MaineCaliforniaUnited StatesHealth 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)WisconsinNew YorkMassachusettsState 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.North CarolinaHealth Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.DelawareData 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.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.MichiganUtahOregonHealth 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.VermontQuality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Organizations, Nonprofit: Organizations which are not operated for a profit and may be supported by endowments or private contributions.MarylandState Government: The level of governmental organization and function below that of the national or country-wide government.Regional Medical Programs: Coordination of activities and programs among health care institutions within defined geographic areas for the purpose of improving delivery and quality of medical care to the patients. These programs are mandated under U.S. Public Law 89-239.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.MinnesotaWashingtonHealth 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).Questionnaires: 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.Rhode IslandHealth 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)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)Professional-Patient Relations: Interactions between health personnel and patients.NebraskaProgram 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.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.Physician's Practice Patterns: Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.Population Surveillance: Ongoing scrutiny of a population (general population, study population, target population, etc.), generally using methods distinguished by their practicability, uniformity, and frequently their rapidity, rather than by complete accuracy.ColoradoManaged 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.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.Communication: The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups.ArkansasInterviews 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.Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population.Public Health Administration: Management of public health organizations or agencies.New MexicoPatient 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.South CarolinaConnecticutState Health Planning and Development Agencies: Agencies established under PL93-641 to coordinate, conduct, and implement state health planning activities. Two primary responsibilities are the preparation of an annual State Health Plan and giving assistance to the Statewide Health Coordinating Council.Physicians: Individuals licensed to practice medicine.FloridaInterinstitutional Relations: The interactions between representatives of institutions, agencies, or organizations.New JerseyComputer Communication Networks: A system containing any combination of computers, computer terminals, printers, audio or visual display devices, or telephones interconnected by telecommunications equipment or cables: used to transmit or receive information. (Random House Unabridged Dictionary, 2d ed)Hospitals: Institutions with an organized medical staff which provide medical care to patients.Patient Acceptance of Health Care: The seeking and acceptance by patients of health service.IowaCross-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.Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care.Focus Groups: A method of data collection and a QUALITATIVE RESEARCH tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions.Hawaii: A group of islands in Polynesia, in the north central Pacific Ocean, comprising eight major and 114 minor islands, largely volcanic and coral. Its capital is Honolulu. It was first reached by Polynesians about 500 A.D. It was discovered and named the Sandwich Islands in 1778 by Captain Cook. The islands were united under the rule of King Kamehameha 1795-1819 and requested annexation to the United States in 1893 when a provisional government was set up. Hawaii was established as a territory in 1900 and admitted as a state in 1959. The name is from the Polynesian Owhyhii, place of the gods, with reference to the two volcanoes Mauna Kea and Mauna Loa, regarded as the abode of the gods. (From Webster's New Geographical Dictionary, 1988, p493 & Room, Brewer's Dictionary of Names, 1992, p2330)Physician-Patient Relations: The interactions between physician and patient.Community Health Services: Diagnostic, therapeutic and preventive health services provided for individuals in the community.Program Development: The process of formulating, improving, and expanding educational, managerial, or service-oriented work plans (excluding computer program development).Public Sector: The area of a nation's economy that is tax-supported and under government control.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.Child Health Services: Organized services to provide health care for children.Public Health Informatics: The systematic application of information and computer sciences to public health practice, research, and learning.Cooperative Behavior: The interaction of two or more persons or organizations directed toward a common goal which is mutually beneficial. An act or instance of working or acting together for a common purpose or benefit, i.e., joint action. (From Random House Dictionary Unabridged, 2d ed)Counseling: The giving of advice and assistance to individuals with educational or personal problems.Referral and Consultation: The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide.VirginiaGuideline Adherence: Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.ArizonaPrivate Sector: That distinct portion of the institutional, industrial, or economic structure of a country that is controlled or owned by non-governmental, private interests.Infant, Newborn: An infant during the first month after birth.KentuckyPublic Health Practice: The activities and endeavors of the public health services in a community on any level.Quality Improvement: The attainment or process of attaining a new level of performance or quality.Total Quality Management: The application of industrial management practice to systematically maintain and improve organization-wide performance. Effectiveness and success are determined and assessed by quantitative quality measures.Medical Record Linkage: The creation and maintenance of medical and vital records in multiple institutions in a manner that will facilitate the combined use of the records of identified individuals.Hospitals, Special: Hospitals which provide care for a single category of illness with facilities and staff directed toward a specific service.Continuity of Patient Care: Health care provided on a continuing basis from the initial contact, following the patient through all phases of medical care.IndianaEconomic 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.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.Insurance Claim Reporting: The design, completion, and filing of forms with the insurer.Medical Records Systems, Computerized: Computer-based systems for input, storage, display, retrieval, and printing of information contained in a patient's medical record.Qualitative Research: Any type of research that employs nonnumeric information to explore individual or group characteristics, producing findings not arrived at by statistical procedures or other quantitative means. (Qualitative Inquiry: A Dictionary of Terms Thousand Oaks, CA: Sage Publications, 1997)AlabamaInservice Training: On the job training programs for personnel carried out within an institution or agency. It includes orientation programs.Marketing of Health Services: Application of marketing principles and techniques to maximize the use of health care resources.MissouriMedicare: 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)West VirginiaModels, Organizational: Theoretical representations and constructs that describe or explain the structure and hierarchy of relationships and interactions within or between formal organizational entities or informal social groups.Mass Screening: Organized periodic procedures performed on large groups of people for the purpose of detecting disease.New HampshirePilot Projects: Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work.Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.Regional Health Planning: Planning for health resources at a regional or multi-state level.Blue Cross Blue Shield Insurance Plans: Prepaid health and hospital insurance plan.Information Services: Organized services to provide information on any questions an individual might have using databases and other sources. (From Random House Unabridged Dictionary, 2d ed)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).Health Care Coalitions: Voluntary groups of people representing diverse interests in the community such as hospitals, businesses, physicians, and insurers, with the principal objective to improve health care cost effectiveness.OhioPrenatal Care: Care provided the pregnant woman in order to prevent complications, and decrease the incidence of maternal and prenatal mortality.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Attitude to Health: Public attitudes toward health, disease, and the medical care system.Midwestern United States: The geographic area of the midwestern region of the United States in general or when the specific state or states are not indicated. The states usually included in this region are Illinois, Indiana, Iowa, Kansas, Kentucky, Michigan, Minnesota, Missouri, Nebraska, Ohio, Oklahoma, North Dakota, South Dakota and Wisconsin.Physicians, Primary Care: Providers of initial care for patients. These PHYSICIANS refer patients when appropriate for secondary or specialist care.Quality Indicators, Health Care: Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.Insurance, Health: Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.Community Health Planning: Planning that has the goals of improving health, improving accessibility to health services, and promoting efficiency in the provision of services and resources on a comprehensive basis for a whole community. (From Facts on File Dictionary of Health Care Management, 1988, p299)Rooming-in Care: Care of the newborn infant in a crib near the mother's bed, instead of in a nursery, during the hospital stay.Obstetrics: A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium.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.Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.