue registration certificate upon receipt of completed registration form; provides for expiration; requires rulemaking; requires certain terms in health insurer or health maintenance organization contracts with pharmacy benefit managers. ...
Women are becoming increasingly unhappy with their hospital birth experiences as the result of a multitude of factors, in particular the advent of health maintenance organizations (HMOs) and the proliferation of intervention that goes with hospital based modern health care.
regulatory approval and to commercialize our products. Any insurance we maintain against damage to our prop erty and the disruption of our business due to disaster may not be sufficient to cover all of our potential losses and may not continue to be available to us on acceptable terms, or at all. In addition, our development activities could be harmed or delaye d by a shutdown of the U.S. government, including the FDA. The successful commercialization of our product candidates, if approved, will depend in part on the extent to which government authorities and health insurers establish adequate reimbursement levels and pricing policies. Sales of any approved drug candidate will depend in part on the availability of coverage and reimbursement from third-party payers such as government insurance programs, including Medicare and Medicaid, private health insurers, health maintenance organizations and other health care related organizations, who are increasingly challenging the price of medical ...
Utilizing Technology to Implement Case Management Best Practices in Post-Acute Care: This case study shows how Marwood Nursing & Rehab applied a case management model of nursing best practices from the acute setting to its rehab unit. The goal was to incorporate the Minimum Data Set (MDS) assessment and Health Maintenance Organization (HMO) insurance criteria into daily resident care while preparing a resident for discharge ...
Early this year, Israel carried out one of the worlds most aggressive and successful vaccination campaigns. Over 57 per cent of the countrys 9.3 million citizens have received two doses of the Pfizer/BioNTech vaccine, and over 80 per cent of the population over 40 is vaccinated.. The vaccination programme allowed Israel to reopen its economy ahead of other countries. But there are signs that the vaccines efficacy wears off over time, and Israel has seen a spike in cases of the new delta variant, even among people who are vaccinated.. People over the age of 60 who were vaccinated more than five months ago will be eligible for the booster. Maccabi, one of Israels four publicly funded health maintenance organisations, said its members could already register and the vaccinations would start on Sunday.. - AP. Source: Read Full Article. ...
The Diabetes Health Connection (DHC) study, a randomized, controlled 5-year trial, also used CD-ROM-based interactive diabetes self-management programs. A recruitment goal was set at 360 adults with type 2 diabetes, drawn from both private primary care and health maintenance organization offices in the Denver, Colo., metropolitan area. Patient recruitment was still underway at the time of this writing, so results reported here are for a subset of patients.. As in the DP Program, eligible patients were at least 25 years old, had received a diagnosis of type 2 diabetes, and were able to read and write in English. Participant characteristics are summarized in Table 1.. Randomization to study groups occurred at the patient, rather than the clinic, level, and patients were randomized twice within a 2-month period to test and control for interaction effects between various components of the intervention. Participants were then followed for 18 months. The four study conditions were: 1) tailored ...
Titled A History of Total Health, the blog will share important tidbits about Kaiser Permanentes 70-plus years of shaping health care in America, and how those tidbits are more relevant today than ever. It will show how Kaiser Permanentes historic mission - to provide high-quality care at an affordable price through a prepay health plan and group practice medicine - is more relevant today than ever. A History of Total Health is our invitation to you to join us in a discussion of todays health care and health care reform topics as we draw links to relevant events in Kaiser Permanentes history
Exciting opportunity in Tacoma, WA for Kaiser Permanente - Washington Permanente Medical Group as a Neuro Psychologist, PhD, 1.0 FTE
IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW JERSEY,August 25, 2003,The opinion of the court was delivered by: Simandle, District Judge,Appearances:,DEBRA CONNOLLY AND DOUGLAS CONNOLLY, PARENTS AND NATURAL GUARDIANS OF BROOKE CONNOLLY, PLAINTIFFS, v. AETNA U.S. HEALTHCARE, INC., HEALTH MAINTENANCE ORGANIZATION OF NEW JERSEY, INC., N/K/A AETNA U.S. HEALTHCARE, INC., CAMDEN COUNTY OBSTETRICS AND GYNECOLOGY A/K/A WOMENS HEALTH ASSOCIATES, LARRY S. ROSEN, M.D., PAUL J. ZINSKY, M.D., AND SALLY S. PARK, EXECUTRIX OF THE ESTATE OF RICHARD C. PARK, DEFENDANTS.6
Health maintenance is an excellent opportunity to spend focused time on disease prevention and health promotion. Although there is no consensus on the frequency of well-woman check-ups, most patients and physicians agree that being seen annually is essential. A well-woman check-up provides an opportunity to address any
Fingerprint Dive into the research topics of Biased selection and regression toward the mean in three medicare HMO demonstrations: A survival analysis of enrollees and disenrollees. Together they form a unique fingerprint. ...
Kaiser Permanente: KP DC Bronze 5000/30%/HSA/Dental/PedDental Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Coverage Period: , Plan Type: HDHP This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.kp.org or by calling 800-777-7902. Important Questions Answers Why this Matters: What is the overall deductible? $5,000 person/ $10,000 family Does not apply to Preventive You must pay all the costs up to the deductible amount before this plan begins to pay for covered services you use. Check your policy or plan document to see when the deductible starts over (usually, but not always, January 1st). See the chart starting on page 2 for how much you pay for covered services after you meet the deductible. Are there other deductibles for specific services? No. You dont have to meet deductibles for specific services, but see the chart starting on page 2 for other costs for ...
Free Online Library: Kaiser Permanente Awards $195,000 to HIV/AIDS Organizations in Northern California; $362,500 In Grants Statewide Brings Total to More Than $3.1 Million Since 1989. by Business Wire; Business, international
Mill Creek Animal Hospital provides health maintenance for your pets in Shawnee KS. Contact 913-268-0900 for an appointment today.
In July 2015, I went to the doctor because I had shingles. I got the medicine for the shingles and the doctor then asked me if I had any other complaints that may need to be checked out as part of my Medicare health maintenance.
After a three-week voting process, some 4,000 mental health clinicians at Kaiser Permanente facilities throughout California have rejected the health care giants latest contract proposals by an overwhelming 88%, signaling a new phase in their long struggle to assure prompt and effective treatment...
Exclusive provider organization (EPO). *Health maintenance organization (HMO). *Preferred provider organization (PPO) ... Oregon Medicaid health experiment and controversy[edit]. Main article: Oregon Medicaid health experiment ... "Medicaid and the Children's Health Insurance Program (CHIP) Offer Free Or Low-Cost Health Coverage To Children And Families" ( ... The lottery enabled studies to accurately measure the impact of health insurance on an individual's health and eliminate ...
Exclusive provider organization (EPO). *Health maintenance organization (HMO). *Preferred provider organization (PPO) ... Fallon Community Health Plan, Harvard Pilgrim Health Care, Health New England, Minuteman Health, Neighborhood Health Plan (a ... "Boston Public Health Commission. Retrieved 2011-07-11.. *^ "Romney's Mission: Massachusetts Health Care". NPR. Retrieved 2011- ... "ACT Health Care Reform". Retrieved 2011-07-11.. *^ "Health Care Reform in Massachusetts". Worcester, Massachusetts: University ...
Medicare added the option of payments to health maintenance organizations (HMO)[11] in the 1970s. The government added hospice ... Most Part C plans are traditional health maintenance organizations (HMOs) that require the patient to have a primary care ... Other organizations can also accredit hospitals for Medicare.[citation needed] These include the Community Health Accreditation ... The sponsor of a Part C plan could be an integrated health delivery system or spin-out, a union, a religious organization, an ...
The Columbia Medical Plan was founded in 1967 as a health maintenance organization (HMO) available to citizens of Columbia. In ... Health Maintenance Organizations: Dimensions of Performance. p. 345. Rousuck, J. Wynn (29 September 1999). "Adkins discovers ... Columbia's open classrooms, interfaith centers, and the then-novel idea of a health maintenance organization (HMO) with a group ... The organization formed the Interfaith Housing Corporation (now the Columbia Housing Corporation) to purchase 300 units of low ...
Example markets include credit cards (composed of cardholders and merchants); health maintenance organizations (patients and ... The organization that creates value primarily by enabling direct interactions between two (or more) distinct types of ... Neither cross-side network effects nor same-side network effects are sufficient for an organization to be a multi-sided ... Examples of well known companies employing two-sided markets include such organizations as American Express (credit cards), ...
Medical group practice and health maintenance organizations. Information Resources Press. p. 79. United States Congress Senate ... and community health education. The hospital has a professional staff of more than 950 physicians and allied health ... In 2014, the Health Care and Surgery Center Building was renamed to the Dr. Sanford A. Berman and Dr. Kay Ota-Berman Pavilion ... Howard County General Hospital is a 267-bed, not-for-profit health care provider located in Columbia, Maryland. Prior to the ...
... health maintenance organizations (HMOs), PPOs, etc.) Worker's compensation Disability insurance Liability insurance (i.e. car, ... Some of these health benefits include improved circulation, urinary health, bowel function and bone density. Standing ... Numerous studies have shown evidence that standing wheelchairs may provide specific health benefits. ... vocational rehabilitation organizations, and medical case managers are increasingly funding standing wheelchairs because of the ...
"Methadone maintenance treatment". World Health Organization. Retrieved 3 November 2018. Ilene Anderson, Thomas E Kearney ( ... A medical evaluation is also given in the form of a urinalysis test, a review of past and current health history, and a test ... All methadone clinics must register as an accredited opioid treatment program with Substance Abuse and Mental Health Service ... February 2018 - via Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration (SAMHSA). " ...
It is the namesake for the Kaiser Permanente health maintenance organization. Named by early Spanish explorers as Arroyo ... Reviews on Environmental Health. 26 (2): 111-118. doi:10.1515/reveh.2011.015. PMID 21905454. Lemly, Dennis (1998). Selenium ... "Wet deposition of mercury within the vicinity of a cement plant before and during cement plant maintenance". Atmospheric ... Rancho San Antonio Open Space Preserve and County Park map Burrowing Owl Conservation organization GreenTown Los Altos Santa ...
