DiseasesAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPsychiatry and PsychologyPhenomena and ProcessesDisciplines and OccupationsAnthropology, Education, Sociology and Social PhenomenaTechnology, Industry, AgricultureInformation ScienceNamed GroupsHealth CareGeographicals
Health Maintenance OrganizationsIndependent Practice AssociationsFee-for-Service PlansCapitation FeePreferred Provider OrganizationsEconomic CompetitionManaged Care ProgramsCaliforniaHealth Care SectorUnited StatesWashingtonHealth Services ResearchCost ControlInsurance Selection BiasFees, MedicalOregonHealth Facility MergerNorthwestern United StatesHealth Benefit Plans, EmployeeEmployer Health CostsQuality of Health CareMedicareInsurance, HealthHealth StatusPrimary Health CareCost SharingGroup Practice, PrepaidDelivery of Health CareHealth Care SurveysMarketing of Health ServicesCompetitive Medical PlansMedicare Part CInsurance, Physician ServicesUtilization ReviewMedicaidHealth ExpendituresRisk Sharing, FinancialHealth Services AccessibilityIsraelGatekeepingPhysician Incentive PlansGroup PracticeData CollectionEconomics, MedicalAmbulatory CareInsurance Claim ReviewOrganizations, NonprofitInsurance BenefitsHealth Care CostsMassachusettsPublic HealthInsurance CoveragePreventive Health ServicesState Health PlansDeductibles and CoinsuranceDrug CostsHospitals, ProprietaryInsurance, Health, ReimbursementSalaries and Fringe BenefitsOutcome Assessment (Health Care)Fees and ChargesMichiganColoradoHealth ServicesAttitude of Health PersonnelHospital AdministrationCosts and Cost AnalysisHealth PromotionDrug Utilization ReviewHealth Services Needs and DemandCost SavingsCase ManagementHealth PolicyPhysician's Practice PatternsRetrospective StudiesHealth Services MisuseChild Health ServicesSpecializationMedicineWisconsinPhysiciansLogistic ModelsReimbursement MechanismsFormularies as TopicCohort StudiesPatient Acceptance of Health CareDrug PrescriptionsMinnesotaQuestionnairesPatient SatisfactionQuality Indicators, Health CareSocioeconomic FactorsRegression AnalysisHealth Care ReformConsumer SatisfactionConsumer ParticipationHealth SurveysCross-Sectional StudiesMental HealthMass ScreeningAttitude to HealthQuality Assurance, Health CareMedical RecordsNew YorkHealthHealth BehaviorDiabetes MellitusAge FactorsHospitalizationWorld Health OrganizationDemographyCost-Benefit AnalysisJob SatisfactionInsurance, Pharmaceutical ServicesHealth PlanningPhysicians, FamilyMultivariate AnalysisOdds RatioRisk AdjustmentSampling StudiesTime FactorsPrevalenceWorld HealthSex FactorsProgram EvaluationPatient Education as TopicPatient ComplianceHealth Knowledge, Attitudes, PracticeInterviews as TopicMammographyHealth PersonnelProspective StudiesRisk FactorsEmergency Service, HospitalDrug UtilizationHealth EducationInfant, NewbornSelf CareGuideline AdherencePractice Guidelines as TopicConfidence IntervalsOral HealthEthnic GroupsTreatment OutcomeEvaluation Studies as TopicGroup PurchasingPublic Health AdministrationMedical Records Systems, ComputerizedLongitudinal StudiesIncomeDatabases, FactualChronic DiseaseRiskOccupational HealthEnvironmental HealthHealth Status DisparitiesPregnancyFamily PracticeSmokingFollow-Up StudiesNational Health ProgramsDelivery of Health Care, IntegratedCase-Control StudiesHealth Care RationingHealth PrioritiesPublic Health PracticeMental Health ServicesChi-Square DistributionCommunity Health ServicesBreast NeoplasmsAsthma
Health Maintenance Organizations: 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)Independent Practice Associations: 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)Fee-for-Service Plans: 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)Capitation Fee: 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.Preferred Provider Organizations: 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.Economic Competition: 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.Managed Care Programs: 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.CaliforniaHealth Care Sector: Economic sector concerned with the provision, distribution, and consumption of health care services and related products.United StatesWashingtonHealth Services Research: 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)Cost Control: 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)Insurance Selection Bias: Adverse or favorable selection bias exhibited by insurers or enrollees resulting in disproportionate enrollment of certain groups of people.Fees, Medical: Amounts charged to the patient as payer for medical services.OregonHealth Facility Merger: The combining of administrative and organizational resources of two or more health care facilities.Northwestern United States: 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 Benefit Plans, Employee: 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.Employer Health Costs: That portion of total HEALTH CARE COSTS borne by an individual's or group's employing organization.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Medicare: 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, Health: Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.Primary Health Care: 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)Cost Sharing: 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)Group Practice, Prepaid: An organized group of three or more full-time physicians rendering services for a fixed prepayment.Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Marketing of Health Services: Application of marketing principles and techniques to maximize the use of health care resources.Competitive Medical Plans: 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)Medicare Part C: 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, Physician Services: 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".Utilization Review: 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.Medicaid: 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.Health Expenditures: 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.Risk Sharing, Financial: 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.Health Services Accessibility: 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.IsraelGatekeeping: 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)Physician Incentive Plans: Compensatory plans designed to motivate physicians in relation to patient referral, physician recruitment, and efficient use of the health facility.Group Practice: 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.Data Collection: 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.Economics, Medical: 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.Ambulatory Care: 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.Insurance Claim Review: 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, Nonprofit: Organizations which are not operated for a profit and may be supported by endowments or private contributions.Insurance Benefits: 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.Health Care Costs: 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.MassachusettsPublic Health: 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.Insurance Coverage: 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)Preventive Health Services: Services designed for HEALTH PROMOTION and prevention of disease.State Health Plans: 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.Deductibles and Coinsurance: 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.Drug Costs: 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, Proprietary: Hospitals owned and operated by a corporation or an individual that operate on a for-profit basis, also referred to as investor-owned hospitals.Insurance, Health, Reimbursement: 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)Salaries and Fringe Benefits: The remuneration paid or benefits granted to an employee.Outcome Assessment (Health Care): 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).Fees and Charges: Amounts charged to the patient as payer for health care services.MichiganColoradoHealth Services: Services for the diagnosis and treatment of disease and the maintenance of health.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Hospital Administration: Management of the internal organization of the hospital.Costs and Cost Analysis: Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care.Drug Utilization Review: 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 Needs and Demand: 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.Cost Savings: Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer.Case Management: 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)Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.Physician's Practice Patterns: Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.Retrospective Studies: 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.Health Services Misuse: Excessive, under or unnecessary utilization of health services by patients or physicians.Child Health Services: Organized services to provide health care for children.Specialization: An occupation limited in scope to a subsection of a broader field.Medicine: The art and science of studying, performing research on, preventing, diagnosing, and treating disease, as well as the maintenance of health.WisconsinPhysicians: Individuals licensed to practice medicine.Logistic Models: 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.Reimbursement Mechanisms: Processes or methods of reimbursement for services rendered or equipment.Formularies as Topic: 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.Cohort Studies: 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.Patient Acceptance of Health Care: The seeking and acceptance by patients of health service.Drug Prescriptions: Directions written for the obtaining and use of DRUGS.MinnesotaQuestionnaires: 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.Patient Satisfaction: 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.Quality Indicators, Health Care: Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.Regression