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)Rural Health Services: Health services, public or private, in rural areas. The services include the promotion of health and the delivery of health care.Hotlines: A direct communication system, usually telephone, established for instant contact. It is designed to provide special information and assistance through trained personnel and is used for counseling, referrals, and emergencies such as poisonings and threatened suicides.Physician Assistants: Health professionals who practice medicine as members of a team with their supervising physicians. They deliver a broad range of medical and surgical services to diverse populations in rural and urban settings. Duties may include physical exams, diagnosis and treatment of disease, interpretation of tests, assist in surgery, and prescribe medications. (from http://www.aapa.orglabout-pas accessed 2114/2011)Diffusion of Innovation: The broad dissemination of new ideas, procedures, techniques, materials, and devices and the degree to which these are accepted and used.Healthcare Disparities: Differences in access to or availability of medical facilities and services.Emergency Service, Hospital: Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.Preventive Health Services: Services designed for HEALTH PROMOTION and prevention of disease.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.Economics, Hospital: Economic aspects related to the management and operation of a hospital.Wounds and Injuries: Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity.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)Registries: The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers.Patient Discharge: The administrative process of discharging the patient, alive or dead, from hospitals or other health facilities.Community Networks: Organizations and individuals cooperating together toward a common goal at the local or grassroots level.RestaurantsHealth 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.Medical Order Entry Systems: Information systems, usually computer-assisted, that enable providers to initiate medical procedures, prescribe medications, etc. These systems support medical decision-making and error-reduction during patient care.Electronic Health Records: Media that facilitate transportability of pertinent information concerning patient's illness across varied providers and geographic locations. Some versions include direct linkages to online consumer health information that is relevant to the health conditions and treatments related to a specific patient.Mental Health Services: Organized services to provide mental health care.TennesseeRural Population: The inhabitants of rural areas or of small towns classified as rural.Hospital Charges: The prices a hospital sets for its services. HOSPITAL COSTS (the direct and indirect expenses incurred by the hospital in providing the services) are one factor in the determination of hospital charges. Other factors may include, for example, profits, competition, and the necessity of recouping the costs of uncompensated care.Beauty CultureEmergency Medical Services: Services specifically designed, staffed, and equipped for the emergency care of patients.Nurse's Practice Patterns: Patterns of practice in nursing related to provision of services including diagnosis and treatment.TexasHospital Records: Compilations of data on hospital activities and programs; excludes patient medical records.Outcome and Process Assessment (Health Care): Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.Pediatrics: A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence.Contract Services: Outside services provided to an institution under a formal financial agreement.Patient Education as Topic: The teaching or training of patients concerning their own health needs.IllinoisOrganizational Policy: A course or method of action selected, usually by an organization, institution, university, society, etc., from among alternatives to guide and determine present and future decisions and positions on matters of public interest or social concern. It does not include internal policy relating to organization and administration within the corporate body, for which ORGANIZATION AND ADMINISTRATION is available.Schools: Educational institutions.Poverty: A situation in which the level of living of an individual, family, or group is below the standard of the community. It is often related to a specific income level.Government Programs: Programs and activities sponsored or administered by local, state, or national governments.Child Welfare: Organized efforts by communities or organizations to improve the health and well-being of the child.NevadaHispanic Americans: Persons living in the United States of Mexican (MEXICAN AMERICANS), Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin. The concept does not include Brazilian Americans or Portuguese Americans.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.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.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)Parents: Persons functioning as natural, adoptive, or substitute parents. The heading includes the concept of parenthood as well as preparation for becoming a parent.Victoria: A state in southeastern Australia, the southernmost state. Its capital is Melbourne. It was discovered in 1770 by Captain Cook and first settled by immigrants from Tasmania. In 1851 it was separated from New South Wales as a separate colony. Self-government was introduced in 1851; it became a state in 1901. It was named for Queen Victoria in 1851. (From Webster's New Geographical Dictionary, 1988, p1295 & Room, Brewer's Dictionary of Names, p574)Urban Health Services: Health services, public or private, in urban areas. The services include the promotion of health and the delivery of health care.Disaster Planning: Procedures outlined for the care of casualties and the maintenance of services in disasters.Medically Uninsured: Individuals or groups with no or inadequate health insurance coverage. Those falling into this category usually comprise three primary groups: the medically indigent (MEDICAL INDIGENCY); those whose clinical condition makes them medically uninsurable; and the working uninsured.Community Health Centers: Facilities which administer the delivery of health care services to people living in a community or neighborhood.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.Ambulatory Care Facilities: Those facilities which administer health services to individuals who do not require hospitalization or institutionalization.Smoking: Inhaling and exhaling the smoke of burning TOBACCO.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.PennsylvaniaReimbursement Mechanisms: Processes or methods of reimbursement for services rendered or equipment.Centers for Disease Control and Prevention (U.S.): An agency of the UNITED STATES PUBLIC HEALTH SERVICE that conducts and supports programs for the prevention and control of disease and provides consultation and assistance to health departments and other countries.Smoking Cessation: Discontinuation of the habit of smoking, the inhaling and exhaling of tobacco smoke.Patient-Centered Care: Design of patient care wherein institutional resources and personnel are organized around patients rather than around specialized departments. (From Hospitals 1993 Feb 5;67(3):14)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)Nurse Practitioners: Nurses who are specially trained to assume an expanded role in providing medical care under the supervision of a physician.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.Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea.Hospitalization: The confinement of a patient in a hospital.Family Planning Services: Health care programs or services designed to assist individuals in the planning of family size. Various methods of CONTRACEPTION can be used to control the number and timing of childbirths.African Americans: Persons living in the United States having origins in any of the black groups of Africa.Tobacco Smoke Pollution: Contamination of the air by tobacco smoke.Patient Care Team: Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient.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.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.Community Mental Health Centers: Facilities which administer the delivery of psychologic and psychiatric services to people living in a neighborhood or community.Reimbursement, Incentive: A scheme which provides reimbursement for the health services rendered, generally by an institution, and which provides added financial rewards if certain conditions are met. Such a scheme is intended to promote and reward increased efficiency and cost containment, with better care, or at least without adverse effect on the quality of the care rendered.HIV Infections: Includes the spectrum of human immunodeficiency virus infections that range from asymptomatic seropositivity, thru AIDS-related complex (ARC), to acquired immunodeficiency syndrome (AIDS).Communication Barriers: Those factors, such as language or sociocultural relationships, which interfere in the meaningful interpretation and transmission of ideas between individuals or groups.Professional Impairment: The inability of a health professional to provide proper professional care of patients due to his or her physical and/or mental disability.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.Interlibrary LoansGeorgiaCosts and Cost Analysis: Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Hospitals, Community: Institutions with permanent facilities and organized medical staff which provide the full range of hospital services primarily to a neighborhood area.Time Factors: Elements of limited time intervals, contributing to particular results or situations.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.
CareStarIt also will manage a network of more than 6,500 care providers. This number will change with the choice of oversight companies ... In a news release, CareStar said it will become the sole statewide provider of home health case management services, overseeing ... CareStar is the contracted case management administrator of the Ohio Home Care Program and HOME Choice through the Ohio ... CareStar case managers and the Ohio HOME Choice program's providers aim to identify individuals who need person-centered ...
It is the statewide provider of Thalassemia services, for both children and adult populations. Most of the services are ... There is a 21 bed cardiac care unit at Monash Medical Centre, Clayton, which manages a high case load of ST-elevation acute ... The Intensive Care Unit specialises in both post-cardiac surgery and post-neurosurgical care, as well as severe sepsis and ... It has a 26 bed Intensive Care Unit (mixed between adults and children), an even larger Neonatal Intensive Care Unit, and 16 ...
Thompson, S. (1 December 2011). "The PBH Managed Care Experience: A Comparison to Non-managed Care Local Managed Entities" (PDF ... intellectual/developmental disability and substance abuse service providers and primary care providers. Additional quantitative ... North Carolina is currently undertaking a statewide policy shift in how it budgets and manages funding for Medicaid programs ... Starting in 2005, the state established one LME as a pilot Medicaid managed care vendor through the use of the Medicaid 1915 (b ...