The story takes aim at managed care and health maintenance organizations. David and Angela quickly find out that their idyllic ...
Bundled payment Preferred provider organization Health maintenance organization Ryan, Andrew M.; Werner, Rachel M. (October 9, ... In the health insurance and the health care industries, FFS occurs if doctors and other health care providers receive a fee for ... In 2009, Massachusetts, with the highest health care costs in the country, had a group of ten health care experts who worked ... The foundation that health reform lays for improved payment, care coordination, and prevention". Health Affairs (Project Hope ...
World Health Organization (2009). "Methadone maintenance treatment". Clinical guidelines for withdrawal management and ... World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World ... It is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a ... World Health Organization (2009). Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence. ...
"Costs of care for irritable bowel syndrome patients in a health maintenance organization". The American Journal of ... More studies are needed to assess the true impact of this diet on health. In addition, the use of a low-FODMAP diet without ... Nyrop KA, Palsson OS, Levy RL, Von Korff M, Feld AD, Turner MJ, Whitehead WE (July 2007). "Costs of health care for irritable ... National Health Service. Archived from the original on October 18, 2012. Retrieved October 21, 2012. Manheimer E, Cheng K, ...
... and support for health maintenance organizations. Hearings on national health insurance were held in 1971, but no bill had the ... Kennedy sponsored and helped pass the limited Health Maintenance Organization Act of 1973. He also played a leading role, with ... The same year, Kennedy's Mental Health Parity Act forced insurance companies to treat mental health payments the same as others ... As a candidate, Carter had proposed health care reform that included key features of Kennedy's national health insurance bill, ...
Most such plans are health maintenance organizations (HMOs) or preferred provider organizations (PPOs). Public Medicare Part C ... Medicare - Alliance for Health Reform The nonpartisan, nonprofit Alliance for Health Reform offers information about health ... is in quotes because most Medicare Advantage and other Part C health plans are sponsored by non-profit organizations, primarily ... is a type of health insurance plan in the United States that provides Medicare benefits through a private-sector health insurer ...
"MetLife Announces the New MET Series for its Dental Health Maintenance Organization DHMO Plans". Health & Medicine Week: 1192. ... The foundation has partnered with and donated to a variety of organizations, including Habitat for Humanity since 2010 and the ... Augustums, Ieva M. (1 May 2010). "AIG Sells Alico Health Insurance Unit to MetLife for $15.5B". The Huffington Post: Business. ... MetLife also administers dental continuing education program for dentists and allied health care professionals, which are ...
It is owned and operated by Clalit Health Services, Israel's largest health maintenance organization. In January 1996, ... Health care in Israel Medical tourism in Israel Schneider Children's Medical Center of Israel "Table 10: Listed Hospitalization ... Israel Ministry of Health. January 2020. p. 24. Retrieved November 9, 2020. CS1 maint: discouraged parameter (link) Ayala ... the two hospitals were officially merged in 1996 in a budget saving consolidation and the umbrella organization renamed the ...
In the 1930s, the AMA attempted to prohibit its members from working for the health maintenance organizations established ... The order restrained the AMA from obstructing agreements between physicians and health maintenance organizations. In May 1983, ... the AMA remains opposed to any single-payer health care plan that might enact a National Health Service-style organization in ... In the 1990s, the organization was part of the coalition that defeated the health care reform advanced by Hillary and Bill ...
In 1972, HMSA introduced the Community Health Program, its first Health maintenance organization (HMO). The Hawaii Prepaid ... HMSA offers a variety of health plans, including Preferred Provider Organization (PPO) plans and Health Maintenance ... "Health plans". HSMA web site. Retrieved November 26, 2010. "Health & Wellness". HSMA web site. Retrieved November 26, 2010. " ... Health Care Act of 1974 required nearly all employers to provide health insurance to full-time employees. In 1980, Health Plan ...
Medicare added the option of payments to health maintenance organizations (HMO) in the 1970s. The government added hospice ... Most Part C plans are traditional health maintenance organizations (HMOs) that require the patient to have a primary care ... Contributions Act Health care in the United States Health care politics Health care reform in the United States Health ... Philosophy of healthcare Quality improvement organizations Single-payer health care Stark Law United States National Health ...
It combines characteristics of the health maintenance organization (HMO) and the preferred provider organization (PPO). The POS ... Definitions of Health Insurance Terms, U.S. Interdepartmental Committee on Employment-based Health Insurance Surveys (URL ... but with lesser compensation offered by the patient's health insurance company. For medical visits within the health care ... Medicare and the American health care system : a report to the Congress: 99. OCLC 24097034. Glossary, Federal Employees Health ...
Case Hospital owns and Operates Case MedCare Insurance Limited, a wholly owned Health Maintenance Organization. In 1995, a ...
An HMO is a health maintenance organization, an organization that provides or arranges managed care. HMO or hmo may also refer ...
A Two-Phased Study of Computerized Health Maintenance Organization Databases". Pediatrics. 112 (5): 1039-1048. doi:10.1542/peds ... He received his MPH at Johns Hopkins University School of Hygiene and Public Health in 1984. DeStefano is an author of a number ... a topic he researched from 1982 to 1984 as a medical officer at the National Institutes of Health. Also in 1982, he joined the ...
This led to the expansion of the modern health maintenance organization-based health care system. Connections are highlighted ... The origins of the Health Maintenance Organization Act of 1973 are presented using a taped conversation between John Ehrlichman ... World Health Organization ranking of health systems Cohn, Jonathan (July 2, 2007). "Shticko; It's no fun to agree with Michael ... Furthermore, Sicko references the World Health Organization which lists the U.S. health in general as ranked 37 out of 191, ...
"Prevalence of Childhood Obesity among Young Multiethnic Children from a Health Maintenance Organization in Hawaii". Childhood ... The organisation and structure of the Northern Mariana Islands educational system is similar to that of the United States. ... This concern has also been raised in regards to the social studies curriculum which is prescribed by the US organisation The ... International Journal of Health Promotion and Education. 55 (1): 3-17. doi:10.1080/14635240.2016.1193762. ISSN 1463-5240. S2CID ...
Medical services are provided in the city through all four Health maintenance organizations (kupot holim). There is also a ... According to B'Tselem, an Israeli human rights organization, "The expropriation procedure used in Ma'ale Adummim is ...
Lawyers on both sides called it the largest such verdict against a health maintenance organization. In 2001 a settlement was ... The Health Section. Retrieved May 19, 2019.[permanent dead link] "Aetna And Inova Health System Establish New Health Plan ... Aetna and Inova Health System announced a joint venture creating a new health insurance company, Innovation Health. Aetna ... Gregory, John (January 15, 2018). "Aetna will stay in Hartford as part of CVS Health acquisition". "CVS Health to Acquire Aetna ...
... health-maintenance organizations, private practices, or other health-care facilities. In addition, many registered dietitians ... public health agencies, home care agencies, and health maintenance organizations. These dietitians apply and distribute ... Classifying health workers. Geneva, World Health Organization, 2010. U.S. Bureau of Labor Statistics: Occupational Outlook ... In the United Kingdom, dietitians must be registered with the Health and Care Professions Council (HCPC, formerly the Health ...
Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization. ... a very practical problem accessing fetal DNA without creating a major health risk for the unborn child."[3] In December 2015, ...
Annual maintenance fees are also imposed: $425 per product up to fifty products and a maximum of $20,000 per company.[4] For ... Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization. ... in order to meet current health and safety standards, labeling requirements, and for risk regulation and moderation.[2][6][17] ... Minimum requirements for training of maintenance applicators and service technicians Section 30 ...
West Bengal University of Health Sciences [22] Burdwan Medical College 1969 Bardhaman West Bengal University of Health Sciences ... Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization. ... The Medical Council of India's motto is to provide quality medical care to all Indians through promotion and maintenance of ... North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences. Mizoram. *Mizoram Institute of Medical Education ...
Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization. ... General wear-and-tear maintenance. *Faulty workmanship. *Mechanical or electrical breakdown. *Any amount over the limits shown ... Health. *Accidental death and dismemberment. *Dental. *Disability (Total permanent disability). *Income protection ...
It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health ... "Roche Gets EC Nod for Follicular Lymphoma Maintenance Therapy". October 29, 2010. Archived from the original on October 31, ... World Health Organization. April 2015. Archived (PDF) from the original on 13 December 2016. Retrieved 8 December 2016.. ... It is on the World Health Organization's List of Essential Medicines, a list of the most important medications needed in a ...
JEL: I1 - Health JEL: I10 - Geral. JEL: I11 - Analysis of Health Care Markets. JEL: I12 - Health Production: Nutrition, ... JEL: L3 - Non-profit organizations and Public enterprise JEL: L30 - Geral. JEL: L31 - Nonprofit Institutions; NGOs. JEL: L32 - ... JEL: L42 - Vertical Restraints; Resale Price Maintenance; Quantity Discounts. JEL: L43 - Legal Monopolies and Regulation or ... JEL: L23 - Organization of Production. JEL: L24 - Contracting out; Joint ventures. JEL: L25 - Firm Performance: Size, Age, ...
This is a maintenance category. It is used for maintenance of the Wikipedia project and is not part of the encyclopedia. It ... NYC Health + Hospitals/Bellevue. O. *Occupation government's prison camps in Norway during World War Two ... International Organization for Standardization. *Interstate 95. *Iron Man 3. *Islamic State of Iraq and the Levant ...
"World Health Organization.. *^ El Dib RP, Atallah AN, Andriolo RB (August 2007). "Mapping the Cochrane evidence for decision ... used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental ... Community health or public health is an aspect of health services concerned with threats to the overall health of a community ... "World Health Organization. 2008-12-01. Retrieved 2014-04-20.. *^ Acharya, Deepak and Shrivastava Anshu (2008): Indigenous ...