Analysis: 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.Health Care Reform: 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.Consumer Satisfaction: Customer satisfaction or dissatisfaction with a benefit or service received.Consumer Participation: Community or individual involvement in the decision-making process.Health Surveys: A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area.Cross-Sectional Studies: 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.Mental Health: The state wherein the person is well adjusted.Mass Screening: Organized periodic procedures performed on large groups of people for the purpose of detecting disease.Attitude to Health: Public attitudes toward health, disease, and the medical care system.Quality Assurance, Health Care: 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.Medical Records: Recording of pertinent information concerning patient's illness or illnesses.New YorkHealth: The state of the organism when it functions optimally without evidence of disease.Health Behavior: 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.Diabetes Mellitus: A heterogeneous group of disorders characterized by HYPERGLYCEMIA and GLUCOSE INTOLERANCE.Age Factors: 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.Hospitalization: The confinement of a patient in a hospital.World Health Organization: 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.Demography: Statistical interpretation and description of a population with reference to distribution, composition, or structure.Cost-Benefit Analysis: 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.Job Satisfaction: Personal satisfaction relative to the work situation.Insurance, Pharmaceutical Services: Insurance providing for payment of services rendered by the pharmacist. Services include the preparation and distribution of medical products.Health Planning: Planning for needed health and/or welfare services and facilities.Physicians, Family: Those physicians who have completed the education requirements specified by the American Academy of Family Physicians.Multivariate Analysis: 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.Odds Ratio: 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.Risk Adjustment: 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)Sampling Studies: 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.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Prevalence: 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.World Health: The concept pertaining to the health status of inhabitants of the world.Sex Factors: 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.Program Evaluation: 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.Patient Education as Topic: The teaching or training of patients concerning their own health needs.Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen.Health Knowledge, Attitudes, Practice: 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).Interviews as Topic: 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.Mammography: Radiographic examination of the breast.Health Personnel: 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)Prospective Studies: 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.Risk Factors: 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.Emergency Service, Hospital: Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.Drug Utilization: The utilization of drugs as reported in individual hospital studies, FDA studies, marketing, or consumption, etc. This includes drug stockpiling, and patient drug profiles.Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis.Infant, Newborn: An infant during the first month after birth.Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends.Guideline Adherence: Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.Practice Guidelines as Topic: 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.Confidence Intervals: 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.Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease.Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships.Treatment Outcome: 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.Evaluation Studies as Topic: 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.Group Purchasing: 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)Public Health Administration: Management of public health organizations or agencies.Medical Records Systems, Computerized: Computer-based systems for input, storage, display, retrieval, and printing of information contained in a patient's medical record.Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time.Income: Revenues or receipts accruing from business enterprise, labor, or invested capital.Databases, Factual: 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.Chronic Disease: 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)Risk: The probability that an event will occur. It encompasses a variety of measures of the probability of a generally unfavorable outcome.Occupational Health: The promotion and maintenance of physical and mental health in the work environment.Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health.Health Status Disparities: 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.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.Smoking: Inhaling and exhaling the smoke of burning TOBACCO.Follow-Up Studies: 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.National Health Programs: Components of a national health care system which administer specific services, e.g., national health insurance.Delivery of Health Care, Integrated: 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)Case-Control Studies: 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.Health Care Rationing: Planning for the equitable allocation, apportionment, or distribution of available health resources.Health Priorities: Preferentially rated health-related activities or functions to be used in establishing health planning goals. This may refer specifically to PL93-641.Public Health Practice: The activities and endeavors of the public health services in a community on any level.Mental Health Services: Organized services to provide mental health care.Chi-Square Distribution: 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.Community Health Services: Diagnostic, therapeutic and preventive health services provided for individuals in the community.Breast Neoplasms: Tumors or cancer of the human BREAST.Asthma: 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)

Health Maintenance Organizations financial definition of Health Maintenance OrganizationsHealth Maintenance Organizations financial definition of Health Maintenance Organizations
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?
NRS: CHAPTER 695C - HEALTH MAINTENANCE ORGANIZATIONSNRS: CHAPTER 695C - HEALTH MAINTENANCE ORGANIZATIONS
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; ...
Health Maintenance Organizations Arlington VA - health maintenance organizations, Arlington VA health plan, Arlington VA ...Health Maintenance Organizations Arlington VA - health maintenance organizations, Arlington VA health plan, Arlington VA ...
Learn more about health maintenance organizations and and pick the right plan for you in Arlington. Get free quotes that compare great rates.
Sec. 62D.12 MN StatutesSec. 62D.12 MN Statutes
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. ...
Plus itPlus it
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 ...
Health Maintenance Organizations (HMOs)Health Maintenance Organizations (HMOs)
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 ...
health maintenance organizations - Boulder, CO - Daily Camerahealth maintenance organizations - Boulder, CO - Daily Camera
Daily Camera reviews for health maintenance organizations in Boulder, CO - Helping Hands Health Education, Herb Research Foundation, Longmont Athletic Club West, Longmont Athletic Club,
Jobs in a Health Maintenance Organization via Ashford and McGuire Consulting - 30 October, 2015Jobs in a Health Maintenance Organization via Ashford and McGuire Consulting - 30 October, 2015
Jobs in a Health Maintenance Organization via Ashford and McGuire Consulting for Business Development Managers in Lagos, Nigeria for job seekers and professionals. Apply today
24/7 Pharmacy: Where to find viagra in winnipeg TOP seller24/7 Pharmacy: Where to find viagra in winnipeg TOP seller
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 ...
Hospital Days per Cancer Patient during the Last Month of Life - Dartmouth Atlas of Health CareHospital Days per Cancer Patient during the Last Month of Life - Dartmouth Atlas of Health Care
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. ...
A comprehensive influenza campaign in a managed care setting. | Base documentaire | BDSPA comprehensive influenza campaign in a managed care setting. | Base documentaire | BDSP
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,...
GLOSSARY OF HEALTH TERMS - SFGateGLOSSARY OF HEALTH TERMS - SFGate
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
Health Insurance Off the Grid | Deductible | Health Maintenance OrganizationHealth Insurance Off the Grid | Deductible | Health Maintenance Organization
Health Insurance Off the GridHealth Insurance Off the Grid A Wonderful Way To Use Alternative Medicine and Save Money on Insurance ...
Alka Aggarwal, MDAlka Aggarwal, MD
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 ...
Kenneth R. Feuer, MDKenneth R. Feuer, MD
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 ...
D. Raymond Knapp, MDD. Raymond Knapp, MD
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 ...
National Health Interview Survey, 1975: Health Maintenance Organization (HMO) SupplementNational Health Interview Survey, 1975: Health Maintenance Organization (HMO) Supplement
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.. ...
Health Maintenance Organizations (HMOs).... : Critical Reasoning (CR)Health Maintenance Organizations (HMOs).... : Critical Reasoning (CR)
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 ...