... such as a Health Maintenance Organization or Preferred Provider Organization. The Managed Care Ombudsman can assist consumers ... A statewide Education Executive Committee, with seven members representing excavators, utility operators, locators, the ... The Managed Care Ombudsman answers inquiries about MCHIPs and managed care, and helps individuals who experience problems. The ... function of the Managed Care Ombudsman is to help Virginia consumers who have health care insurance provided by a Managed Care ...
... in partnership with the largest health care provider organizations in Maryland in the interest of establishing a statewide ... From 1972 to 1979, as president of Florida Leisure Communities, Inc., Erickson acquired, built and managed over 3,000 housing ... Erickson converted the turn-of-the-century abandoned seminary at Charlestown into the United States' largest continuing care ... Erickson has been involved in the senior care industry since the early 1970s, acquiring and developing moderate-income ...
Other goals include preventing disease, closing care gaps, and cost savings for providers. In the last few years, more effort ... Some states, like New York, have implemented statewide initiatives to address population health. In New York state there are 11 ... Within the ACO model, hospitals have to meet specific quality benchmarks, focus on prevention, and carefully manage patients ... "Accountable Care Organizations, Explained". Kaiser Health News. Retrieved 21 November 2015. Kutscher B. Outpatient care takes ...
... managed care, disaster preparedness, children with special health care needs, mental health, family-centered care, and cultural ... The percent of prehospital provider agencies in the state/territory that have off-line pediatric medical direction available ... The percent of hospitals recognized through a statewide, territorial, or regional standardized system that are able to ... "Ensuring that all children receive appropriate care in a health care emergency." EMSC National Resource Centre. Accessed March ...
The mission of the California EMS Authority is to ensure quality patient care by administering an effective, statewide system ... This legislation (SB 125) was the culmination of several years of effort by local administrators, health care providers, ... The EMS Authority manages the state's medical response to major disasters. This includes maintenance, staffing and deployment ... It is principally through these agencies that the EMS Authority works to promote quality EMS services statewide. State of ...
... instead of the managed care model. However, more than 879,000 Denti-Cal enrollees do receive dental care through managed care ... Eleven counties had no Denti-Cal providers or no providers willing to accept new child patients covered by Denti-Cal: Del Norte ... C4Yourself and CalWIN are statewide online application systems that allows you to apply for benefits. Federal law mostly ... "Medi-Cal Managed Care Models" (PDF). Retrieved 6 December 2014. "Medi-Cal Managed Care Division". Retrieved 6 December 2014. ...
This tool made it easy for veterans to obtain their medical records and coordinate care with healthcare providers. As of 2015, ... After receiving his M.P.P., Chopra worked for The Advisory Board Company where he was a Managing Director. In 2006, Virginia ... In 2008 Chopra implemented a statewide performance management strategy, that Governing magazine described as "venture ... to reducing health care costs, to protecting the homeland." Chopra was confirmed by the United States Senate on August 7, 2009 ...
Kongstvedt, Peter (2009). Managed Care: What It Is and How It Works. Jones & Bartlett Publishers. p. 212. ISBN 978-0763759117. ... "High US Health-Care Spending and the Importance of Provider Payment Rates". Forum for Health Economics & Policy. 15 (3): 1-22. ... ISBN 978-0-7637-5661-1. State of California Office of Statewide Health Planning and Development (August 8, 2012). "Healthcare ... According to Essentials of Managed Health Care, as of 2012 the chargemaster file typically included between 20,000 and 50,000 ...
... is a private not-for-profit health care system and health care provider in the State of New ... The board of directors hired a professional hospital administrator to help manage the institution. A new administrator brought ... a statewide multi-hospital system was formed. The Presbyterian Hospital Center was renamed Southwestern Community Health ...
By October, the system was facing criticism from health care providers that were concerned that the system was not reimbursing ... In July 2013, DHHS went live with its NCTracks system for managing Medicaid billings, a system contracted in 2008 under the ... These entities would operate state-wide and serve as insurance plans from which Medicaid recipients can choose. The plan faced ... rather than letting proven in-state and nonprofit providers, such as Community Care of N.C., take the lead". It also suffered a ...
In doing so, CRISP offers a suite of tools aimed at improving the facilitation of care for their service region's providers. ... Audacious Inquiry is one of several contracted service providers and developers that works with CRISP to enable and manage ... guides and prioritizes reporting and analytics services designed to support statewide efforts of improving care and reducing ... Today, CRISP has connected with all of the acute care hospitals in Maryland and DC, and has rolled out several new services, ...
Latvia also appears unique in that it compels health care providers to obtain the signatures of those who decline vaccination. ... In the United Kingdom, the purchase and distribution of vaccines is managed centrally, and recommended vaccines are provided ... In addition, in 1855 the Commonwealth of Massachusetts had established its own statewide vaccination requirements for all ... Individuals have the right to refuse a vaccination, but if they do so, health providers have a duty to explain the health ...
The organization began a statewide listening tour in the fall to orient new leadership to the state and hear from communities ... In January 2013, the Foundation supported the state's expansion of Medicaid under the Affordable Care Act. and produced its own ... The Foundation continued to partner with HealthONE in managing five Denver-area physician-training residency programs. The ... dental hygienists and behavioral health providers during the next three years (from 2011 through 2013). These professionals ...
MHC provides the technological infrastructure for health care providers to coordinate care for their patients through a secure ... and cost of patient care. IHDE is a non-profit 501(c)(6) company. The IHDE is Idaho created, based, and managed. Located in ... along with the vast majority of Delaware providers, in the first statewide community health record. As of June 2013, DHIN has ... In this method patients give implicit consent to join an HIE when they agree to use the services of a health care provider who ...
This award is given annually to a recent college graduate to study community-based primary health care in Jamkhed. "Leadership ... JSI is a managing partner in the Supply Chain Management System (SCMS) project, which is funded by the US government's PEPFAR ... and other healthcare providers to use in creating, storing, and exchanging medical records. The plan was submitted to the ... it turned to JSI to assist with developing a statewide plan to phase in a standardized electronic system for the state's ...
1993 - Among the fastest-growing healthcare companies with a managed care product known today as SuperMed. SuperMed proved ... 2001 - Medical Mutual's Preferred Provider Organization (PPO), SuperMed Plus, is recognized as the first PPO in the United ... Headquartered in Cleveland's historic Rose Building, the company also has statewide offices in Cincinnati, Columbus, Dayton, ... 2007 - Medical Mutual acquired Carolina Care Plan, one of the largest health maintenance organizations (HMOs) in South Carolina ...
He manages the day-to-day operations of HPI and works with government, foundation and business funders to support the ... He leads Pitt and UPMC's comparative effectiveness research program, which analyzes health data from existing health care ... the 25th Secretary of the Pennsylvania Department of Health during which time he implemented the commonwealth's first statewide ... www.thehealthplan.com/documents/providers/guidelines/pediatric%20obesity.pdf Conrad Weiser Middle School celebrates , http:// ...
Most large statewide and interstate newspapers are also available from local retailers, albeit with a delay in arrival. ... Water storage, supply and Power for Palmerston is managed by Power and Water Corporation, which is owned by the Government of ... Pay TV is also available through both satellite and fixed cable from the encumbant provider, Austar. Palmerston receives most ... Many of Palmerston's health needs are serviced by the Palmerston Health Precinct which includes the Palmerston Community Care ...