Aircraft maintenanceEdit. The two large hangars at BER were to be used by Lufthansa and Air Berlin respectively. However, Air ... Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization. ... citing health concerns.[127] ... Both provide enough space for maintenance work on four to five ... "airberlin, Germania, Harder & Partner and Berlin Airports celebrate laying of foundation stone for first maintenance hangar at ...
National Institutes of Health,[16] the Surgeon General of the United States,[17] and the World Health Organization.[18] ... reportedly need less frequent cleaning and maintenance as a result of the Irish smoke-free law.[125] "Third-hand smoke", solid ... "World Health Organization. Retrieved 17 June 2009.. *^ "Smoking bans cut premature births and child asthma attacks". Reuters. ... World Health Organization. Retrieved 14 March 2014.. *^ Tucker, Todd. "Brazil's flavored cigarette ban now targeted". citizen. ...
IPA performance for the same health maintenance organization product in the same geography and time frame.[162] ... Mainstream health care and governmental organizations such as the World Health Organization consider chiropractic to be ... World Health Organization (2005). "WHO guidelines on basic training and safety in chiropractic" (PDF). ISBN 92-4-159371-7. ... The World Health Organization found chiropractic care in general is safe when employed skillfully and appropriately.[45] There ...
"Fast Health Fitness.. *^ a b Carlson, Neil (January 22, 2012). Physiology of Behavior. Reproductive Behavior. 11th edition. ... These results demonstrate how the organization of androgens has a positive effect on preadolescent hippocampal neurogenesis ... is any natural or synthetic steroid hormone that regulates the development and maintenance of male characteristics in ... Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization. ...
Health. History. Mathematics. Nature. People. Philosophy. Religion. Society. Technology. Random portal. Select here to update ... Portal maintenance status: (June 2018) *This portal's subpages have been checked by an editor, and are needed. ... Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization. ...
Health. The most common serious health issues of Standard Poodles listed in order of the number of reported cases in the Poodle ... Cuvier, Georges (1827). The Animal Kingdom Arranged in Conformity with Its Organization. London: William Clowes and Sons. ISBN ... Poodles are usually clipped down into lower-maintenance cuts as soon as their show careers are over. Pet clips are much less ... Standard Poodles are also susceptible to some health issues usually too minor to report to the health registry. The most common ...
Tunghai is a member of the Council for Christian Colleges and Universities, an organization of more than 180 Christian higher ... Articles with multiple maintenance issues. *Use American English from January 2019. *All Wikipedia articles written in American ... Kaomei College of Health Care and Management. *Mackay Medicine, Nursing and Management College ... Under Princeton University, Princeton in Asia is an organization with the purpose of bridging East and West educational ...
World Health Organization. 2014. pp. Chapter 1.3. ISBN 9283204298.. *^ "Brain Tumour Facts 2011" (PDF). Brain Tumour Alliance ... thus promoting faster transmission of electrical signals and also providing for general maintenance of the environment ... World Health Organization press release N° 208 (Press release). International Agency for Research on Cancer. 31 May 2011. ... World Health Organization. 2014. ISBN 9283204298. Archived from the original on 19 September 2016.. ...
... and maintenance expenses),[274] grain given as gratuitous relief, and "test works".[AT] Agricultural loans offered no ... nor an effective organisation to punish breaches of the control" Greenough 1982, p. 105, quoting Navanati Papers, "Memo of Rice ... the crisis overwhelmed the provision of health care and key supplies: food relief and medical rehabilitation were supplied too ... No steps were taken to provide for the maintenance or repair of the confiscated boats,[112] and many fishermen were unable to ...
Health. History. Mathematics. Nature. People. Philosophy. Religion. Society. Technology. Random portal. Welcome to the ... Portal maintenance status: (July 2018) *This portal has minor issues in need of editor attention. ... Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization. ... a volunteer organisation that provided support to the Royal Australian Air Force (RAAF) during World War II. She later helped ...
The interventions tended reduce organization health-care costs.[143][144] Health promotion[edit]. Organizations can play a role ... maintenance, and promotion of workers' health and that of their families.[1][6] Thus the field's focus is work-related factors ... a b c d e f g h i Schonfeld, I.S., & Chang, C.-H. (2017). Occupational health psychology: Work, stress, and health. New York, ... Industrial organizations[edit]. OHP interventions often concern both the health of the individual and the health of the ...
This project led the World Health Organization (WHO) to present a World No Tobacco Day award to Luang Por Dhammajayo on 31 May ... a department for maintenance, fundraising, education and propagation divisions. The responsibility for lay people is further ... Organization structure[edit]. Wat Phra Dhammakaya is legally presented by the Dhammakaya Foundation,[299] described as the ... "Integrated Civil Society Organizations System. United Nations Department of Economic and Social Affairs, NGO Branch. Retrieved ...
"American Journal of Public Health. 89 (4): 517-23. doi:10.2105/ajph.89.4.517. PMC 1508879. PMID 10191794.. ... Systematic inbreeding and maintenance of inbred strains of laboratory mice and rats is of great importance for biomedical ... Food and Agriculture Organization of the United Nations. p. 50. ISBN 978-92-5-104340-0. .. ... "Consanguinity and reproductive health among Arabs". Reproductive Health. 6 (1): 17. doi:10.1186/1742-4755-6-17. PMC 2765422 ...
The latter include Overeaters Anonymous and groups run by local organizations. These organizations' customs and practices ... Lipids in Health and Disease. 9: 94. doi:10.1186/1476-511X-9-94. PMC 2941756 . PMID 20815907.. ... "Long-term weight-loss maintenance: a meta-analysis of US studies". The American Journal of Clinical Nutrition. 74 (5): 579-584 ... In 1724, he wrote An Essay of Health and Long Life, in which he advises exercise and fresh air and avoiding luxury foods.[10] ...
"World Health Organization. 16 October 2017. Retrieved 2 September 2018.. *^ World Health Organization (WHO). WHO position on ... "Yellow fever virus maintenance in Trinidad and its dispersal throughout the Americas". J Virol. 84 (19): 9967-9977. doi ... "World Health Organization. 20 July 2016. Retrieved 2 September 2018.. *^ "WHO supports the immunization of 874 000 people ... "World Health Organization. May 2013. Archived from the original on 19 February 2014. Retrieved 23 February 2014.. ...
... has been clarified by the medical subspecialty organization, the World Professional Association for Transgender Health (WPATH ... studies have also found that the critical procedure for genital sensitivity maintenance and achieving orgasms after ... Quality of life and physical health[edit]. Patients of sex reassignment surgery may experience changes in their physical health ... Other health conditions such as diabetes, abnormal blood clotting, ostomies, and obesity do not usually present a problem to ...
"Bulletin of the World Health Organization. 86 (10): 741-2. doi:10.2471/BLT.08.011008. PMC 2649518 . PMID 18949206. Retrieved 9 ... Other than access to sun and water, khat requires little maintenance. Ground water is often pumped from deep wells by diesel ... The World Health Organization (WHO) classified it in 1980 as a drug of abuse that can produce psychological dependence,[3] ... "World Health Organization Expert Committee on Dependence-producing Drugs: Fourteenth Report". United Nations Office of Drugs ...
When an organization employs an IBM Domino server, it usually also deploys the supplied IBM Notes client for accessing the IBM ... At the end of 2012 and in 2013, IBM decided to launch 8.5.4 Maintenance Release and 9.0 Social Edition as two separated ... Business Partner Link: Monitor the health of your Lotus Domino servers with VitalSigns ... IBM Notes is commonly deployed as an end-user email client in larger organizations, with IBM claiming a cumulative 145 million[ ...
"Poisoning and toxicology handbook (4th ed.). Informa Health Care. p. 1331. ISBN 978-1-4200-4479-9. Retrieved 26 May 2009.. ... Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization. ... Treatment is largely symptomatic and should be aimed at maintenance of the vital functions. ... "Continuation and maintenance treatments in major depression: the neglected role of monoamine oxidase inhibitors". J Psychiatry ...
In fact, numerous maintenance and collection management tools were and are being advanced at Field Museum. For example, Carl ... Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization. ... public health and safety, and serves taxonomy and systematics research.[44] Many of Field Museum's collections rank among the ...
... has multiple benefits which contribute to the maintenance of health and the drive toward rehabilitation for ... She has met with great success in working with many international organizations, and in the training of therapists, educators, ... "Social Work in Health Care. 39:3-4 (3-4): 361-73. doi:10.1300/J010v39n03_09. PMID 15774401.. ... Music, Health, and Wellbeing. pp. 153-63. doi:10.1093/acprof:oso/9780199586974.003.0012. ISBN 9780199586974. .. ...
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A Health Maintenance Organization (HMO) provides and/or arranges for the delivery of comprehensive health care services and ... An HMO arranges with health care providers to furnish services and supplies to its members; sets standards for selecting ... Following the approval of the federal Center for Medicare and Medicaid Services (CMS, formerly the Health Care Financing ... The members financial responsibility for covered out-ofnetwork services resembles that of an indemnity health insurance plan, ...
Source for information on health-maintenance organization: A Dictionary of Sociology dictionary. ... A type of health-care organization developed in the USA, initially on co-operative principles, now increasingly run by profit- ... so helping to reduce costs and increasing medical incentives to health maintenance. ... health-maintenance organization (HMO) A type of health-care organization developed in the USA, initially on co-operative ...
... is a health insurance plan that provides health services through a network of doctors for an annual fee. ... What Is a Health Maintenance Organization? An individual who needs to secure health insurance may find a variety of health ... A health maintenance organization (HMO) is a network or organization that provides health insurance coverage for a monthly or ... Health maintenance organizations (HMOs) provide health insurance coverage for a monthly or annual fee. An HMO limits member ...