Browse subject: Mental health -- United States -- Periodicals | The Online Books PageBrowse subject: Mental health -- United States -- Periodicals | The Online Books Page
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 ...
INSURANCE CODE CHAPTER 843. HEALTH MAINTENANCE ORGANIZATIONSINSURANCE CODE CHAPTER 843. HEALTH MAINTENANCE ORGANIZATIONS
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 ...
Accountable Care SystemsAccountable Care Systems
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 ...
Competition, Payer, and Hospital QualityCompetition, Payer, and Hospital Quality
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 ...
Issue Brief No. 28Issue Brief No. 28
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 ...
Building Resilience - Benton Franklin Health DistrictBuilding Resilience - Benton Franklin Health District
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 ...
Statistics: Dansk Kennel Klub (DENMARK)Statistics: Dansk Kennel Klub (DENMARK)
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. ...
Институт педагогикиИнститут педагогики
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. ...
Exclusive: Costs to public of $84,000 hep C drug outrageous - Kaiser | ReutersExclusive: Costs to public of $84,000 hep C drug 'outrageous' - Kaiser | Reuters
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.
The Main Forms Of Managed Care - tribunedigital-thecourantThe Main Forms Of Managed Care - tribunedigital-thecourant
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
Statutes & Constitution :View Statutes :->2010->Chapter 641->Part I : ...Statutes & Constitution :View Statutes :->2010->Chapter 641->Part I : ...
Soliciting or accepting new or renewal health maintenance contracts by insolvent or impaired health maintenance organization prohibited; penalty ...
FAQs on HMO Plans - Outsource2indiaFAQs on HMO Plans - Outsource2india
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.
April 7 - News Room - UNC Health CareApril 7 - News Room - UNC Health Care
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 expected to see big increases in HMO insurance costs next year, study says - California Hospital AssociationLarge companies expected to see big increases in HMO insurance costs next year, study says - California Hospital Association
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. ...
Bill to force HMOs to take more black doctors stalls Hearing panel cites weaknesses in proposal to quell alleged racism -...Bill to force HMOs to take more black doctors stalls Hearing panel cites weaknesses in proposal to quell alleged racism -...
An attempt to propel legislation requiring health maintenance organizations to accept more black doctors into citywide health care plans stalled at a City Council hearing last night when a panel
Plus itPlus it
The complete outpatient medical record of frequent callers and a comparison group were carefully examined for all office contacts between April 2000 and March 2001. When the caller was not the patient (parent, spouse, caretaker, etc), we used the identified patients chart. Three charts of frequent callers could not be located and were not included in further analysis. The first author used a standardized chart abstraction instrument to determine age, sex, number of office visits, number of diagnoses listed on the problem list, and details of prescribed medications. The practice had approximately 12,000 active patients (at least 1 visit to the practice in the last 2 years) with about 1,350 patient visits per month. Approximately 30% were insured by Medicaid, 10% by Medicare, 35% by a health maintenance organization/preferred provider organization, and 12% by a third party payer; 13% were uninsured.. Data were entered into an Access database. Medications were categorized as prescribed for pain, ...
Glossary | Benefit Plan AdministratorsGlossary | Benefit Plan Administrators
Systems and techniques used to control the use of health care services. Includes a review of medical necessity, incentives to use certain providers, and case management. The body of clinical, financial and organizational activities designed to ensure the provision of appropriate health care services in a cost-efficient manner. Managed care techniques are most often practiced by organizations and professionals which assume risk for a defined population (e.g., health maintenance organizations) but this is not always the case. Managed care is a broad term and encompasses many different types of organizations, payment mechanisms, review mechanisms and collaborations. Managed care is sometimes used as a general term for the activity of organizing doctors, hospitals, and other providers into groups in order to enhance the quality and cost-effectiveness of health care. Managed Care Organizations (MCO) include HMO, PPO, POS, EPO, PHO, IDS, AHP, IPA, etc. Usually when one speaks of a managed care ...
Sec. 256B.692 MN StatutesSec. 256B.692 MN Statutes
a) Notwithstanding chapters 62D and 62N, a county that elects to purchase medical assistance in return for a fixed sum without regard to the frequency or extent of services furnished to any particular enrollee is not required to obtain a certificate of authority under chapter 62D or 62N. The county board of commissioners is the governing body of a county-based purchasing program. In a multicounty arrangement, the governing body is a joint powers board established under section 471.59.. (b) A county that elects to purchase medical assistance services under this section must satisfy the commissioner of health that the requirements for assurance of consumer protection, provider protection, and, effective January 1, 2010, fiscal solvency of chapter 62D, applicable to health maintenance organizations will be met according to the following schedule:. (1) for a county-based purchasing plan approved on or before June 30, 2008, the plan must have in reserve:. (i) at least 50 percent of the minimum amount ...
Medicine by remote control - tribunedigital-baltimoresunMedicine by remote control - tribunedigital-baltimoresun
A FRIEND received a phone call that her 18-year-old son had been in a serious accident. He needed delicate reconstructive surgery on his face.The Health Maintenance Organization (HMO) that provided
Medical Assisting | Stanly Community CollegeMedical Assisting | Stanly Community College
Contact(s): Starra Herring. The Medical Assisting curriculum prepares multi-skilled health care professionals qualified to perform administrative, clinical, and laboratory procedures.. Coursework includes instruction in scheduling appointments, coding and processing insurance accounts, billing, collections, computer operations, assisting with examinations/treatments, performing routine laboratory procedures, electrocardiography, supervised medication administration; and ethical/legal issues associated with patient care.. Employment opportunities include physicians offices, health maintenance organizations, health departments, and hospitals. If possible, individuals desiring a career in medical assisting should take biology, mathematics, and typing courses prior to entering the program. Students are admitted to the Medical Assisting program during the fall semester.. ...
HEALTH CARE WATCH;MANAGING CARE FOR SENIORS ON A MONTHLY FEE BASIS;BETH ABRAHAM EXPANDING PROJECTHEALTH CARE WATCH;MANAGING CARE FOR SENIORS ON A MONTHLY FEE BASIS;BETH ABRAHAM EXPANDING PROJECT
Hotly pursued by health maintenance organizations, New Yorks senior citizens are getting their first taste of managed care.But some 400 elderly patients in the Bronx already have had years of experience with paying a set monthly fee to cover all their medical services. These low-income seniors are…
Doctors May Lie To Get Aid For Patients - tribunedigital-chicagotribuneDoctors May Lie To Get Aid For Patients - tribunedigital-chicagotribune
Many physicians approve of deceiving insurance companies or health maintenance organizations to secure payment for treatment if patients cannot get it any other way, a survey found.The survey of 169
Section 31Section 31
... To the maximum extent possible, every health maintenance organization shall attribute every member to a primary care provider. Members may change their primary care provider, provided that the member gives notice to the carrier. ...
Prevention and Health Maintenance Research Studies, Clinical Trials and Publications at Sutter Health | Sutter HealthPrevention and Health Maintenance Research Studies, Clinical Trials and Publications at Sutter Health | Sutter Health
Review the latest Prevention and Health Maintenance research at Sutter Healths world-class research institutes. See current studies, clinical trials, publications and more.