A health care provider may ask a patient to consent to receive therapy before providing it, or a clinical researcher may ask a ... "Managing clinical research permissions electronically: A novel approach to enhancing recruitment and managing consents". ... More recently, Health Sciences South Carolina, a statewide research collaborative focused on transforming healthcare quality, ... To capture and manage informed consents, hospital management systems typically use paper-based consent forms which are scanned ...
In the Alabama House of Representatives, Bentley made it a priority to train primary care health care providers and to increase ... Bentley received just over 58% of the statewide vote and won by a margin of over 230,000 votes-the largest margin recorded for ... As President of Alabama Dermatology Associates, Bentley managed the practice's growth into one of the largest dermatology ...
... their use by providers to achieve significant improvements in care." The Centers for Medicare and Medicaid (CMS) managed and ... As of Quarter 3 of 2013, 32 states/territories had operational query-based exchange broadly available statewide through single ... The REC program goals were to enroll 100,000 Primary Care Providers (PCPs) in the REC program, help them go "live" on EHRs, and ... RECs were also encouraged to reach out to all providers, not only PCPs. Among all providers, 149,315 enrolled with RECs, ...
Children, pregnant women, TANF families, and children in state custody receive their medical care through managed care ... and maintains a statewide statistical database of juvenile court referrals. DYS is administratively organized into one central ... into a rebate agree with the Federal Department of Health and Human Services and that are dispensed by qualified providers, ... A mandatory Medicaid managed care program is in place for eligible participants in the eastern, central, and western areas of ...
Managed care (CCP) *Exclusive provider organization (EPO). *Health maintenance organization (HMO). *Preferred provider ... "Comprehensive Statewide Program Combines Training and Higher Reimbursement for Providers With Outreach and Education for ... many states received waivers from the federal government to create Medicaid managed care programs. Under managed care, Medicaid ... "States Turn to Managed Care To Constrain Medicaid Long-Term Care Costs". Agency for Healthcare Research and Quality. April 9, ...
Little Rock, Arkansas, Healthcare Market Overview: December 2000... outpatient centers and long-term care facilities. St. Vincents response to Baptists managed care partnership with Arkansas BC ... a statewide provider contracting network of 73 hospitals and 3,000 physicians. Total HMO enrollment in Little Rock is ... Vincent is not a member of the provider network for Baptists Health Advantage HMO, and Baptist is not a member of the provider ... Vincents market share is stronger locally than statewide; Baptist has developed an extensive statewide network including 80 ...
Biography - Sandral Hullet, MD, MPH - AlabamaManaged Care, and the Future Viability of Safety Net Providers. Hullett has devoted her career to improving rural health care ... and helping restructure the provision of health care statewide. As a result, countless Alabamians who otherwise would have ... Hullett is the co-author of numerous articles on health care issues faced by rural primary care communities. For her efforts in ... she pursued her interest in rural health care, including health care planning and delivery to the under-insured, and poor. She ...
Dr. Shah blasts Long Beach hospitalHRINJ said its provider network will be run by QualCare, a statewide managed care company based in Piscataway. The plans ... Sponsored By Heritage Provider Network Winning a Heritage Award: Strong Demand for Yaopeng Zhous eye-care model ... Primary care, behavioral health providers urge measures to sustain telehealth access post-pandemic. ... Primary care, behavioral health providers urge measures to sustain telehealth access post-pandemic ...
Colorado leads in developing health navigator workforce | Department of Public Health and Environment... coordinate care across different health care providers; and work with patients to maintain a healthy lifestyle and manage their ... own health care. The navigators work statewide in hospitals, community health centers, private practices and other agencies. ... A health navigator is a trained, unlicensed member of the health care team who helps patients overcome barriers to health care ... The department funded a survey of health care employers that showed a growing demand for a qualified unlicensed workforce to ...
Effectiveness of a Seventh Grade School Entry Vaccination
Requirement -- Statewide and Orange County, Florida, 1997-1998... these adolescents from their primary-care provider or managed-care organization is unknown. Finally, data were not available to ... consisting of private and public health-care providers, local businesses, nongovernment organizations, and local colleges. The ... Effectiveness of a Seventh Grade School Entry Vaccination Requirement -- Statewide and Orange County, Florida, 1997-1998 ... Other successful programs to vaccinate adolescents in schools and in provider settings have been previously described (3,4). ...
New York State Prevention Agenda - Prevention Agenda 2013-2018 - Preventing Chronic Diseases Action Plan - Appendix 1:...Statewide. Health Plan Provider. Region. Plan type (Medicaid vs. Commercial managed care). For MMC enrollees only: By gender, ... Statewide. Health Plan Provider. Region. Plan type (Medicaid vs. Commercial managed care). For MMC enrollees only: By gender, ... Statewide. Region. Plan type (Medicaid vs. Commercial managed care). For MMC enrollees only: By gender, age, race/ethnicity. ... Statewide. Region. Plan type (Medicaid vs. Commercial managed care). For MMC enrollees only: By gender, age, race/ethnicity. ...
JMIR - Identification of Patients in Need of Advanced Care for Depression Using Data Extracted From a Statewide Health...... identifying cases of depression that require advanced care may be challenging to primary care providers and health care team ... Other less severe cases can be effectively managed by primary care or family practitioners [11-13]. However, other forms of ... Identifying cases of depression that require advanced care may be challenging to primary care providers and health care team ... our outcome of interest are patients in need of advanced care, as identified by primary care providers. Thus, we were unable to ...
Medicaid and Managed Care - Policy BriefEnsuring that plans have provider networks in place, educating both providers and beneficiaries on how managed care works, and ... Two states with statewide Medicaid demonstrations, Tennessee and Oregon, include in their mandatory managed care programs acute ... Impact on access to care: There is evidence suggesting that managed care shifts the type of care and the site of care. Most ... Health Care Financing Administration, Office of Managed Care. 1994. Medicaid Managed Care Enrollment Report Summary Statistics ...
Statewide Managed Care System | Colorado General AssemblyColorado Society of Addiction Medicine and Center for Dependency, Addiction and Rehabilitation Provider Perspective ... Statewide Managed Care System. Concerning updating managed care provisions in the medical assistance program, and, in ... Clarifies that the statewide managed care system is authorized to provide services under a single managed care entity (MCE) or ... managed care and managed care entities and adds definitions for medical home and primary care case management entities; ...
Chapter 391 - 2014 Florida Statutes - The Florida Senate... means a statewide managed care service system that includes health care providers, as defined in this section. ... 391.065 Health care provider agreements.-The department is authorized to establish health care provider agreements for ... and coordinated statewide managed system of care that links community-based health care with multidisciplinary, regional, and ... "Health care provider" means a health care professional, health care facility, or entity licensed or certified to provide health ...
Certain providers are statewide resources and essential providers for all managed care plans in all regions. All managed care ... Managed care plans that have not contracted with all statewide essential providers in all regions as of the first date of ... 1) PROVIDER NETWORKS.-Managed care plans must develop and maintain provider networks that meet the medical needs of their ... 409.975 Managed care plan accountability.-In addition to the requirements of s. 409.967, plans and providers participating in ...
Managed Care in North Carolina Today. Community Care of North Carolina (CCNC) is North Carolinas provider-led enhanced primary ... State law specified three commercial plans would offer products statewide. Additionally, providers with a history of serving ... payment approach to support safety net providers in compliance with new federal rules as it transitions to managed care.40 ... Anticipate targeted provider rate increases in FY 2018 for physician-administered vaccines and contraceptives and personal care ...