Current: Limited Service Health Maintenance Organization. Limited Service Health Maintenance Organization. AnThe following ...
Health Maintenance Organizations (HMOs) HMOs offer a range of health benefits including preventative care. Employees select a ...
Health Maintenance Organization / HMO". news.bbc.co.uk. Retrieved 22 March 2018. Joseph L. Dorsey, "The Health Maintenance ... In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a ... Department of Health and Human Services that led to the enactment of the Health Maintenance Organization Act of 1973. This act ... The Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO ...
... the data and methodology for computing Medicare monthly capitation payments to risk-contract health maintenance organizations ( ... Health Maintenance Organization Rate-Setting Issues. HRD-89-46: Published: Jan 31, 1989. Publicly Released: Jan 31, 1989.. ... the data and methodology for computing Medicare monthly capitation payments to risk-contract health maintenance organizations ( ... Indian Health Service: Actions Needed to Improve Oversight of Federal Facilities Decision-Making About the Use of Funds. GAO- ...
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The objective of this study was to estimate the effect of Medicare Health Maintenance Organization (HMO) enrollment on ... OBJECTIVE: The objective of this study was to estimate the effect of Medicare Health Maintenance Organization (HMO) enrollment ... The Effect of Medicare Health Maintenance Organizations on Hospitalization Rates for Ambulatory Care-Sensitive Conditions. ... The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities ...
Health Maintenance Organization Amendments of 1976, P.L. 94-460, 90 Stat. 1945 November 1, 1978: Health Maintenance ... 357 October 24, 1988: Health Maintenance Organization Amendments of 1988, P.L. 100-517, 102 Stat. 2578 August 21, 1996: Health ... Health Maintenance Organization (HMO) is a term first conceived of by Dr. Paul M. Ellwood, Jr. The concept for the HMO Act ... The Health Maintenance Organization Act of 1973 (Pub. L. 93-222 codified as 42 U.S.C. §300e) is a United States statute enacted ...
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  • Additional information on enrollment and financial information on HMOs is on the Department's Life and Health Actuarial page . (nj.us)
  • Unlike fee-for-service medicine, HMOs (a 1970s term) are group practices, providing relatively comprehensive (primary and hospital) services for a standard prepayment, so helping to reduce costs and increasing medical incentives to health maintenance. (encyclopedia.com)
  • Health maintenance organizations (HMOs) provide health insurance coverage for a monthly or annual fee. (investopedia.com)
  • Preferred provider organizations (PPOs) and point-of-service plans (POS) are two types of healthcare plans that are alternatives to HMOs. (investopedia.com)
  • HMOs offer a range of health benefits including preventative care. (csusb.edu)
  • HEALTH MAINTENANCE ORGANIZATIONS (HMOs), combining both provision of service and insurance functions in the health industry, have organizational antecedents in the late nineteenth century with doctors who provided medical care to members of fraternal organizations in return for a fixed periodic fee per member. (encyclopedia.com)
  • HMOs cover emergency care regardless of the health care provider's contracted status. (wikipedia.org)
  • Doctor: Health Maintenance Organizations (HMOs) should not be used to replace traditional fee-for-service methods of delivering health care. (gmatclub.com)
  • The less health care that HMOs deliver, the greater the profit these companies receive. (gmatclub.com)
  • b)An effective way for HMOs to cut health care delivery costs is to prevent diseases from occurring by providing considerable amounts of preventive health care. (gmatclub.com)
  • c) If HMOs deliver less health care, competitive pressures will force these companies to lower the rates they charge for health care coverage, returning the profit margin to former levels. (gmatclub.com)
  • The Health Maintenance Organization Act, informally known as the federal HMO Act, is a federal law that provides for a trial federal program to promote and encourage the development of health maintenance organizations (HMOs). (wikipedia.org)
  • Second, there is a fear that while select black physicians will be "gobbled" up by multi-physician health maintenance organizations (HMOs), those that do not want to or are not asked to join such groups will lose their practices. (thefreedictionary.com)
  • TO LOWER COSTS, MEDICARE AND MEDICAID ARE encouraging their beneficiaries to enroll in health maintenance organizations (HMOs). (thefreedictionary.com)
  • Managed care practice arrangements, or health maintenance organizations (HMOs), are sufficiently mature to examine whether physicians' level of satisfaction has changed as managed care has developed. (nih.gov)
  • OBJECTIVE: The increasing enrollment of Medicare beneficiaries in health maintenance organizations (HMOs) in recent years has caused concern about whether HMOs and their providers have created an unfavorable environment for members who are chronically ill. (diabetesjournals.org)
  • Health Maintenance Organizations (HMOs) as an organizational form have a number of features potentially attractive in Canada as elsewhere. (semanticscholar.org)
  • HMOs operate similarly to other types of health insurance plans in several ways. (semanticscholar.org)
  • All HMOs undergo close scrutiny by many government organizations, including each State Department of Health in which they operate. (thebalancecareers.com)
  • HMOs are often cheaper health care plans for employers and members over the life of the plans. (thebalancecareers.com)
  • PLEXIS offers Health Maintenance Organizations (HMOs) an unbeatable toolset for managed care for multiline health plans, self-funded plans, and a diverse set of healthcare provider organizations. (plexishealth.com)
  • Health Maintenance Organizations, otherwise known as HMOs, are one type of Medicare Advantage plan. (medicaresolutionslongisland.com)
  • HMOs have a set network of hospitals, doctors, and other health care providers. (medicaresolutionslongisland.com)
  • The PCP system allows many HMOs to provide integrated care with a focus on prevention and wellness to reduce overall costs and improve health outcomes. (medicaresolutionslongisland.com)
  • The Florida Health Maintenance Organization Consumer Assistance Plan ("HMOCAP") was created by Florida statute to protect persons enrolled for coverage with HMOs, subject to certain limitations, against the failure of their HMO to perform its contractual obligations due to its insolvency. (flhmocap.com)
  • Although HMOs are more restrictive than other health insurance plans, they are typically suitable for us millennials. (wordpress.com)
  • All HMOs provide comprehensive hospital, medical/surgical, mental health/substance abuse, and prescription drug coverage. (albany.edu)
  • Minnesota lays claim to the idea of prepaid health plans-health services operated and administered by medical doctors and professional staff, and managed by health maintenance organizations (HMOs) -a design formulated in the early 1960s by Dr. Paul M. Ellwood, then executive director of the American Rehabilitation Foundation and the Sister Kenny Institute of Minneapolis. (mnhs.org)
  • The statute defined health maintenance organizations (HMOs) as 'non-profit organizations, providing comprehensive health maintenance services in exchange for a fixed prepaid sum, regardless of frequency or extent of care required. (mnhs.org)
  • Association of Health Maintenance Organization of the Philippines, Inc. (AHMOPI) is the first recognized trade association of Health Maintenance Organization (HMOs) in the Philippines. (ahmopi.org.ph)
  • As HMOs committed to the value, integrity and credibility of our respective organizations, we shall strictly adhere to sound business ethics and achieve far greater performance standards and operational efficiencies. (ahmopi.org.ph)
  • Health Maintenance Organizations - shortened to HMOs - are a type of health insurance provider using a unique business model. (generalliabilityinsure.com)
  • Health maintenance organizations (HMOs) act as both a medical insurance carrier and as the coordinator of health services for its members, who pay a monthly fee to receive all the medical services needed at a reduced cost or co-payment to them. (generalliabilityinsure.com)
  • As health insurance providers, HMOs will understand the fact that disaster can strike unexpectedly better than most businesses. (generalliabilityinsure.com)
  • HMOs help reduce health costs by keeping people out of hospitals. (thecrimson.com)
  • HMOs thus encourage members to keep a check on health problems before they become serious, Biblo said yesterday. (thecrimson.com)
  • A July Federal Trade Commission report indicates HMOs not only provide cheaper health care to their members but also apply competitive pressure to other insurance agencies. (thecrimson.com)
  • At the ceremony certifying the Harvard Community Health Plan, Senator Edward Kennedy '54 (D.-Mass.) described HMOs as "an important model for the development of future national health insurance programs. (thecrimson.com)
  • In 2020, the Centers for Medicare and Medicaid Services awarded Kaiser their highest rating of 5.0 out of 5.0 stars for their Medicare health plans in their annual Star Ratings. (medicalnewstoday.com)
  • The Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options if the employer offers traditional healthcare options. (wikipedia.org)
  • They trace their origins to the early 20th century, but became more popular after the Health Maintenance Organization Act of 1973 . (thefreedictionary.com)
  • Passage of the 1973 Health Maintenance Organization Act (P.L. 93-222) represents a significant effort by the Federal government to experiment with organizational change in the structure of the health care delivery system. (semanticscholar.org)
  • In 1973, The Health Maintenance Organization Act amended the previous Public Health Service Act of 1944 and effectively transformed the way health benefits were to be managed in America. (thebalancecareers.com)
  • In order to protect and nurture what was then a new approach in health care, Congress passed the HMO Act of 1973. (newyorkessays.com)
  • The Health Maintenance Act of 1973 was passed by the Minnesota Legislature and codified as Chapter 62D of the Minnesota Statutes. (mnhs.org)
  • Recognition came after recent modifications enabled the Harvard organization to fulfill federal guidelines set down in a 1976 amendment to a 1973 law. (thecrimson.com)
  • A Health Maintenance Organization (HMO) provides and/or arranges for the delivery of comprehensive health care services and supplies to its members in a designated geographic service area in exchange for prepaid premiums. (nj.us)
  • These contracts both allow for premiums to be lower than for traditional health insurance-since the health providers have the advantage of having patients directed to them-but they also add additional restrictions to the HMO's members. (investopedia.com)
  • The agreed payment allows an HMO to offer lower premiums than other types of health insurance plans while retaining a high quality of care from its network. (investopedia.com)
  • In response, both private firms that paid for employees' health insurance premiums and governments that were financing care for the poor and the elderly sought mechanisms to control costs. (encyclopedia.com)
  • Insurance premiums are never eligible for reimbursement with a flexible spending account (FSA), but may be eligible with a health reimbursement arrangement (HRA) and are eligible on a health savings account (HSA) unless already paid for with pre-tax dollars. (fsastore.com)