Group Health Cooperative Scored Above Regional Average in 11 of 15 Qualit... ( SEATTLE July 20 --...)Group Health Cooperative Scored Above Regional Average in 11 of 15 Qualit... ( SEATTLE July 20 --...)
Health,... ... ... ...SEATTLE July 20 -- Group Health Cooperative m...,Group,Health,Cooperative,Scored,Above,Regional,Average,in,11,of,15,Quality,Measures,medicine,medical news today,latest medical news,medical newsletters,current medical news,latest medicine news
Medical Assistant - Primary Care Float Per Diem East King Job in Bellevue, WA at Group Health Cooperative, 575915544 | Americas...Medical Assistant - Primary Care Float Per Diem East King Job in Bellevue, WA at Group Health Cooperative, 575915544 | Americas...
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.
Post-traumatic stress disorder and somatization symptoms : a prospective study. | Base documentaire | BDSPPost-traumatic stress disorder and somatization symptoms : a prospective study. | Base documentaire | BDSP
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...
CMS1191574 - Centers for Medicare & Medicaid ServicesCMS1191574 - Centers for Medicare & Medicaid Services
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 ...
Survey: Health insurers show advances in NP credentialing, reimbursement - Drug Store NewsSurvey: Health insurers show advances in NP credentialing, reimbursement - Drug Store News
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 ...
Kaiser Permanente Study Shows Minorities Had Lower Risk of Coronary Heart Disease than Whites :: By :: Article :: Super DoctorsKaiser Permanente Study Shows Minorities Had Lower Risk of Coronary Heart Disease than Whites :: By :: Article :: Super Doctors
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 ...
MEDICARE HMOS: State Senator Calls For Federal Action To Halt Withdrawals | California HealthlineMEDICARE HMOS: State Senator Calls For Federal Action To Halt Withdrawals | California Healthline
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 ...
IDOI: Limited Service Health Maintenance OrganizationIDOI: Limited Service Health Maintenance Organization
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. ...
14 topics14 topics
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 ...
1. Healthcare System in the United States1. Healthcare System in the United States
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 ...
Dean lends hand to Group Health caregivers - seattlepi.comDean lends hand to Group Health caregivers - seattlepi.com
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.
Fighting Strokes at Lightspeed - Kaiser Permanente Look insideKP Northern CaliforniaFighting Strokes at Lightspeed - Kaiser Permanente Look insideKP Northern California
Neurologists of the Kaiser Permanente Northern California Stroke FORCE team get clot-busting alteplase to patients twice as fast as the national average.
United Healthcare Exclusive Provider Organization (EPO) | MNCPPC, MDUnited Healthcare Exclusive Provider Organization (EPO) | MNCPPC, MD
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).
Kaiser Permanente Approves $22 Million in Community Benefit Grants in Second Quart... ( Focus on Community Health an.....Kaiser Permanente Approves $22 Million in Community Benefit Grants in Second Quart... ( Focus on Community Health an.....
Health,... Focus on Community Health and Charitable Care and Coverage/...OAKLAND Calif. July 29 /- Kaiser Permanente announcedt... Kaiser Permanente has a long history of funding programs that extend...Care and Coverage for Low-Income People ...,Kaiser,Permanente,Approves,$22,Million,in,Community,Benefit,Grants,in,Second,Quarter,of,2008,medicine,medical news today,latest medical news,medical newsletters,current medical news,latest medicine news
What are (a) preferred provider organizations and (b) health maiWhat are (a) preferred provider organizations and (b) health mai
... ntenance organizations? In your answer, explain how each is designed to alleviate the overconsum
Transforming the Health Care Response to Domestic Violence - Kaiser Permanente ShareTransforming the Health Care Response to Domestic Violence - Kaiser Permanente Share
Using an innovative approach, Kaiser Permanente Northern California has dramatically increased the recognition of patients experiencing intimate partner or
California State Auditor - Report 2001-126 Summary - May 2002California State Auditor - Report 2001-126 Summary - May 2002
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 ...
5 Takeaways That I Learned About Policies - AC5 Takeaways That I Learned About Policies - AC
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 ...
IBIS-PH - Related Health Indicator Reports - Managed Care (CAHPS) Survey: Patient Ratings of Health Plan ExperienceIBIS-PH - Related Health Indicator Reports - Managed Care (CAHPS) Survey: Patient Ratings of Health Plan Experience
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
Plus itPlus it
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 ...
DMS Memo on Telehealth & Immunizations for State Group Insurance - Katherine Fernandez RundleDMS Memo on Telehealth & Immunizations for State Group Insurance - Katherine Fernandez Rundle
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 Coverage - Visalia CA & Tulare CA - DG Insurance Agency, Inc.Dental Coverage - Visalia CA & Tulare CA - DG Insurance Agency, Inc.
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 Coverage - Champaign IL & Urbana IL - Prairieland Insurance Group, LLCDental Coverage - Champaign IL & Urbana IL - Prairieland Insurance Group, LLC
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).
IBIS-PH - Related Health Indicator Reports - Managed Care (CAHPS) Survey: Patient Rating of Experience with Getting Needed...IBIS-PH - Related Health Indicator Reports - Managed Care (CAHPS) Survey: Patient Rating of Experience with Getting Needed...
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
Florida Pricing Transparency | Blake Medical Center | Bradenton, FLFlorida Pricing Transparency | Blake Medical Center | Bradenton, FL
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.. ...
Fresenius Medical Care - Stapleton | Clinic | Health & Nutrition ...Fresenius Medical Care - Stapleton | Clinic | Health & Nutrition ...
Fresenius Medical Care - Stapleton | Clinic | Health & Nutrition | Health & Wellness | Health Counseling | Health Maintenance Organization | Health Products | Health Services Companies | Healthcare | Healthcare Management | Healthcare Support Services | Healthy Living & Wellness Consultant
Kaiser Permanente Pharmacy Locations & Hours Near Kensington, MD - YP.comKaiser Permanente Pharmacy Locations & Hours Near Kensington, MD - YP.com
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.
Little Pharmacy: Canadian pharmacy nolvadex no prescription prime quality!Little Pharmacy: Canadian pharmacy nolvadex no prescription prime quality!
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 - Manteca, CAKaiser Permanente Manteca Medical Center - Manteca, CA
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.
House Bill 351 (2018) - The Florida SenateHouse Bill 351 (2018) - The Florida Senate
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. ...
Why Homebirth? • Midwifery TodayWhy Homebirth? • Midwifery Today
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.
Arrowhead Pharmaceuticals, Inc. - Annual ReportArrowhead Pharmaceuticals, Inc. - Annual Report
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 ...
Plus itPlus it
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 ...
Kaiser Permanente research « A History of Total Health | Kaiser Permanente History BlogKaiser Permanente research « A History of Total Health | Kaiser Permanente History Blog
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
FindACase | Connolly v. Aetna U.S. HealthcareFindACase | Connolly v. Aetna U.S. Healthcare
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: Be Healthy, Stay Healthy - Love WellnessHealth Maintenance: Be Healthy, Stay Healthy - Love Wellness
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
Kaiser Permanente: KP DC Bronze 5000/30%/HSA/Dental/PedDental This is only a summary.Kaiser Permanente: KP DC Bronze 5000/30%/HSA/Dental/PedDental This is only a summary.