HMOS RULE IN BOSTON MARKET: BUT COSTS, UTILIZATION ARE HIGHIn particular, a triad of managed-care biggies-Blue Cross and Blue Shield of… ... the popular public transit system-theres no escaping the ads for managed-care plans.HMOs rule in Boston. ... The influences on high provider utilization are still strong and resist the brake of managed care. "I dont see costs going ... Statewide, the not-for-profit triads combined 2.1 million HMO enrollees represented 78% of the 2.6 million total enrollment ...
Amerigroup Tennessee Receives Multicultural Health Care Distinction from the National Committee for Quality Assurance |...NASHVILLE, Tenn.--(BUSINESS WIRE)--Amerigroup Tennessee, a statewide provider of Medicaid managed care services, today ... NCQA is committed to providing health care quality information for consumers, purchasers, health care providers and researchers ... "Eliminating racial and ethnic disparities in health care is essential to improving the quality of care overall." ... multicultural health care. In acknowledgement of these efforts, NCQA awarded the health plan with the Multicultural Health Care ...
2016 legislative agenda seeks bold steps toward HIV prevention, treatment: AIDS Foundation Chicago... and ensure that providers are fully paid for services rendered under contract with the state during the budget impasse. ... Empowering Meaningful Patient Choice in Medicaid Managed Care (HB 6213). The statewide rollout of Medicaid managed care has ... The bill requires the state to directly test a sample of each Medicaid managed care plans provider network to ensure contact ... With the statewide rollout of Medicaid managed care, Medicaid is the largest payer of HIV care in Illinois, and thousands of ...
McCrory offers plan to privatize NC Medicaid risk - News - Hendersonville Times-News - Hendersonville, NC... and dental care to the elderly and disabled for a stable cost, Gov. Pat McCrory said Wednesday.McCrory and state Health and ... 13 billion Medicaid program needs a big dose of private competition that will come from paying a handful of statewide managed- ... program needs a big dose of private competition that will come from paying a handful of statewide managed-care providers to ... Managed-care companies would be required to operate statewide so they couldnt pick healthier communities and leave the rest, ...
Securely Linking Regional HIEs Statewide - HealthcareInfoSecurityAs 10 regional health information exchanges in New York become interconnected into a statewide network, consistency in core ... Theres been fairly low adoption of managed care payment systems. Why is that relevant? If the providers dont really have a ... or maybe its from primary care to specialty care for a referral and then back again from specialty care to primary care after ... not just with Medicaid but also with commercial plans where their incentivizing providers to care what the other providers are ...
Academic Enterprise Faculty Awards (05/24/12)... managed care organizations, HIV care providers and consumers to ensure state-of-the art clinical management for people living ... Raffanti also has been closely involved in the establishment of the statewide Centers of Excellence Program, a collaborative ... Just as he pioneered a model of managed HIV care that has minimized hospitalizations and improved outcomes for patients, ... Ely and his team have revolutionized major components of the care of critically ill patients in intensive care units. Through ...
2016 LSA-DN Summer Meeting | Lutheran Services in America... "the state has laid out a comprehensive validation process for the site-specific assessment involving managed care organizations ... Tennessee is the first and only state to receive approval of their statewide transition plan to comply with the HCBS Settings ... MCCP works with individuals, private providers and public agencies in the Twin Cities metropolitan area to prevent crises and ... At the BND celebration, their direct care staff received official designation as a Direct Support Professional (DSP). Cedar ...
It also will manage a network of more than 6,500 care providers. This number will change with the choice of oversight companies ... In a news release, CareStar said it will become the sole statewide provider of home health case management services, overseeing ... CareStar is the contracted case management administrator of the Ohio Home Care Program and HOME Choice through the Ohio ... CareStar case managers and the Ohio HOME Choice programs providers aim to identify individuals who need person-centered ...
The Changing Health Care Landscape by Insightful Discussions | Sponsored InsightsThe new law creates a hybrid model of statewide managed care organizations (MCOs) competing with regional Provider Led Entities ... This gives these people the ability to get preventive care from a primary care provider compared to seeking care from the ... a key factor in managing care - and have had a measureable impact.. Moore: Partnering with health care providers mainly applies ... Hospitals and their providers will focus more on managing care, even after the patient returns home. Programs such as Community ...
The Past, Present, and Future of Managed Long-Term Care | ASPEPresent and Future of Managed Long-Term Care Paul Saucier, Brian Burwell and Kerstin Gerst Thomson/MEDSTAT and University of ... Long-term care providers, particularly nursing home providers, often saw the selective contracting aspect of managed care as an ... implement managed long-term care programs, either on a demonstration basis or on a larger statewide basis, only to have the ... Breadth of managed care benefit package. With the exception of Wisconsin Family Care and the New York Managed Long Term Care ...
Kentucky's new Medicaid copays confuse providers, patientsA spokesman for Passport, the Louisville-based managed care company that serves about 320,000 Medicaid enrollees statewide, ... The email asks managed care officials to notify individual providers, such as doctors, dentists, pharmacists and others, that ... Health care providers said the copays triggered confusion among patients, some afraid they wouldnt be able to afford items ... Some health providers reassured patients they would still get care if they couldnt pay, including clients at Bridgehaven, a ...
Legislative Conference Wrap-Up: Health & Human Services Policy Committee | Florida Association of CountiesSUPPORT efforts to enable CHDs to transition to managed care under the Statewide Medicaid Managed Care Program without ... particularly in communities without adequate substitutes or alternative providers for these services ... SUPPORT preserving the ability of CHDs to provide primary care and direct patient care services, ... with particular emphasis on children aging out of the foster care system. SUPPORT continued coordination with the states ...