  • Health insurance premiums reimbursement is not eligible with a limited care flexible spending account (LCFSA) or a dependent care flexible spending account (DCFSA). (fsastore.com)
  • Health insurance premiums fall outside of this definition and pay for coverage, not direct care, so therefore FSA funds cannot cover policy premiums. (fsastore.com)
  • Conversely, business-sponsored accounts like health reimbursement arrangements (HRAs) may be underwritten to cover HMO premiums, but this is left up to the employer to decide and varies greatly. (fsastore.com)
  • However, health savings accounts (HSAs) are personal savings accounts that are designed to cover health expenses, and therefore they can be used to pay for HMO premiums if the policyholder desires. (fsastore.com)
  • In 1988, the employers' war against escalating health care costs shifted to a new front as demands rose for a variety of measures to control the premiums paid to health maintenance organizations. (newyorkessays.com)
  • An HMO is a type of managed care health plan where members choose their physician from a network of approved health care providers which typically results in lower premiums and/or copayments. (cascadehc.org)
  • Health insurance premiums rose 50% between 2008 and 2017, according to the Colorado Division of Insurance. (benzinga.com)
  • Typically, CDHPs have lower premiums but higher deductibles (the amount members pay out-of-pocket for health services before the health plan pays). (anthem.com)
  • This pressure forces other programs either to make their health packages more comprehensive or to reduce their premiums. (thecrimson.com)
  • Health care is typically managed by primary care physicians, specialists, hospitals and labs inside the provider network, with premiums and co-payment for certain services or prescriptions. (cthealthchannel.org)
  • Least Expensive Health Insurance Instead of a deductible, most HMO plans have monthly premiums and small co-payments for medical services and treatments, regardless of a member's medical needs. (cthealthchannel.org)
  • The Federal Government requires employers to include a health maintenance organization in their employees' health benefit plans. (gao.gov)
  • It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers (hospitals, doctors, etc.) on a prepaid basis. (wikipedia.org)
  • Over the past few years, third-party payers, such as large employer-based benefit plans, health maintenance organizations and traditional insurers, have increasingly found a new profit source--recoveries from prescription-drug overcharge litigation. (thefreedictionary.com)
  • health care plans to provide coverage for newborn children. (richmondsunlight.com)
  • Requires health care plans provided by a health maintenance organization to provide coverage for newborn children. (richmondsunlight.com)
  • Catastrophic health plans permitted. (wa.gov)
  • Mental health services - Health plans - Definition - Coverage required, when. (wa.gov)
  • According to the experts in health care, the trend away from traditional fee-for-service health care plans has been steady over the last two decades. (thebalancecareers.com)
  • The US Department of Labor advises that fee-for-service plans accounted for 96% of health care plans offered by medium and large public employers in 1984 and 20 years later they account for less than 15% of employer-provided health insurance. (thebalancecareers.com)
  • Health maintenance organization plans continue to be a strong component of care in the health insurance market today. (thebalancecareers.com)
  • Health insurers are selling more than 100,000 plans at a county level through the Affordable Care Act's marketplaces, at radically different prices and varied designs. (swimincorp.com)
  • But a new analysis from the McKinsey Center for U.S. Health System Reform suggests insurers had some luck in holding down prices if they offered plans that limited a consumer's choice of doctors and hospitals. (swimincorp.com)
  • Plans featuring health maintenance organizations or restricted networks of providers typically had the lowest year-over-year premium increases, according to McKinsey, which sifted through information on the 223,000 plans offered in the marketplaces at the county level over the last two years. (swimincorp.com)
  • The more widely known P.P.O., or preferred provider organization, plans, which typically allow people to go outside their plan's network if they are willing to pay a greater share of the cost, had a median increase of 9 percent. (swimincorp.com)
  • As one of the lowest cost options, Health Maintenance Organization plans can be a great fit depending on your situation. (medicaresolutionslongisland.com)
  • These plans are also an attractive option for individuals who are generally in good health, allowing them to obtain the security of an insurance plan while keeping costs low. (medicaresolutionslongisland.com)
  • Private health insurance companies administer Medicare Advantage Prescription Drug (MAPD) plans. (medicalnewstoday.com)
  • Medicare Advantage (MA) plans, also known as Medicare Part C, is a group of insurance plans administered by private health insurance companies. (medicalnewstoday.com)
  • This briefing will explore the rise of consumer wearables as increasingly prevalent tools in health care delivery and as part of patient care plans. (allhealthpolicy.org)
  • Citizens are required to purchase their own health insurance from a private marketplace, while children and the elderly can be covered under free plans from the government. (benzinga.com)
  • Here are the different types of plans you can access: preferred provider (PPO), health maintenance organization (HMO) and point of service plans (POS). (benzinga.com)
  • These plans tend to more complicated because all of your health care referrals must go through your primary doctor and add in more steps between you and treatment. (benzinga.com)
  • Rocky Mountain Health Plans is a nonprofit HMO-based health care system. (benzinga.com)
  • There are different types of plans, including health savings accounts and plans with a high or low deductible. (chiefofleast.com)
  • These types of plans are good for the people who rarely go to the doctor and need little health care. (chiefofleast.com)
  • Private health insurance is allowed, but in six provincial governments only for services that the public health plans do not cover (for example, semi-private or private rooms in hospitals and prescription drug plans). (chiefofleast.com)
  • Introduction to managed care : health maintenance organizations, preferred provider organizations, and competitive medical plans / Robert G. Shouldice. (who.int)
  • Kaiser Permanente is a nonprofit organization that offer healthcare plans, including Medicare Advantage. (medicalnewstoday.com)
  • Kaiser Medicare Preferred Provider Organization (PPO) plans offer more freedom. (medicalnewstoday.com)
  • The Affordable Care Act (ACA) guidelines stipulate that vision care is an essential benefit for children under age 19 - all plans sold in the Health Insurance Marketplace should include vision care for children. (benzinga.com)
  • The Health Insurance Marketplace does not offer stand-alone plans. (benzinga.com)
  • Vision insurance doesn't use the deductible available with traditional health insurance plans but borrows the idea of copayments. (benzinga.com)
  • Vision insurance plans are available as either add-on (optional riders) to your primary health insurance plan or through an ancillary plan (stand-alone plan) that provides benefits not available through major health plans, like vision and dental insurance . (benzinga.com)
  • Explore Anthem group medical plans, including flexible PPO, POS, and Consumer-Driven Health Plans (CDHP) - all with one of the largest physician and hospital-based networks in Wisconsin. (anthem.com)
  • POS plans are a type of managed care that requires members to choose an in-network physician for a PCP, but like a PPO, patients may go outside the network for health care services. (anthem.com)
  • All ACA Marketplace plans cover the 10 Essential Health Benefits . (illinois.gov)
  • This requires health plans to cover a person regardless of age, gender or health status (including pre-existing conditions). (quote.com)
  • The ACA requires most individual and small employer health insurance plans, including all plans offered through the Health Insurance Marketplace to cover substance use and mental health services. (quote.com)
  • Curry SJGrothaus LCMcAfee TPabinak C Use and cost effectiveness of smoking-cessation services under four insurance plans in a health maintenance organization. (jamanetwork.com)
  • Market Metro Health's various Health Plans in achieving significant Market penetration in accordance with set organizational goals. (jobinformant.com)
  • While an HMO is more restrictive than other plans, doctor visits and health care can be simple, easy and reliable. (cthealthchannel.org)
  • No Lifetime Maximum Payout Unlike other health insurance plans, many HMO policies do not have a lifetime maximum payout. (cthealthchannel.org)
  • The member's financial responsibility for covered out-ofnetwork services resembles that of an indemnity health insurance plan , with a deductible and coinsurance structure that generally results in a higher payment by the member than if he or she obtained services or supplies from a network provider. (nj.us)
  • A preferred provider organization (PPO) is a medical care plan in which health professionals and facilities provide services to subscribed clients at reduced rates. (investopedia.com)
  • a plan for comprehensive health services, prepaid by an individual or by a company for its employees, that provides treatment, preventive care, and hospitalization to each participating member in a central health center. (dictionary.com)
  • The Sound Health Association, Inc., of Tacoma, Washington, is a consumer-owned, prepaid health plan and was the first health maintenance organization qualified by the Department of Health, Education, and Welfare (HEW) under the Health Maintenance Organization Act. (gao.gov)
  • his health plan took on the general outline of a modern health maintenance organization with its own medical and hospital sites and paid physicians providing group practice care to the insured employees. (encyclopedia.com)
  • This Kaiser Foundation Health Plan owned medical facilities, clinics, and hospitals, and employed doctors to provide medical care in return for a fixed fee. (encyclopedia.com)
  • Smokers receiving advice to quit reported greater satisfaction with their health plan than those who did not receive advice, a finding consistent with several recent studies showing higher patient satisfaction with medical care when they receive advice and assistance in quitting smoking. (confex.com)
  • Articulate the relationship between health plan tobacco control policies and the delivery of tobacco cessation services to patients. (confex.com)
  • A Health Maintenance Organization (HMO) is a managed care plan that incorporates financing and delivery of an inclusive set of health care services to individuals enrolled in a network. (wikipedia.org)
  • HMO: or health maintenance organization , is a medical insurance and health care plan that offers a specific list of doctors and hospitals from whom members must receive their care. (thefreedictionary.com)
  • Prepaid group health insurance plan that entitles members to services of participating physicians, hospitals, and clinics. (realestateagent.com)
  • 8) "Enrollee" means an individual who is enrolled in a health care plan and includes covered dependents. (tx.us)
  • E) services provided under a limited health care service plan or a single health care service plan. (tx.us)
  • 14) "Health maintenance organization" means a person who arranges for or provides to enrollees on a prepaid basis a health care plan, a limited health care service plan, or a single health care service plan. (tx.us)