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 ...
Kaiser Permanente Awards $195,000 to HIV/AIDS Organizations in Northern California; $362,500 In Grants Statewide Brings Total...Kaiser Permanente Awards $195,000 to HIV/AIDS Organizations in Northern California; $362,500 In Grants Statewide Brings Total...
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
Pet Health Maintenance in Shawnee KSPet Health Maintenance in Shawnee KS
Mill Creek Animal Hospital provides health maintenance for your pets in Shawnee KS. Contact 913-268-0900 for an appointment today.
Jacquelyn N. | American Lung AssociationJacquelyn N. | American Lung Association
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.
Kaiser Permanente Names Kathryn Beiser Chief Communications OfficerKaiser Permanente Names Kathryn Beiser Chief Communications Officer
/PRNewswire/ -- Kaiser Permanente announced today that Kathryn Beiser has been selected as senior vice president and chief communications officer for Kaiser...
Intake of Antidepressants by Expecting Mothers Can Cause Autism in the Baby | Health DoctrineIntake of Antidepressants by Expecting Mothers Can Cause Autism in the Baby | Health Doctrine
According to a study conducted by a team of researchers in Kaiser Permanente Northern California, Oakland, expecting mothers should stay away from antidepressants since the drugs might cause autism in babies.
High-quality Personal Relationships Improve Survival in Women with Breast Cancer - Healthcanal.com : Healthcanal.comHigh-quality Personal Relationships Improve Survival in Women with Breast Cancer - Healthcanal.com : Healthcanal.com
Previous research has shown that women with larger social networks-includingspouses or partners, female relatives, friends, religious and social ties, and ties to the community through volunteering-have better breast cancer survival. This study is among the first to show that the quality of those relationships also is important to survival.. The study included 2,264 women who were diagnosed with early-stage, invasive breast cancer between 1997 and 2000, and who were part of the Life After Cancer Epidemiology (LACE) study. After providing information on their personal relationships, they were characterized as socially isolated (few ties), moderately integrated, or socially integrated (many ties). "We found that women with small social networks had a significantly higher risk of mortality than those with large networks," said Candyce H. Kroenke, ScD, MPH, a research scientist with the Kaiser Permanente Northern California Division of Research and lead author of the study. The study found that ...
Old Oakland hospital holds memories of Kaiser Permanentes dynamic past « A History of Total Health | Kaiser Permanente...Old Oakland hospital holds memories of Kaiser Permanente's dynamic past « A History of Total Health | Kaiser Permanente...
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
What are some of the benefits of Kaiser Permanente health care? | Reference.comWhat are some of the benefits of Kaiser Permanente health care? | Reference.com
Kaiser Permanente health care offers 24-hour medical advice, online appointment setting, access to online health records and test results, individual doctor profiles, and multilingual doctors and...
Lessons America Should Learn From a Land of Free Health Care | Managed Care magazineLessons America Should Learn From a Land of 'Free' Health Care | Managed Care magazine
Im surprised by those experts in the United States who dont seem to understand that if medical care has low or no copayments people will use the service more. If there were no charge for going to the movies, wouldnt we go more often? If we could get a baby sitter at little or no cost, wouldnt she be in our house all the time?. Similarly, when my San Diego group added 17,000 Medicare HMO patients in 1986, we found a very high percentage of frail, elderly, ill patients amongst those joining. The patients who flocked to us then were not vital, healthy souls with little previous medical expense; they were, in contrast, those who had been overwhelmed by constant visits to their doctors and were bewildered by the paper work of Medicare Part B.. Of course, not all demands on medical services are unwarranted. Still, my sense of déjà vu prompts the questions: What can the British experience teach the United States? What might help U.S. managed care executives and their doctors reduce unfair ...
Richard W. Grant, MD, MPH: Tips to Prevent DiabetesRichard W. Grant, MD, MPH: Tips to Prevent Diabetes
Richard W. Grant, MD, MPH, a research scientist at the Division of Research, Kaiser Permanente Northern California, advises clinicians to first try to gain and understanding of each individual patient first then move forward for a tailored approach to diabetes management.... More videos with Dr. Grant: Richard
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Health Maintenance OrganizationsIndependent Practice AssociationsFee-for-Service PlansCapitation FeePreferred Provider OrganizationsEconomic CompetitionManaged Care ProgramsCaliforniaHealth Care SectorUnited StatesWashingtonHealth Services ResearchCost ControlInsurance Selection BiasFees, MedicalOregonHealth Facility MergerNorthwestern United StatesHealth Benefit Plans, EmployeeEmployer Health CostsQuality of Health CareMedicareInsurance, HealthHealth StatusPrimary Health CareCost SharingGroup Practice, PrepaidDelivery of Health CareHealth Care SurveysMarketing of Health ServicesCompetitive Medical PlansMedicare Part CInsurance, Physician ServicesUtilization ReviewMedicaidHealth ExpendituresRisk Sharing, FinancialHealth Services AccessibilityIsraelGatekeepingPhysician Incentive PlansGroup PracticeData CollectionEconomics, MedicalAmbulatory CareInsurance Claim ReviewOrganizations, NonprofitInsurance BenefitsHealth Care CostsMassachusettsPublic HealthInsurance CoveragePreventive Health ServicesState Health PlansDeductibles and CoinsuranceDrug CostsHospitals, ProprietaryInsurance, Health, ReimbursementSalaries and Fringe BenefitsOutcome Assessment (Health Care)Fees and ChargesMichiganColoradoHealth ServicesAttitude of Health PersonnelHospital AdministrationCosts and Cost AnalysisHealth PromotionDrug Utilization ReviewHealth Services Needs and DemandCost SavingsCase ManagementHealth PolicyPhysician's Practice PatternsRetrospective StudiesHealth Services MisuseChild Health ServicesSpecializationMedicineWisconsinPhysiciansLogistic ModelsReimbursement MechanismsFormularies as TopicCohort StudiesPatient Acceptance of Health CareDrug PrescriptionsMinnesotaQuestionnairesPatient SatisfactionQuality Indicators, Health CareSocioeconomic FactorsRegression AnalysisHealth Care ReformConsumer SatisfactionConsumer ParticipationHealth SurveysCross-Sectional StudiesMental HealthMass ScreeningAttitude to HealthQuality Assurance, Health CareMedical RecordsNew YorkHealthHealth BehaviorDiabetes MellitusAge FactorsHospitalizationWorld Health OrganizationDemographyCost-Benefit AnalysisJob SatisfactionInsurance, Pharmaceutical ServicesHealth PlanningPhysicians, FamilyMultivariate AnalysisOdds RatioRisk AdjustmentSampling StudiesTime FactorsPrevalenceWorld HealthSex FactorsProgram EvaluationPatient Education as TopicPatient ComplianceHealth Knowledge, Attitudes, PracticeInterviews as TopicMammographyHealth PersonnelProspective StudiesRisk FactorsEmergency Service, HospitalDrug UtilizationHealth EducationInfant, NewbornSelf CareGuideline AdherencePractice Guidelines as TopicConfidence IntervalsOral HealthEthnic GroupsTreatment OutcomeEvaluation Studies as TopicGroup PurchasingPublic Health AdministrationMedical Records Systems, ComputerizedLongitudinal StudiesIncomeDatabases, FactualChronic DiseaseRiskOccupational HealthEnvironmental HealthHealth Status DisparitiesPregnancyFamily PracticeSmokingFollow-Up StudiesNational Health ProgramsDelivery of Health Care, IntegratedCase-Control StudiesHealth Care RationingHealth PrioritiesPublic Health PracticeMental Health ServicesChi-Square DistributionCommunity Health ServicesBreast NeoplasmsAsthma
National Health Interview Survey, 1975: Health Maintenance Organization (HMO) SupplementNational Health Interview Survey, 1975: Health Maintenance Organization (HMO) Supplement
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DiseasesAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPsychiatry and PsychologyPhenomena and ProcessesDisciplines and OccupationsAnthropology, Education, Sociology and Social PhenomenaTechnology, Industry, AgricultureInformation ScienceNamed GroupsHealth CareGeographicals