Preferred provider orgCentersOrganizationsHospitals2018PhysiciansAffordable Care ActAssessmentMedicaid Managed Care ProgramOutcomesEnrollmentImplementationState'sServicesPracticesNorth CarolinaPlan'sCaliforniaPatientsCollaborativeMedi-CalProgramRisk-based Medicaid managed carePopulationsEnrollAvailable statewideTransitionEligibleMedicareInitiativeCliniciansPayersImplementClinical2020CoordinationReimbursementProvideAcuteFamily-centeredEnrollees in managedPlansWorkforceFloridaSubstanceNation'sHospitalizationNetworkAccessInsurersAgenciesHealthcareInnovationState2016WebinarsPediatricPhysicianPlanHMOsEntities
- preferred provider organization. (gartner.com)
- Most private insurance policies are designed either as a health maintenance organization (HMO) or preferred provider organization (PPO). (ncsl.org)
- Baptist has developed an extensive statewide network including 80 statewide Baptist hospitals, outpatient centers and long-term care facilities. (gartner.com)
- The navigators work statewide in hospitals, community health centers, private practices and other agencies. (colorado.gov)
- b) The regional perinatal intensive care centers program established in ss. (flsenate.gov)
- 2. Regional perinatal intensive care centers as defined in s. 383.16 (2). (flsenate.gov)
- Indeed, the managed care that has evolved in the shadow of half a dozen renowned academic medical centers is not the cost-crunching, pinch-the-providers brand that has seized sections of California and has been expected in other markets that have nearly 50% HMO penetration. (modernhealthcare.com)
- About 70 percent of the country's Medicaid enrollees are served through managed care systems that pay providers a monthly rate, according to the U.S. Centers for Medicare & Medicaid Services. (blueridgenow.com)
- If you are a MassHealth PCC Plan Member, you have access to a large network of primary care providers including physicians, community health centers, and hospitals. (masspartnership.com)
- McLaren operates the state's largest network of cancer centers and providers anchored by Karmanos Cancer Institute - one of only two NCI-designated cancer centers in the state. (cerner.com)
- Tacoma Wash.-based MultiCare Health System, a five-hospital not-for-profit, added 14 urgent-care clinics to the 15 centers it already operated in the Puget Sound area when it bought Immediate Clinic Seattle in September. (modernhealthcare.com)
- Northwell Health, based in New Hyde Park, N.Y., expects to have 45 urgent-care centers open around New York City by yearend from the 33 it started the year with, said Adam Boll, vice president of ventures for the 21-hospital not-for-profit system. (modernhealthcare.com)
- Northwell owns and operates the centers through a 50/50 joint venture with for-profit GoHealth Urgent Care, Boll said. (modernhealthcare.com)
- Numbers of urgent-care centers nationally range from 7,500 to 10,000, said Andrew Bab, partner and co-head of the healthcare practice for law firm Debevoise & Plimpton. (modernhealthcare.com)
- The centers relieve some of the stress on emergency departments so clinicians can take care of higher-acuity patients who really need to be there, Bab said. (modernhealthcare.com)
- Urgent-care centers in a hospital's system also likely can immediately share patient records safely and securely, he said. (modernhealthcare.com)
- San Francisco-based Dignity Health, which owns 39 hospitals in California, Arizona and Nevada, has opened 10 urgent-care centers in a joint venture with GoHealth since the partnership was created early in 2016, Dignity CEO Lloyd Dean said this month at the J.P. Morgan Healthcare Conference. (modernhealthcare.com)
- Seattle is experiencing a busy flu season this year and MultiCare has increased the hours at its urgent-care centers to handle the pressure on its emergency departments, McCarren said. (modernhealthcare.com)
- From nursing homes to small rural hospitals, suburban community facilities and urban academic medical centers, New York's healthcare provider organizations demonstrate their unwavering Commitment to Excellence every day, for every patient," said HANYS President Bea Grause, RN, JD. (hanys.org)
- HSSC also works with 12 South Carolina SmartState Centers of Economic Excellence to create economic opportunities related to health and health care in South Carolina. (dukeendowment.org)
- The committee should include child health-care providers as well as representatives from local health departments, managed-care organizations, Medi- caid, private insurance organizations, and the community. (cdc.gov)
- Involvement of health-care providers, their organizations, and managed-care organizations throughout the process will improve acceptance of screening recommendations. (cdc.gov)
- Greco and Eisenberg, 1993) also indicate that health-care providers respond well to information and recommendations that come from peers and from their organizations. (cdc.gov)
- To ensure vaccination of seventh graders, Orange County Health Department (OCHD) officials teamed with a community coalition consisting of private and public health-care providers, local businesses, nongovernment organizations, and local colleges. (cdc.gov)
- Almost 8 million Medicaid beneficiaries, predominately poor children and their parents, now receive health care services through a broad array of managed care arrangements, including Health Maintenance Organizations (HMOs) and less structured primary care case management systems. (kff.org)
- BUSINESS WIRE )--Amerigroup Tennessee, a statewide provider of Medicaid managed care services, today announced that it has been recognized by the National Committee for Quality Assurance (NCQA), which awards distinction to organizations that meet or exceed its rigorous requirements for multicultural health care. (businesswire.com)
- In acknowledgement of these efforts, NCQA awarded the health plan with the Multicultural Health Care Distinction, which recognizes organizations that lead the market in providing culturally and linguistically sensitive services, and work to reduce health care disparities. (businesswire.com)
- The Multicultural Health Care Distinction evaluates organizations, such as health plans, wellness, disease management and managed behavioral health organizations through use of an evidence-based set of requirements. (businesswire.com)
- NCQA accredits and certifies a wide range of health care organizations. (businesswire.com)
- CMS points out that "the state has laid out a comprehensive validation process for the site-specific assessment involving managed care organizations" and other providers. (lutheranservices.org)
- Managed long-term care suppliers are largely local non-profit plans or provider organizations that evolved specifically to respond to a single state's procurement. (hhs.gov)
- The news came late Thursday in a brief email from Jill Hunter, the state's acting Medicaid commissioner, to officials with the five managed care organizations that operate most of Kentucky's Medicaid program under contract to the state. (courier-journal.com)
- In 1996, 46 percent of the county s publicly and privately insured residents were enrolled in health maintenance organizations (HMOs), compared with 32 percent for all U.S. metropolitan areas, and the remainder were mostly in preferred provider organizations (PPOs). (hschange.org)
- Orange County s health plans have delegated significant risk to physician organizations, typically paying capitation for primary and specialty care, as well as some ancillary services. (hschange.org)
- Unlike many other markets, physician organizations in Orange County also typically share risk for hospital utilization and have responsibility for care management. (hschange.org)
- While plans have broad networks, and most providers contract with most plans, capitation has resulted in tightly managed gatekeeping systems with clearly defined subnetworks controlled by physician organizations. (hschange.org)
- Services provided through children's Medicaid dental plans are separate from the medical services provided by the STAR, STAR+PLUS, and STAR Health managed care organizations. (tmhp.com)
- Recognized for innovation, Cerner solutions assist clinicians in making care decisions and enable organizations to manage the health of populations. (cerner.com)
- The company also offers an integrated clinical and financial system to help health care organizations manage revenue, as well as a wide range of services to support clients' clinical, financial and operational needs. (cerner.com)
- Information was gathered from state Medicaid and/or behavioral health officials, managed care representatives, behavioral health providers, housing providers, and consumer advocacy organizations. (hhs.gov)
- At the level of the health care organization, the lack of common data standards has prevented information sharing between commercial clinical laboratories and health care facilities, between pharmacies and health care providers regarding prescriptions, and between health care organizations and payers for reimbursement (Hammond, 2002). (nap.edu)
- The fact that there is no standard means of representing the data for any of these datasets or requirements is astonishing and highlights the amount of unnecessary work performed by health care and regulatory organizations to prepare, transmit, and use what amount to custom reports. (nap.edu)
- The EVCTP used that formative experience to build statewide capacity to provide complex care coordination and care transitions services to the Medicaid population served by managed care organizations. (asaging.org)