  • A health maintenance organization (HMO) is a type of managed care health insurance plan. (semanticscholar.org)
  • Health plan benefits for small employers - Coverage - Exemption from statutory requirements - Premium rates - Requirements for providing coverage for small employers. (wa.gov)
  • In fact, this is the most popular of all health care plan models in the market. (thebalancecareers.com)
  • The quality of the doctors and health care centers are carefully monitored to the highest of standards, so plan members know they are getting the best possible care. (thebalancecareers.com)
  • NRS 695C.165 Eligibility for coverage: Organization prohibited from asserting certain grounds to deny enrollment of child pursuant to order if parent is enrolled in health care plan. (nv.us)
  • NRS 695C.167 Eligibility for coverage: Certain accommodations to be made when child is covered under health care plan of noncustodial parent. (nv.us)
  • In response to recent evidence about the safety of calcium channel blockers, Group Health Cooperative of Puget Sound (GHC), a large health maintenance organization, implemented a plan in April 1996 to reevaluate the medications of 1349 patients who were taking short-acting nifedipine. (elsevier.com)
  • That's why we've taken the following steps to make sure your information stays between you and your health plan. (bcbsla.com)
  • A health maintenance organization, also commonly referred to as an HMO, is a type of insurance plan in which the policyholder fight chooses a primary care physician (PCP) from the insurance company's network of local healthcare providers, who will handle all primary care responsibilities and refer the policyholder to specialists and hospitals when advanced care is necessary. (fsastore.com)
  • If you have an Health Maintenance Organization (HMO) Plan, you can only see doctors that are in the plan's network. (wordpress.com)
  • The benefits of a Health Maintenance Organization (HMO) can differ depending on the company and group plan. (cascadehc.org)
  • At Carewell , we are committed to assist you in making full use of your health plan. (carewellhealthsystems.com)
  • A managed care plan that combines the function of insurer and provider to give members comprehensive health care from a network of affiliated providers. (allhealthpolicy.org)
  • Graduate and Teaching Assistants are eligible for the Student Employee Health Plan (SEHP) as employees represented by the Graduate Student Employees Union (GSEU). (albany.edu)
  • The Empire Plan covers hospitalization through Blue Cross, surgical/medical care through United HealthCare, mental health/substance abuse treatment through Optum Health Behavioral Solutions, and prescription drugs through Medco. (albany.edu)
  • The Empire Plan includes "managed care" components for certain services, such as hospital and skilled nursing facility admissions, mental health and substance abuse treatment, home health care and durable medical goods, and chiropractic/physical therapy. (albany.edu)
  • The pilot program involved 5000 patients from General Mills, the Dayton Company, and other local corporations who were enrolled in this employer-sponsored prepaid health plan. (mnhs.org)
  • We shall endeavor to achieve excellence in our health delivery systems, and help our plan holders live happy, healthy lives. (ahmopi.org.ph)
  • This plan also includes dental, behavioral health, maternity-related visits, prescription drug coverage and laboratory tests. (benzinga.com)
  • The Health Maintenance Organization ( HMO) Plan limits coverage to care from in-network doctors. (princeton.edu)
  • Visits are covered at the same cost as in-network mental health visits under the Princeton medical plan. (princeton.edu)
  • The Kaiser Permanente organization are a nonprofit healthcare plan provider with a hospital network, an insurance system, and a network of salaried healthcare providers. (medicalnewstoday.com)
  • Vision insurance - a type of supplemental health plan - may help offset expenses related to eye care, such as vision corrective wear, annual eye examinations, corrective eye surgery, contact lens exams and more. (benzinga.com)
  • This plan provides coverage to participants through a network of select health care providers, like physicians and hospitals. (benzinga.com)
  • This plan lets you pay less if you use hospitals, doctors and other health care providers who belong to the plan's network. (benzinga.com)
  • Kaiser Permanente Colorado is the state's largest nonprofit health plan, proudly working to improve the lives and health of Colorado residents. (westmetrochamber.org)
  • Choosing the right health plan can be confusing at times, but you are not alone. (illinois.gov)
  • If your health care needs are moderate, are you concerned about being able to pay for services for an unexpected illness or injury if your plan has high out-of-pocket costs? (illinois.gov)
  • A provider network is a specific list of the doctors, hospitals, pharmacies, and other health care providers that your plan covers. (illinois.gov)
  • If you get health services in multiple places or travel often, does the plan cover out-of-network providers or have a national provider network? (illinois.gov)
  • a) Each enrollee residing in this state is entitled to evidence of coverage under a health care plan. (texas.gov)
  • c) If the enrollee obtains coverage under a health care plan through an insurance policy or a contract issued by a group hospital service corporation, whether by option or otherwise, the insurer or the group hospital service corporation shall issue the evidence of coverage. (texas.gov)
  • b) A health maintenance organization may provide an individual health care plan in accordance with this section and Section 1271.307 . (texas.gov)
  • c) A health maintenance organization may limit enrollment in an individual health care plan to individuals who reside or work within the service area for the plan's network. (texas.gov)
  • a) Chapters 1368 and 1652 apply to a health maintenance organization other than a health maintenance organization that offers only a single health care service plan. (texas.gov)
  • b) A health maintenance organization may provide benefits under a health care plan to an enrollee's dependent grandchild who is living with and in the household of the enrollee. (texas.gov)
  • The Harvard Community Health Plan, an innovative program combining preventive care and health insurance, received certification September 28 from the Department of Health, Education and Welfare, making it the first Health Maintenance Organization (HMO) in Massachusetts. (thecrimson.com)
  • According to Robert L. Biblo, president of the Health Plan. (thecrimson.com)
  • The very basic difference between the Harvard Plan and conventional health insurance programs is that we combine the financing mechanism and the delivery system. (thecrimson.com)
  • When you choose a health plan, be sure to review the plan's covered and non-covered services and the restrictions on your choice of providers. (csub.edu)
  • As a PPO health plan member, you get maximum benefit coverage when you use the PPO network of physicians and hospitals. (csub.edu)
  • Stat., defines an HMO as 'a health care plan offered by an organization established under chs. (wi.gov)
  • All applications for Certificates of Incorporation and Certificates of Authority for health maintenance organizations shall include a proposed business plan. (wi.gov)
  • One type of insurance provider that is popular in the health insurance marketplace is a health maintenance organization (HMO), an insurance structure that provides coverage through a network of physicians. (investopedia.com)
  • A health maintenance organization (HMO) is a network or organization that provides health insurance coverage for a monthly or annual fee. (investopedia.com)
  • The same requirement currently exists for health insurance policies and subscription contracts with family coverage. (richmondsunlight.com)
  • Beyond health coverage, you can count on us to provide impactful community initiatives and leadership in improving health care. (baycityarea.com)
  • You may use this site as your basic guide to better understand your Carewell Health Care Coverage . (carewellhealthsystems.com)
  • Health Insurance eligibility requirements and coverage effective dates vary by employee type. (albany.edu)
  • The U.S. government requires that J-1 visa holders and their dependents have health insurance coverage while at Princeton University as an exchange scholar. (princeton.edu)
  • If medical coverage is waived at Princeton, J-1 visa holders must be covered for health insurance through their home country, institution, or own private policy. (princeton.edu)
  • What types of Georgia health maintenance organization insurance coverage are crucial? (generalliabilityinsure.com)
  • Our funding options and group health expense accounts offer even more ways to create health coverage on your terms. (anthem.com)
  • Individuals and families that fall between 100 to 400% of the federal poverty level can receive federal subsidies for their health care coverage. (quote.com)
  • b) The health maintenance organization shall issue the evidence of coverage, except as provided by Subsection (c). (texas.gov)
  • d) By agreement between the health maintenance organization, insurer, or group hospital service corporation and the subscriber or person entitled to receive the evidence of coverage, policy, or contract, the evidence of coverage required by this section may be delivered electronically. (texas.gov)
  • An evidence of coverage is not a health insurance policy as that term is defined by this code. (texas.gov)
  • 3) in which the evidence of coverage meets the requirements of the definition of "basic health care services" provided by Section 843.002 . (texas.gov)
  • e) Notwithstanding any other law, Section 1201.062 applies to an evidence of coverage issued by a health maintenance organization. (texas.gov)
  • We wanted to determine whether a health maintenance organization's (HMO's) implementation of a pediatric hospitalist system affected LOS, costs, mortality, readmission rate, follow-up rate, and parents' ratings of care. (aappublications.org)
  • HMO's are still one of the more popular health management options that employers offer, for a number of reasons. (thebalancecareers.com)
  • Managed-care programs include Health-maintenance Organizations (HMO's) and Preferred-provider Organizations (PPO's). (animated-teeth.com)
  • The provision of health care services on the basis of prepaid rates provides incentives for the organization to emphasize preventive medicine to reduce overall health care costs. (gao.gov)
  • The Sound Health Association appears to be providing comprehensive prepaid health care in accordance with the act. (gao.gov)
  • What's required is a network of Preventive Health Maintenance Organizations (PHMO) to provide prepaid care for a wide range of alternative or simply relaxing treatments. (thefreedictionary.com)
  • The health maintenance organization (HMO) and Seattle fee-for-service (FFS) visits files contain data concerning the use of inpatient and outpatient health services by Seattle FFS participants and participants enrolled in Group Health Cooperative of Puget Sound, a large prepaid group practice in Seattle. (rand.org)
  • B) that consists in part of providing or arranging for health care services on a prepaid basis through insurance or otherwise, as distinguished from indemnifying for the cost of health care services. (tx.us)
  • Group Health: An American Success Story in Prepaid Health Care , by Mary Jo and Walter H. Uphoff, in collaboration with Russell K. Lewis. (mnhs.org)