Health Maintenance OrganizationsIndependent Practice AssociationsFee-for-Service PlansCapitation FeePreferred Provider OrganizationsEconomic CompetitionManaged Care ProgramsCaliforniaHealth Care SectorUnited StatesWashingtonHealth Services ResearchCost ControlInsurance Selection BiasFees, MedicalOregonHealth Facility MergerNorthwestern United StatesHealth Benefit Plans, EmployeeEmployer Health CostsQuality of Health CareMedicareInsurance, HealthHealth StatusPrimary Health CareCost SharingGroup Practice, PrepaidDelivery of Health CareHealth Care SurveysMarketing of Health ServicesCompetitive Medical PlansMedicare Part CInsurance, Physician ServicesUtilization ReviewMedicaidHealth ExpendituresRisk Sharing, FinancialHealth Services AccessibilityIsraelGatekeepingPhysician Incentive PlansGroup PracticeData CollectionEconomics, MedicalAmbulatory CareInsurance Claim ReviewOrganizations, NonprofitInsurance BenefitsHealth Care CostsMassachusettsPublic HealthInsurance CoveragePreventive Health ServicesState Health PlansDeductibles and CoinsuranceDrug CostsHospitals, ProprietaryInsurance, Health, ReimbursementSalaries and Fringe BenefitsOutcome Assessment (Health Care)Fees and ChargesMichiganColoradoHealth ServicesAttitude of Health PersonnelHospital AdministrationCosts and Cost AnalysisHealth PromotionDrug Utilization ReviewHealth Services Needs and DemandCost SavingsCase ManagementHealth PolicyPhysician's Practice PatternsRetrospective StudiesHealth Services MisuseChild Health ServicesSpecializationMedicineWisconsinPhysiciansLogistic ModelsReimbursement MechanismsFormularies as TopicCohort StudiesPatient Acceptance of Health CareDrug PrescriptionsMinnesotaQuestionnairesPatient SatisfactionQuality Indicators, Health CareSocioeconomic FactorsRegression AnalysisHealth Care ReformConsumer SatisfactionConsumer ParticipationHealth SurveysCross-Sectional StudiesMental HealthMass ScreeningAttitude to HealthQuality Assurance, Health CareMedical RecordsNew YorkHealthHealth BehaviorDiabetes MellitusAge FactorsHospitalizationWorld Health OrganizationDemographyCost-Benefit AnalysisJob SatisfactionInsurance, Pharmaceutical ServicesHealth PlanningPhysicians, FamilyMultivariate AnalysisOdds RatioRisk AdjustmentSampling StudiesTime FactorsPrevalenceWorld HealthSex FactorsProgram EvaluationPatient Education as TopicPatient ComplianceHealth Knowledge, Attitudes, PracticeInterviews as TopicMammographyHealth PersonnelProspective StudiesRisk FactorsEmergency Service, HospitalDrug UtilizationHealth EducationInfant, NewbornSelf CareGuideline AdherencePractice Guidelines as TopicConfidence IntervalsOral HealthEthnic GroupsTreatment OutcomeEvaluation Studies as TopicGroup PurchasingPublic Health AdministrationMedical Records Systems, ComputerizedLongitudinal StudiesIncomeDatabases, FactualChronic DiseaseRiskOccupational HealthEnvironmental HealthHealth Status DisparitiesPregnancyFamily PracticeSmokingFollow-Up StudiesNational Health ProgramsDelivery of Health Care, IntegratedCase-Control StudiesHealth Care RationingHealth PrioritiesPublic Health PracticeMental Health ServicesChi-Square DistributionCommunity Health ServicesBreast NeoplasmsAsthma
HMOsPhysicians1973InsurersServicesHospitals2016InsuranceHealthcarePublic HealthHospital1975PlanPreventive healthType 2 diabetDelivering health careGroupContractsOutcomesDefinitionLargeCentersCoveragePremiumsHMO'sInsurerPlansServicesPrimary care physEnrollmentOutpatientOrganization'sSearchChronic ObstrucUtilizationPolit Policy LawDefinitionHypertensionWolters KluwerCapitationProvidersWest Metro ChamberBenefitsDefinitionsMentalContractsMembersProvideTypeReformEntitiesPreventive medicine
HMOs8
  • Health Maintenance Organizations (HMOs). (gmatclub.com)
  • 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)
  • 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)
  • Health maintenance organization (HMO): HMOs offer prepaid, comprehensive health coverage for both hospital and physician services. (sfgate.com)
Physicians1
19732
  • They trace their origins to the early 20th century, but became more popular after the Health Maintenance Organization Act of 1973 . (thefreedictionary.com)
  • Nixon responded to a healthcare funding crisis in 1970 when healthcare was 7.1% of GDP and passed the Health Maintenance Organisation Act 1973. (sochealth.co.uk)
Insurers6
  • 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 maintenance organization subject to requirements for certain insurers. (nv.us)
  • But Gilead has come under fire, from insurers and Congress, for Sovaldi's $1,000-a-pill price at a time when U.S. healthcare spending is under scrutiny and President Barack Obama's Affordable Care Act aims to make health coverage accessible to everyone. (reuters.com)
  • She called Kaiser's discount on Sovaldi "modest" and said state Medicaid programs and private health insurers "are going to have to make very serious tradeoffs just based on a single manufacturer's decision on pricing a drug because they can. (reuters.com)
  • Insurers and state officials running the Medicaid health program for the poor fear a multibillion-dollar tab from Sovaldi alone. (reuters.com)
  • Investment bank Leerink Partners estimates the drug's cost could trim as much as 10 percent from the earnings of publicly traded health insurers. (reuters.com)
Services9
  • 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)
  • Members must use participating providers for all health services. (sfgate.com)
  • to provide health services. (sfgate.com)
  • Like other providers, Beth Abraham is looking to position itself geographically in order to be a more effective competi tor," notes Jeffrey G. Blumengold, partner in charge of health-care services at accounting firm M.R. Weiser & Co. (crainsnewyork.com)
  • CONCLUSIONS Frequent callers represent a unique group of patients with high utilization of health care services. (annfammed.org)
  • Better targeted patient education and referral to other support services may decrease the number of calls and utilization of health services. (annfammed.org)
  • Health services researchers typically identify high utilizers by their number of visits to the office. (annfammed.org)
  • These are defined as a medical insurance group that provides health services for a fixed annual fee. (sochealth.co.uk)
Hospitals2
  • 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)
  • An HMO contracts with health care providers, including doctors, hospitals and others. (sfgate.com)
20161
Insurance4
  • A nonprofit organization that offers health insurance to a group of persons and charges members of the group the same monthly premium. (thefreedictionary.com)
  • NRS 695C.057 Applicability of certain provisions concerning portability and availability of health insurance. (nv.us)
  • 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. (calhospital.org)
  • It is an organisation that provides or arranges managed care for health insurance, self-funded health care benefits plans, individuals, or other entities, acting as a liaison with healthcare providers on a prepaid basis. (sochealth.co.uk)
Healthcare2
  • They are a Health Maintenance Organization which was established with the objective of becoming the HMO of choice for corporate entities and all subscribing enrolees, who want good quality healthcare accessed through a technology enabled platform that will enhance the whole customer experience. (myjobmag.com)
  • The largest provider in the Maryland-Washington area is the first healthcare system to join a network leveraging Cerner's electronic health record and HealtheIntent platforms to support clinical research. (healthdatamanagement.com)
Public Health3
  • 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. (umich.edu)
  • It's an outrageous price for a therapy that has huge public health implications. (reuters.com)
  • In the wake of the novel coronavirus outbreak, the HHS Office for Civil Rights is detailing how patient information can be shared to protect public health under the HIPAA privacy rule. (healthdatamanagement.com)
Hospital2
  • Because of Beth Abraham's expertise in capitation and its ability to generate a surplus, many health-care facilities have approached the Bronx hospital about joint ventures. (crainsnewyork.com)