- As the healthcare system continues to pivot toward rewarding value, accountability, and integration, successful examples of cross-sector partnerships such as EVCTP and VAAACares are bringing community-based organizations (CBO) together with traditional payers and providers, and are serving as models for achieving the Triple Aim of better care, better outcomes, and lower costs. (asaging.org)
- Several types of health plans will offer services through the MMA program: Standard Health Plan Health Maintenance Organizations Provider Service Networks Specialty Plans Comprehensive Plans Children s Medical Services Network MMA plans were selected through a competitive bid for each of 11 regions of the state. (docplayer.net)
- Our survey found that providers are optimistic about the progress their organizations can make, with 65 percent stating they believe their organizations will deliver fully-scaled population health management programs within five years, while 16 percent report their organizations area already doing so. (histalkpractice.com)
- In developing MIChild, MDCH officials maintained their commitment to managed care, specifying that only insurers offering a preferred-provider arrangement and health maintenance organizations (HMOs) will be eligible to extend MIChild benefits. (publicsectorconsultants.com)
- Additionally, managed health care systems, health maintenance organizations, health service contractors, insurance carriers and the Division of Medical Assistance Program (DMAP) may also request access. (oregon.gov)
- 3) The authority shall establish performance-based contracts with managed care organizations and behavioral health administrative services organizations and implement the integrated screening and assessment process. (wa.gov)
- ALBANY, N.Y. - Hospitals, health systems and other healthcare provider organizations across the state are signing on to the Healthcare Association of New York State's Commitment to Excellence program, affirming their commitment to continuous quality improvement, patient safety and performance excellence. (hanys.org)
- Under the approach, health plan or provider entities known as Regional Care Collaborative Organizations, or RCCOs are responsible for linking Medicaid enrollees to health care and social services in a coordinated manner, with the goal of improving health outcomes and reducing costs for the state. (hschange.org)
- It also supports our collaborative work with the state and federal governments, quality improvement organizations, hospitals, physicians, community health providers and their respective association leaders to direct home care resources toward treating a potentially deadly condition that drives health care costs and imperils health outcomes in each of these settings. (hca-nys.org)
- It was also viewed by a legion of health care consultants and the swelling ranks of software vendors as a multibillion-dollar bonanza, as health care organizations were expected to rush forward to meet federal deadlines. (managedcaremag.com)
- BUSINESS WIRE )--Summit Community Care, one of Arkansas' provider owned and operated managed care organizations, has launched an innovative model of care that integrates physical health, behavioral health, home and community services under one entity. (businesswire.com)
- Summit Community Care is one of Arkansas' first provider owned and operated managed care organizations built to provide services to Arkansas Medicaid beneficiaries. (businesswire.com)
- UCare's fight to retain its contracts, and allow counties to indicate a preference for its health care plans, is part of a larger statewide shakeup for Minnesota managed care organizations that provide Medicaid and MinnesotaCare services. (accesspress.org)
- Minnesota hires county-based purchasing organizations and health maintenance organizations to manage care for most clients in public health insurance programs. (accesspress.org)
- The market is split between two alliances of providers and payers: o Baptist Health (Baptist), with three hospitals in the Little Rock market and 41 percent share of annual hospital discharges, is aligned with Arkansas Blue Cross and Blue Shield (BC/BS). (gartner.com)
- o St. Vincent Health System (St. Vincent), with five local hospitals and nearly 27 percent share of annual hospital discharges, is the largest local hospital system in the provider network of QualChoice of Arkansas (QCA) Health Plan with 85,000 statewide HMO members. (gartner.com)
- St. Vincent's response to Baptist's managed care partnership with Arkansas BC/BS has been to join NovaSys Health Network, a statewide provider contracting network of 73 hospitals and 3,000 physicians. (gartner.com)
- But the relationships between HMOs and providers have changed, and observers say the change dates to 1994, when the city's two biggest academic and research hospitals decided to partner in the market's first alliance. (modernhealthcare.com)
- To make ends meet, hospitals hike the rates charged paying customers to cover the cost of uncompensated care. (bizjournals.com)
- Blue Cross offers its customers access to 100 percent of nonfederal hospitals and more than 93 percent of professional providers statewide. (healthplanone.com)
- The community is served by a relatively large number of physicians who remain largely independent in small primary care or consolidating specialty practices, yet some are exploring tighter affiliations with hospitals. (hschange.org)
- FLINT, Mich. - Oct. 6, 2015 - McLaren Health Care announced today that it has selected Cerner, a global leader in health care technology, to implement an electronic health record (EHR) system including integrated revenue cycle management, along with population health management solutions, at McLaren's hospitals and outpatient facilities throughout Michigan. (cerner.com)
- This final rule finalizes a policy that provides flexibility in the determination of episode spending for Comprehensive Care for Joint Replacement Payment Model (CJR) participant hospitals located in areas impacted by extreme and uncontrollable circumstances for performance years 3 through 5. (cornell.edu)
- These vary from 12% to 70% across California's 251 hospitals providing maternity care. (chcf.org)
- Successfully defended many hospitals, physicians, managed care entities, and other healthcare providers and professionals sued for medical malpractice. (clarkhill.com)
- The state says insurance companies were required to have a larger network of doctors, hospitals and providers compared to the number of consumers. (washingtontimes.com)
- QARI helps New York's hospitals and health systems prioritize, manage and sustain initiatives that improve patient care and outcomes. (hanys.org)
- The dataset contains information submitted by New York State Article 28 Hospitals as part of the New York Statewide Planning and Research Cooperative (SPARCS) and Institutional Cost Report (ICR) data submissions. (ny.gov)
- Highlighting its significance to major state health reforms, the tool was also recently presented to managed care health plans and many hospitals across the state. (hca-nys.org)
- While South Carolina had several hospitals and research universities studying a wide variety of health issues, the state had no easy or formal mechanism for sharing the work of these institutions and scaling their successes statewide. (dukeendowment.org)
- The provider network includes 100 percent of Iowa hospitals and 96 percent of Iowa doctors. (iowa.gov)
- In Iowa, in-network care can be received at 100 percent of hospitals and 99 percent of doctors. (iowa.gov)
- Not previously included in another bill, House Bill 7113 was amended to include a CON exemption for hospitals with at least 500 beds that meet defined criteria related to indigent care and bond credit rating. (adamsandreese.com)
- Qualified hospitals would be permitted to relocate up to 15 percent of their licensed acute care beds within the county where the hospital is located. (adamsandreese.com)
- Dianne provides an update on and summary of the Texas Legislature's adoption of a state fiscal year (SFY) 2018-2019 budget, as well as a review of health care legislation passed by the Legislature this session. (healthmanagement.com)
- The agency may not classify physicians and other practitioners as essential providers. (flsenate.gov)
- The physicians group and a spokesman for the North Carolina Hospital Association said they worried the system McCrory calls his "Partnership for a Health North Carolina" would overwhelm the state's home-grown, non-profit Community Care of North Carolina series of Medicaid managed care networks. (blueridgenow.com)
- The organization says it will survey employers, hospital leaders, physicians and other health care providers and consumers before determining what network and programs it will have for its commercial business. (courant.com)
- Health information technology can enhance physicians%u2019 ability to provide high-quality care, suggesting that physicians should use it more extensively in their practices. (ajmc.com)
- Our nearly 1,700 physicians and more than 525 advanced practice providers are treating ever-increasing numbers of patients - totaling 530,000 annually and representing more than 2.4 million patient visits. (mcw.edu)
- Cerner's integrated system will help McLaren as we look to better manage the health status of the Michigan residents and communities we serve, as well as make life easier for our physicians and staff," said Ron Strachan, chief information officer, McLaren Health Care. (cerner.com)
- By aligning with McLaren across each of its acute care and ambulatory points of care, Cerner is working to ensure physicians who care for a large percentage of Michigan residents have access to the right patient data, at the right time, no matter which facility they visit," said Zane Burke, president, Cerner. (cerner.com)