  • It would not be wise or logical or feasible or probably even legal to use the entire facilities of Moses Cone Hospital as a prepaid provider of-health services. (uncg.edu)
  • Following the approval of the federal Center for Medicare and Medicaid Services ( CMS, formerly the Health Care Financing Administration (HCFA)) on 06/07/1995, recipients of Aid for Families with Dependent Children (AFDC) were required to select an HMO for the provision of their health care services and supplies. (nj.us)
  • An HMO is an organized public or private entity that provides basic and supplemental health services to its subscribers. (investopedia.com)
  • As of December 31, 1976, it was providing comprehensive health care services to 6,016 members. (gao.gov)
  • In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. (wikipedia.org)
  • It is this inclusion of services intended to maintain a member's health that gave the HMO its name. (wikipedia.org)
  • Some services, such as outpatient mental health care, are limited, and more costly forms of care, diagnosis, or treatment may not be covered. (wikipedia.org)
  • I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session. (confex.com)
  • United States Department of Health and Human Services. (umich.edu)
  • The purpose of the National Health Interview Survey (NHIS) is to obtain information about the amount and distribution of illness, its effects in terms of disability and chronic impairments, and the kinds of health services people receive. (umich.edu)
  • Managed-care companies such as health maintenance organizations and preferred provider organizations must select and retain qualified physicians who will provide quality services to their sub scribers, according to Margolis & Co. (thefreedictionary.com)
  • HMO Outpatient Health Services Provided at HMO Facility-include physician services, preventive health services, diagnosis and treatment services, skilled nursing facility services, mental health and/or alcohol and drug abuse services, dental care under specific circumstances, and emergency services in and out of the HMO area. (realestateagent.com)
  • This codebook describes the contents of a data file from the Health Insurance Experiment (HIE), a large social experiment conducted by The RAND Corporation from 1974 to 1982 under a grant from the U.S. Department of Health and Human Services. (rand.org)
  • The new program, known as TennCare, operates as a special demonstration project authorized by the Secretary of Health and Human Services under the waiver authority conferred on him by Section 1115 of the Social Security Act, 42 U.S.C. § 1315. (openjurist.org)
  • 1) "Adverse determination" means a determination by a health maintenance organization or a utilization review agent that health care services provided or proposed to be provided to an enrollee are not medically necessary or are not appropriate. (tx.us)
  • 2) "Basic health care services" means health care services that the commissioner determines an enrolled population might reasonably need to be maintained in good health. (tx.us)
  • 4) "Capitation" means a method of compensating a physician or provider for arranging for or providing a defined set of covered health care services to certain enrollees for a specified period that is based on a predetermined payment per enrollee for the specified period, without regard to the quantity of services actually provided. (tx.us)
  • 13) "Health care services" means services provided to an individual to prevent, alleviate, cure, or heal human illness or injury. (tx.us)
  • This retrospective, cohort study included members ≥ 21 years old from the Maccabi Healthcare Services, a large health maintenance organization in Israel, who were diagnosed with FM from 2008 through 2011. (jrheum.org)
  • The conclusion is that the organization of mental health services is strongly influenced by whether the HMO is organized as a group-based delivery system or as a contractually-linked set of independent providers. (semanticscholar.org)
  • Name restrictions - Discrimination - Recovery of costs of health care services participant not entitled to. (wa.gov)
  • Therefore, an HMO is an organization that has the sole purpose of providing equal access to health care services in exchange for members agreeing to certain terms. (thebalancecareers.com)
  • DefinitionIllustrative caselaw A health care delivery system where the provider offers a participant a comprehensive range of health services for a fixed premium. (cornell.edu)
  • Even before the enactment of the law, an organization called Group Health, Inc., had been providing medical services to its subscribing members since 1957. (mnhs.org)
  • Workplace wellness programs are increasingly adopted by companies for their value in improving the health and well-being of their employees, as are school health services in order to improve the health and well-being of children. (chiefofleast.com)
  • As per the Constitution of Canada, health care is mainly a provincial government responsibility in Canada (the main exceptions being federal government responsibility for services provided to aboriginal peoples covered by treaties, the Royal Canadian Mounted Police, the armed forces, and Members of Parliament). (chiefofleast.com)
  • Under the Canada Health Act, the federal government mandates and enforces the requirement that all people have free access to what are termed "medically necessary services," defined primarily as care delivered by physicians or in hospitals, and the nursing component of long-term residential care. (chiefofleast.com)
  • Four provinces allow insurance for services also mandated by the Canada Health Act, but in practice there is no market for it. (chiefofleast.com)
  • Inpathy, Aetna's in-network telemental health services provider (also known as Televideo): Call (800) 442-8938. (princeton.edu)
  • Georgia health maintenance organization insurance protects your HMO insurance and health services business from lawsuits with rates as low as $77/mo. (generalliabilityinsure.com)
  • The briefest definition of an HMO is A corporation which provides health services to enrollees on a prepayment per capita basis. (uncg.edu)
  • The health services may be provided by the corporation or may be subcontracted in part or in whole. (uncg.edu)
  • Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies, for the fiscal year ending September 30, 1995, and for other purposes. (govtrack.us)
  • In general, the more you are willing to pay out-of-pocket for health care services, like doctor visits or prescription medications, the less you will pay for your monthly premium. (illinois.gov)
  • Use of services by diabetes patients in managed care organizations. (jamanetwork.com)
  • Stat., that makes available to its enrolled participants in consideration for predetermined periodic fixed payments, comprehensive health care services performed by providers selected by the organization. (wi.gov)
  • This virtual symposium gathered a range of experts after election day to discuss how the results could influence the health policy agenda in 2021 and beyond. (allhealthpolicy.org)
  • 2021 CT Health Insurance Channel. (cthealthchannel.org)
  • By presenting physicians and patients with recent evidence about the safety of short- acting nifedipine, a large health maintenance organization was able to motivate broad-scale changes to safer alternative drug therapies. (elsevier.com)
  • Golston, Alan G. / Replacing short-acting nifedipine with alternative medications at a large health maintenance organization . (elsevier.com)
  • Health Insurance Alert: Out-of-Network Rip-Offs [ez_date] Much has been made in the health insurance debate surrounding Obamacare of the growing reliance by health insurers on "narrow networks" of doctors and hospitals willing to accept their discounted payments as a means of keeping healthcare costs under control. (ourhealthcaresucks.com)
  • The HMO contracts with doctors, hospitals, and other health care professionals to serve members 24 hours a day, seven days per week. (generalliabilityinsure.com)
  • 1984 WHO revised the definition of health defined it as "the extent to which an individual or group is able to realize aspirations and satisfy needs and to change or cope with the environment. (chiefofleast.com)
  • OBJECTIVE: The objective of this study was to estimate the effect of Medicare Health Maintenance Organization (HMO) enrollment on hospitalization rates and total inpatient days for ambulatory care-sensitive conditions (ACSCs) after controlling for selection. (rand.org)
  • A Health Maintenance Organization (HMO) provides a wide range of benefits that cover the entire health care spectrum, from preventive care and education to physician care, surgery and hospitalization. (cthealthchannel.org)
  • SUBJECTS: Enrollment data on Medicare beneficiaries in California were linked to hospital discharge data from the California Office of Statewide Health Planning and Development for January through December 1996. (rand.org)
  • In administrative areas an HMO must prove its fiscal soundness, offer a standard grievance procedure to its members and allow open enrollment at specific intervals, regardless of the current health of an applicant. (thecrimson.com)
  • Organization founded in 1993, the thesis of which is to apply quality management principles to insurance functions. (realestateagent.com)
  • Minneapolis, MN : The Organization, 1985-1993. (mnhs.org)
  • A primary care physician is typically an individual's first point of contact for all health-related issues. (investopedia.com)
  • One organization, typically a national government, covers all the costs of its citizens' health care in a single-payer system. (benzinga.com)
  • Health insurance policies typically cover eye care only if you have a medical issue. (benzinga.com)
  • CDHPs are typically paired with a Health Savings Account (HSA). (anthem.com)
  • Because patients increasingly carried health insurance, often through their employers, they did not have incentives to question the physicians' advice. (encyclopedia.com)
  • and required employers with 25 or more employees to offer federally certified HMO options IF they offered traditional health insurance to employees. (wikipedia.org)
  • It did not require employers to offer health insurance. (wikipedia.org)
  • H.M.O.s experienced a backlash in the early 1990s after employers embraced them as a solution to rising health care costs, and patients and doctors complained about strategies they said were aimed at keeping patients from getting the care they needed. (swimincorp.com)
  • It's important to know how health insurance is organized and what it will and won't cover before you search how to get health insurance . (benzinga.com)
  • Pursuant to a legislative requirement, GAO provided an overview of the data and methodology for computing Medicare monthly capitation payments to risk-contract health maintenance organizations (HMO). (gao.gov)
  • Payroll deductions for capitation payments to health maintenance organizations. (wa.gov)
  • The costs attributable to the 25 conditions accounted for 78 percent of the health maintenance organization's total direct medical expense for this age-group. (nih.gov)
  • 6) "Complaint" means any dissatisfaction expressed orally or in writing by a complainant to a health maintenance organization regarding any aspect of the health maintenance organization's operation. (tx.us)
  • This packet summarizes the procedures for incorporating and licensing a domestic, not for profit, health maintenance organization insurer in Wisconsin under ch. 613, Wis. (wi.gov)
  • CONCLUSIONS: A 6-month cluster visit group model of care for adults with diabetes improved glycemic control, self-efficacy, and patient satisfaction and resulted in a reduction in health care utilization after the program. (diabetesjournals.org)