  • The Department of Veterans Affairs' Palo Alto Health Care System is on the verge of becoming the world's first 5G-enabled hospital. (healthdatamanagement.com)
19751
  • 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)
Plan2
  • 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)
Preventive health1
  • 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)
Type 2 diabet1
  • First 20 months' experience with use of metformin for type 2 diabetes in a large health maintenance organization. (diabetesjournals.org)
Delivering health care1
  • d)Fee-for-service methods of delivering health care have perverse incentives to provide unnecessary health care at inflated costs. (gmatclub.com)
Group1
Contracts1
  • NRS 695C.123 Contracts with certain federally qualified health centers. (nv.us)
Outcomes1
  • 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. (wa.gov)
Definition1
  • This resembles the definition of Health Maintenance Organisations that emerged in the 1970s. (sochealth.co.uk)
Large1
  • 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. (diabetesjournals.org)
Centers3
  • 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.123 Contracts with certain federally qualified health centers. (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)
Coverage37
  • 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)
  • Beyond health coverage, you can count on us to provide impactful community initiatives and leadership in improving health care. (baycityarea.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)
  • 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)
  • 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)
  • 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)
  • This plan provides coverage to participants through a network of select health care providers, like physicians and hospitals. (benzinga.com)
  • Our funding options and group health expense accounts offer even more ways to create health coverage on your terms. (anthem.com)
  • a) Each enrollee residing in this state is entitled to evidence of coverage under a health care plan. (texas.gov)
  • b) The health maintenance organization shall issue the evidence of coverage, except as provided by Subsection (c). (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)
  • 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)
  • As a PPO health plan member, you get maximum benefit coverage when you use the PPO network of physicians and hospitals. (csub.edu)
  • The amount of coverage offered for each essential health benefit varies by plan type and insurance company. (progressive.com)
  • At Blue Cross and Blue Shield of Illinois (BCBSIL), we want to help you better understand your health care coverage. (bcbsil.com)
  • If you have a Qualified Health Plan , please select your coverage type below. (bcbsil.com)
  • If you purchased your health insurance plan directly from BCBSIL or through the Health Insurance Marketplace, you have Individual Coverage . (bcbsil.com)
  • If you have health care coverage through your job and your employer has between 1 and 50 full-time employees (FTEs), your insurance is considered Small Group Coverage . (bcbsil.com)
  • More and more people are doing their shopping for health insurance on the Internet, and finding affordable policies and the exact coverage they are looking for. (insurancespecialists.com)
  • Comparing affordable health insurance rates and coverage side by side on Insurancespecialists.com is a huge help! (insurancespecialists.com)
  • It is easy to be led astray and purchase a health insurance policy that is either too much or too little coverage for your needs. (insurancespecialists.com)
  • While more expensive than the other two coverage plans, indemnity health plans allow their clients to choose the doctor and the hospital they want, as long as they are in members of the plan. (insurancespecialists.com)
  • DHS employees may be eligible to enroll in Federal benefits programs available to Federal employees, including healthcare, dental and vision coverage, life insurance, retirement savings accounts, long term care and flexible health savings accounts. (dhs.gov)
  • These plans do not have good coverage for people with health problems who need regular care or tests. (medlineplus.gov)
  • You can only buy a catastrophic plan if you are under age 30 years or can prove you cannot afford health coverage. (medlineplus.gov)
  • Because of these costs, people with diabetes frequently ask how to choose the right health plan with the right coverage at a price they can afford. (diabetesselfmanagement.com)
  • Items in health insurance plan coverage. (diabetesselfmanagement.com)
  • Limited coverage for home health care authorized. (flsenate.gov)
  • Some people have private health insurance coverage either through an employer (often called a group plan) or through an individual policy they've purchased. (lls.org)
Premiums10
  • 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)
  • 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)
  • These plans offer a network of health care providers and low monthly premiums. (medlineplus.gov)
  • In addition, you will not be able to get federal subsidies to help pay the premiums for these private health plans. (diabetesselfmanagement.com)
HMO's3
  • 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)
Insurer2
  • 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)
  • Health insurance works by splitting the cost of health care between you and your insurer. (progressive.com)
Plans38
  • 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)
  • The Federal Government requires employers to include a health maintenance organization in their employees' health benefit plans. (gao.gov)
  • 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)
  • 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)
  • 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)
  • 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)
  • 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)
  • Curry SJGrothaus LCMcAfee TPabinak C Use and cost effectiveness of smoking-cessation services under four insurance plans in a health maintenance organization. (jamanetwork.com)
  • Most health plans also cover preventive care, including annual physical exams and shots. (progressive.com)
  • Note that the following information is a general overview of information related to insurance and Health Maintenance Organization (HMO) health plans. (bcbsil.com)
  • There are also different health insurance plans to consider, such as Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), and Indemnity Health Plans. (insurancespecialists.com)
  • Before the rise of managed health care plans, indemnity health plans dominated the health care landscape. (insurancespecialists.com)
  • DHS employees, retirees and their eligible family members may be eligible to access the widest selection of healthcare plans in the country through the Federal Employee Health Benefits program. (dhs.gov)
  • Most insurance companies offer different types of health plans. (medlineplus.gov)
  • Depending on how you get your health insurance, you may have a choice of different types of plans. (medlineplus.gov)
  • High Deductible Health Plans (HDHPs). (medlineplus.gov)
  • These full benefit plans are known as qualified health plans (QHPs). (diabetesselfmanagement.com)
  • This is true for new plans sold both inside and outside the government health insurance marketplace under the ACA. (diabetesselfmanagement.com)
  • In addition, plans must limit how much you pay out of pocket for benefits and must provide certain health services aimed at preventing disease at no charge. (diabetesselfmanagement.com)
  • Setting Automated healthcare claims data (2000-10) derived from the virtual data warehouse of 11 health plans in the US Mental Health Research Network. (bmj.com)
Services45
  • 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)
  • 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)
  • 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)
  • As of December 31, 1976, it was providing comprehensive health care services to 6,016 members. (gao.gov)
  • 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)
  • 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 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)
  • 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)
  • 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)