  • Payers recover significant savings and reduce utilization rates by leveraging PLEXIS' real-time alerts, automatic audits, health risk assessments (HRAs), responsive reporting, and more. (plexishealth.com)
  • Health Care Utilization in Chronic Obstructive Pulmonary Disease: A Case-Control Study in a Health Maintenance Organization. (jamanetwork.com)
  • Hurley JFrost FGTrinkaus KMBuatti MCEmmett KE Relationship of compliance with hormone replacement therapy to short-term health care utilization in a managed care population. (jamanetwork.com)
  • The diagnoses and mental health utilization associated with their use are explored, and concomitant drug use is investigated. (elsevier.com)
  • The organization secures its network of health providers by entering into contracts with primary care physicians, clinical facilities, and specialists. (investopedia.com)
  • These health insurers partner with a network of physicians. (generalliabilityinsure.com)
  • This position paper of the American College of Physicians (ACP) provides ample evidence illustrating that minorities do not always receive the same quality of health care, do not have the same access to health care, are less represented in the health professions, and have poorer overall health status than nonminorities. (annals.org)
  • The American College of Physicians (ACP), whose mission is "to enhance the quality and effectiveness of health care by fostering excellence and professionalism in the practice of medicine," has a long-standing commitment to improving public health. (annals.org)
  • Elective healthcare procedures are procedures that are not required to maintain your overall health and often aren't covered by health insurance. (benzinga.com)
  • In addition to writing for a variety of publications, Scott also offers his insights on healthcare technology and its leaders on his site, Electronic Health Reporter . (multibriefs.com)
  • Any business employing 50 or more people that does not offer health insurance to full-time employees must pay a tax penalty if the government has subsidized a full-time employee's healthcare through tax deductions. (quote.com)
  • FHCP is a healthcare maintenance organization with a large network of providers. (afionline.org)
  • Generally, members of an HMO can only see a health care specialist (hematologist, cardiologist, rheumatologist) if they get a referral from their primary care physician, also known as a gatekeeper. (cascadehc.org)
  • Your primary care physician serves as your health care advocate and will help you find the best treatment for physical and mental health problems you might face. (cascadehc.org)
  • Like an HMO, you will need to pick a regular doctor, called a primary care physician (PCP), to help monitor your health care. (illinois.gov)
  • health maintenance organization subject to requirements for certain insurers. (nv.us)
  • The Centers for Disease Control and Prevention (CDC) reports that "relatively little progress has been made toward the goal of eliminating racial/ethnic disparities" among a wide range of health indicators (1) . (annals.org)
  • NRS 695C.123 Contracts with certain federally qualified health centers. (nv.us)
  • HMO Managing Physician & new member can select an HMO physician, who is then responsible for providing all of his or her health care needs. (realestateagent.com)
  • There is a central place for physician-based review in 'pro-competitive' health-care-financing systems and multiple sources of funding and a linkage of local PSRO budgets to local effectiveness could further enhance the performance of the best PSROs. (semanticscholar.org)
  • This chapter may be cited as the Texas Health Maintenance Organization Act. (tx.us)
  • 9-b) "Freestanding emergency medical care facility" means a facility licensed under Chapter 254 , Health and Safety Code. (tx.us)
  • c) A health maintenance organization shall comply with Subchapter B, Chapter 542 , with respect to prompt payment to an enrollee. (texas.gov)
  • d) Notwithstanding any other law, Subchapter C, Chapter 1355 , applies to a group contract issued by a health maintenance organization. (texas.gov)
  • High blood pressure (also known as hypertension) is the health condition of having blood pressure readings above 140/90 mmHg, over a number of weeks. (reliancehmo.com)
  • Mental health treatment - Waiver of preauthorization for persons involuntarily committed. (wa.gov)
  • Mental, intellectual, emotional and social health referred to a person's ability to handle stress, to acquire skills, to maintain relationships, all of which form resources for resiliency and independent living. (chiefofleast.com)
  • On the medical side, these standards require any certified HMO to provide regular preventive physical, mental health, drug, and alcohol care. (thecrimson.com)
  • Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. (lww.com)
  • Contact Wolters Kluwer Health, Inc. (lww.com)
  • The term "health maintenance organization" originated in the 1970s and is credited to Paul Ellwood, a policy adviser to the federal government on medical care. (encyclopedia.com)
  • Health Maintenance Organization (HMO) is a term first conceived of by Dr. Paul M. Ellwood, Jr. The concept for the HMO Act began with discussions Ellwood and his Interstudy group members had with Nixon administration advisors who were looking for a way to curb medical inflation. (wikipedia.org)
  • Get details on your medical and pharmacy claims to better manage your health benefits. (bcbsla.com)
  • If you already possess some knowledge of medical care and wish to be a health care professional, or Recommended Internet page in case you are a health care worker, but want to get started your own process and earn a little extra salary. (daytonamagazine.club)
  • You are able to offer good quality maintenance at competitive prices after which shift the profits for the medical doctor to make money. (daytonamagazine.club)
  • Health care companies classify a medical expense as either elective or nonelective procedures. (benzinga.com)
  • A nonelective procedure is a medical need that is required to maintain your health, while an elective procedure is often not. (benzinga.com)
  • Subsequently, clients who opt to insure themselves through the Health Maintenance Organization may access covered medical care through this network. (generalliabilityinsure.com)
  • Health insurance helps cover these medical expenses, from routine visits and prescriptions to specialists and nuclear imaging. (quote.com)
  • Enrollees go to their primary provider for health care or referrals to specialists. (albany.edu)
  • With traditional insurance programs these preventive health measures are not covered and must be paid for by the member. (thecrimson.com)
  • A nonprofit organization that offers health insurance to a group of persons and charges members of the group the same monthly premium. (thefreedictionary.com)
  • Which company or nonprofit offers the best health insurance in Colorado? (benzinga.com)
  • An individual who needs to secure health insurance may find a variety of health insurance providers with unique features. (investopedia.com)
  • In many cases, the HMO supports preventative wellness care, which is what health care providers advocate for. (thebalancecareers.com)
  • You'll be given a list of health care providers that you can visit. (benzinga.com)
  • Do you prefer having one doctor who recommends other providers for your total health care? (illinois.gov)
  • This project assessed implementation of tobacco control policies and cessation outcomes in nine non-profit health maintenance organizations across the United States. (confex.com)
  • The aim of this study was to 1) assess if there were differences in staff attitudes within a national OMT programme, and 2) investigate the associations of staff attitudes with treatment organisation, clinical practices and outcomes. (biomedcentral.com)
  • Data describing treatment organisation, clinical practices and patient outcomes in these centres were extracted from the annual OMT programme assessment 2007. (biomedcentral.com)
  • Providing information on cancellation or refusal - No liability for insurance commissioner or health maintenance organization. (wa.gov)
  • Preventive maintenance also reduces building liability risk. (multibriefs.com)
  • Taking on maintenance early can significantly reduce liability for those in the building while reducing safety hazards and increasing productivity levels. (multibriefs.com)
  • Your organization or institution (if applicable), e.g. (bmj.com)
  • Health First Colorado is a health care network funded in part by Medicare and Medicaid. (benzinga.com)
  • Medicaid Health Maintenance Organizations: Can They Reduce Program Spending? (lww.com)
  • Individuals and families facing financial hardship can receive insurance at a reduced rate through special government programs such as Medicaid and the Children's Health Insurance Program (CHIP). (quote.com)
  • Iglehart JK The American health care system: Medicaid. (jamanetwork.com)
  • d)Fee-for-service methods of delivering health care have perverse incentives to provide unnecessary health care at inflated costs. (gmatclub.com)
  • 3) "Blended contract" means a single document that provides a combination of indemnity and health maintenance organization benefits. (tx.us)
  • A person may also be able to use the gym facilities and enjoy complimentary health benefits, such as massages. (medicalnewstoday.com)
  • Data on detailed provisions of health insurance and retirement benefits for both private industry and state and local government also are available. (bls.gov)
  • The 1975 Health Maintenance Organization (HMO) Supplement provides variables from the core Person File (see HEALTH INTERVIEW SURVEY, 1975 [ICPSR 7672]) including sex, age, race, marital status, veteran status, education, income, industry and occupation codes, and limits on activity. (umich.edu)
  • Minneapolis: Twin City Health Care Development Project, Federal Reserve Bank, 1975. (mnhs.org)
  • Just as there was a shift from viewing disease as a state to thinking of it as a process, the same shift happened in definitions of health. (chiefofleast.com)
  • In this study, exposure to antipsychotic drugs among ambulatory health maintenance organization (HMO) members is described. (elsevier.com)
  • Diabetes management in a health maintenance organization. (diabetesjournals.org)
  • Diabetes and disenrollment in a health maintenance organization setting: a 4-year longitudinal study with a matched cohort. (diabetesjournals.org)
  • Health insurance contributions are deducted from payroll checks on a pre-tax basis if an employee elects in writing to participate in the Pre-Tax Contribution Program (PTCP) . (albany.edu)
  • To provide in-depth perspective on some aspects of disparities in health care, we have commissioned 4 brief commentaries (see pages 221-225). (annals.org)
  • Payers keep costs from spiraling out of control through early identification of outliers and critical health issues. (plexishealth.com)
  • As a result, each citizen is expected to contribute to his or her own health care costs. (benzinga.com)
  • The federal government influences health insurance by virtue of its fiscal powers - it transfers cash and tax points to the provinces to help cover the costs of the universal health insurance programs. (chiefofleast.com)
  • Deferred facility maintenance costs can run the gamut, including managing staffing the maintenance department, but specific areas of the budget can be hard to nail down. (multibriefs.com)
  • Preventive maintenance, done regularly, increases facility life and leads to reduced costs of buildings failing prematurely. (multibriefs.com)
  • Blue Cross and Blue Shield of Louisiana, incorporated as Louisiana Health Service & Indemnity Co., offers Blue Advantage (PPO). (bcbsla.com)
  • Preventative maintenance keeps equipment and building in check as repairs are made as needed. (multibriefs.com)