  • 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)
  • 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)
  • 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)
  • 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)
  • 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)
  • 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)
  • Health insurance typically covers a wide range of medical services, including doctor and hospital visits, emergency care, and more. (progressive.com)
  • Bear in mind, these are broad categories of health services. (progressive.com)
  • Some health care services require preapproval or prior authorization from your insurance provider before care is given (emergency services don't need preapproval). (progressive.com)
  • In the US, health care services for the elderly are funded mainly by Medicare , Medicaid , the Veterans Health Administration , private insurance , and out-of-pocket payments. (merckmanuals.com)
  • In addition, many states offer health-related benefits and programs, such as subsidies for transportation, housing, utilities, telephone, and food expenses, as well as help at home and nutrition services. (merckmanuals.com)
  • Collectively, these programs rarely promote integration of acute and long-term care or coordination of health and social services. (merckmanuals.com)
  • PACE includes medical and dental care, adult day care (including transportation to and from the facility), health and personal care at home, prescription drugs, social services, rehabilitation, meals, nutritional counseling, and hospital and long-term care when needed. (merckmanuals.com)
  • PACE programs provide social and medical services primarily in an adult day health center, supplemented by in-home and referral services. (merckmanuals.com)
  • A life-care community or continuing care retirement community provides housing, health care, and other services under packaged financing and management. (merckmanuals.com)
  • Members of a PPO can receive health care services from a participating medical network at a discount. (insurancespecialists.com)
  • and children's health services (including oral and vision care). (diabetesselfmanagement.com)
Primary care phys3
  • A primary care physician is typically an individual's first point of contact for all health-related issues. (investopedia.com)
  • 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)
Enrollment4
  • 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)
  • 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)
  • The ideal time to do this is during the open enrollment period with their employer or during the sign-in period for the health market exchanges under the Patient Protection and Affordable Care Act. (diabetesselfmanagement.com)
Outpatient1
  • Peterson, Christine E., M. M. Nelsen, and Deborah L. Wesley, Aggregated Claims Series: Volume 4: Codebooks for Health Maintenance Organization and Seattle Fee-for-Service Visits - Outpatient and Inpatient. (rand.org)
Organization's2
  • 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)
Search1
  • 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)
Chronic Obstruc1
  • Health Care Utilization in Chronic Obstructive Pulmonary Disease: A Case-Control Study in a Health Maintenance Organization. (jamanetwork.com)
Utilization2
  • 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)
Polit Policy Law2
Definition1
  • 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)
Hypertension1
  • 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)
Wolters Kluwer2
  • 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)
Capitation1
  • 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)
Providers4
  • 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)
  • FHCP is a healthcare maintenance organization with a large network of providers. (afionline.org)
West Metro Chamber1
  • Being a West Metro Chamber member has been invaluable to the success of our nonprofit organization and allowed us to focus more time on our mission and less time on everything else. (westchamber.org)
Benefits4
  • 3) "Blended contract" means a single document that provides a combination of indemnity and health maintenance organization benefits. (tx.us)
  • Data on detailed provisions of health insurance and retirement benefits for both private industry and state and local government also are available. (bls.gov)
  • Health care workers should help elderly patients learn about health benefits and programs they are entitled to. (merckmanuals.com)
  • Individuals learn about contraceptive methods, including their risks and benefits, as well as how to use them, from a wide variety of sources: friends and family, the electronic and print media, health professionals and the educational materials that they distribute, such institutions as schools and colleges, and numerous community resources. (nap.edu)
Definitions1
  • 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)
Mental1
  • 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)
Contracts1
Members2
  • A nonprofit organization that offers health insurance to a group of persons and charges members of the group the same monthly premium. (thefreedictionary.com)
  • In this study, exposure to antipsychotic drugs among ambulatory health maintenance organization (HMO) members is described. (elsevier.com)
Provide3
  • d)Fee-for-service methods of delivering health care have perverse incentives to provide unnecessary health care at inflated costs. (gmatclub.com)
  • 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)
  • 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)
Type1
  • health-maintenance organization (HMO) A type of health-care organization developed in the USA, initially on co-operative principles, now increasingly run by profit-making corporations. (encyclopedia.com)
Reform1
  • Health care concerns have placed the matter high on the national agenda, with calls for reform. (mnhs.org)
Entities1
  • They are a Health Maintenance Organization which was established with the objective of becoming the HMO of choice for corporate entities and all subscribing enrolees, who want good quality healthcare accessed through a technology enabled platform that will enhance the whole customer experience. (myjobmag.com)
Preventive medicine1
GLOSSARY OF HEALTH TERMS - SFGate
GLOSSARY OF HEALTH TERMS - SFGate (sfgate.com)
Plus it
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Mark V. Pauly | RAND (rand.org)
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Best Cheap Colorado Health Insurance in 2020 • Benzinga (benzinga.com)
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Best Cheap Medicare in Wyoming for 2020 • Benzinga (benzinga.com)
The Health Maintenance Organization: I. Historical perspective and current status.
The Health Maintenance Organization: I. Historical perspective and current status. (wizdom.ai)
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Medical Insurance Plans | California State University, Bakersfield (csub.edu)
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Glossary of Employee Benefit Terms (bls.gov)
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Find the Best Ways to Lower Your Insurance | LowerMyBills (lowermybills.com)
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Models for Comprehensive Health Care Coverage for the Elderly - Geriatrics - Merck Manuals Professional Edition (merckmanuals.com)
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Primary and Secondary Syphilis --- Jefferson County, Alabama, 2002--2007 (cdc.gov)
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Medicaid - Wikipedia (en.wikipedia.org)
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Prevalence of Undiagnosed HIV Infection Among Persons Aged ≥13 Years - National HIV Surveillance System, United States, 2005...
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Best Cheap Health Insurance in Georgia for 2020 • Benzinga (benzinga.com)
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Pharmacoepidemiology, 5th Edition | Pharmacology & Pharmaceutical Medicine | Medicine, Nursing & Dentistry | Subjects | Wiley (wiley.com)
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Table of Contents - May 01, 1996, 97 (5) | Pediatrics (pediatrics.aappublications.org)
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Federal Register :: Document Search (federalregister.gov)