- A new collaboration with Mount Sinai connects VNSNY nurses, paramedics like the one pictured above, and emergency physicians to provide in-home emergency care for patients in distress. (vnsny.org)
- An amendment by Senator Bean that proposed to expand the definition of telemedicine provider to include physicians and other health professionals, and allow out-of-state practitioners, failed to pass. (adamsandreese.com)
- Two amendments offered by Senator Rene Garcia (R-Hialeah) were adopted that define telemedicine providers to include physicians, physician assistants, ARNPs or pharmacists, require liability coverage for telemedicine providers and a requirement for board approved training and examination on telemedicine standards. (adamsandreese.com)
- With the statewide rollout of Medicaid managed care, Medicaid is the largest payer of HIV care in Illinois, and thousands of people with HIV have gained coverage thanks to the Affordable Care Act. (aidschicago.org)
- How has the Affordable Care Act (also known as Obamacare) most affected health care in our region? (wilmingtonbiz.com)
- Overall, largely because of this bad debt issue, the value of care we provide without compensation is higher under the Affordable Care Act (ACA) than it was before. (wilmingtonbiz.com)
- When the U.S. Supreme Court issued its ruling on the Affordable Care Act in June, justices upheld the individual mandate and new protections in the law, but made Medicaid expansion optional for states. (bizjournals.com)
- The now-optional provision of the Affordable Care Act expands Medicaid eligibility to adults with incomes up to 138 percent of the federal poverty line, effective Jan. 1, 2014. (bizjournals.com)
- A provision in the Affordable Care Act (ACA) that required every American to purchase some form of health insurance took effect in 2014. (ncsl.org)
- The program is not linked to National Health Care Reform, or the Affordable Care Act passed by the U.S. Congress. (docplayer.net)
- 7 Children s Health Insurance Program (CHIP) Transition The Affordable Care Act increased the minimum eligibility level for participation in the Medicaid program for children from ages 6 through 18 from 100% to 133% of the Federal poverty level. (docplayer.net)
- Some experts predicted that if the feds approved the program that Republican Gov. Rick Scott would support expanding Medicaid coverage to nearly 1 million additional Floridians under the Affordable Care Act. (washingtontimes.com)
- Even before the 2010 Patient Protection and Affordable Care Act (ACA) passed, Colorado was proactive in reforming the small-group insurance market and expanding Medicaid and the Children's Health Insurance Program (CHIP) to more low-income adults and children. (hschange.org)
- Enactment of the federal Affordable Care Act, which expanded availability of Medicaid for people at or below the poverty level, has changed the landscape of this contract process. (accesspress.org)
- c) The integrated, comprehensive screening and assessment process shall be implemented statewide by all substance use disorder and mental health treatment providers and designated crisis responders. (wa.gov)
- 2) The authority shall provide for adequate training to effect statewide implementation and, upon request, shall report the rates of co-occurring disorders [and] the stage of screening or assessment at which the co-occurring disorder was identified to the appropriate committees of the legislature. (wa.gov)
- SUPPORT efforts to enable CHDs to transition to managed care under the Statewide Medicaid Managed Care Program without impacting service capacity. (fl-counties.com)
- How do Medicaid managed care program managers use enrollment and disenrollment information to manage their programs? (nashp.org)
- Because of the Statewide Medicaid Managed Care program, the Agency is changing how a majority of individuals receive most health care services from Florida Medicaid. (docplayer.net)
- DENVER - Colorado has established the first competency-based statewide registry in the nation for health navigators, an emerging workforce that has been proven to increase patient access to health care, improve health outcomes and equity, and reduce health care costs. (colorado.gov)
- The managed-care operators will be "responsible for the outcomes and for managing their own risk so the taxpayer will no longer be on the hook for all of the overruns," said Wos, a retired physician. (blueridgenow.com)
- When aggregated data regarding health outcomes are shared, a clearer picture emerges of provider performance baselines and improvements with which payment models can be developed. (ajmc.com)
- It makes sense - with providers compensated for successful health outcomes, it's critical for them to focus on effective management of patient populations. (histalkpractice.com)
- In addition, these tools address data management challenges by predicting health outcomes and providing actionable ways for clinicians to intervene and improve individual care - stated by polled executives as the as the most important driver of population health. (histalkpractice.com)
- The Oklahoma Health Care Authority (OHCA), Pharmacy Management Consultants (PMC) and Amgen (NASDAQ:AMGN) announced a new collaborative agreement to help improve clinical outcomes, experience and satisfaction for Oklahoma's 796,000 SoonerCare (Oklahoma Medicaid) members. (worldpharmanews.com)
- Through this first-of-its-kind, comprehensive statewide consortium, New York's healthcare providers demonstrate how they are working together to improve patient care, the patient experience and clinical and operational outcomes. (hanys.org)
- Together, we are introducing a new model of care that is consumer-focused, and offers innovative, effective solutions that consumers with specialized needs require to achieve optimal health outcomes. (businesswire.com)
- The option that will yield the better result is not always clear to the doctor, and this lack of scientific data on outcomes produces huge "practice variations" in treatment decisions--with serious consequences in terms of health care costs and quality. (bcg.com)
- Baptist and Arkansas BC/BS are co-owners of the state's largest health maintenance organization (HMO), HMO Partners, which markets Health Advantage HMO with a statewide enrollment of 178,000 members. (gartner.com)
- This brief summarizes current trends in Medicaid managed care enrollment, describes the major models of Medicaid managed care, and raises issues for consideration with regard to managed care for low-income populations. (kff.org)
- The most significant growth occurred between 1993 and 1994, when Medicaid managed care enrollment grew 63 percent, from 4.8 million beneficiaries to 7.8 million (HCFA, 1994) (Figure 1). (kff.org)
- In 1981, 85 percent of all Medicaid managed care enrollment took place in four states - California, Maryland, Michigan, and New York. (kff.org)
- Managed care plans that have not contracted with all essential providers in the region as of the first date of recipient enrollment, or with whom an essential provider has terminated its contract, must negotiate in good faith with such essential providers for 1 year or until an agreement is reached, whichever is first. (flsenate.gov)
- Managed care plans that have not contracted with all statewide essential providers in all regions as of the first date of recipient enrollment must continue to negotiate in good faith. (flsenate.gov)
- However, two national commercial HMOs, Evercare and AmeriGroup, have multi-state presence and account for a substantial portion of all managed long-term care enrollment. (hhs.gov)
- Enrollment in high-deductible health plans is associated with reduced spending on healthcare and with moderate reductions in the use of preventive care. (ajmc.com)
- The company has the most members in the Sacramento managed care program, with more than 98,000 of the enrollment total of 231,000. (bizjournals.com)
- Providers shall not be entitled to enrollment in the Medicaid provider network. (flsenate.gov)
- Despite the automatic termination of the CCI, the Governor's budget proposes continuing certain major CCI components, including: (1) Cal MediConnect, (2) mandatory enrollment in managed care for dual eligibles for their Medi‑Cal benefits, and (3) the integration of LTSS other than IHSS under managed care. (ca.gov)
- The long term care population, which includes those 65 and over who reside in nursing homes, recently completed enrollment. (washingtontimes.com)
- In the wake of significant Medicaid enrollment growth and the earlier demise of risk-based Medicaid managed care, Colorado has adopted an Accountable Care Collaborative model. (hschange.org)
- The bill amends, repeals, and relocates provisions of part 4 of article 5 of title 25.5, Colorado Revised Statutes, relating to managed care provisions under the medical assistance program to align with the federal 'Medicaid and CHIP Managed Care Final Rule of 2016', and to reflect the implementation of the accountable care collaborative as the statewide managed care system. (colorado.gov)
- Medicaid managed care implementation proceeded smoothly, but safety net providers continue to struggle. (hschange.org)
- Association of Statewide Implementation of the Prehospital Traumatic Brain Injury Treatment Guidelines With Patient Survival Following Traumatic Brain Injury: The Excellence in Prehospital Injury Care (EPIC) Study. (zoll.com)
- Dr. Allen is nationally recognized for his leadership in the development and implementation of innovative models of geriatric care spanning population health, community integration, interprofessional practice, chronic illness management, transitional care and patient safety. (asaging.org)
- The goal of the hearing was to share views about the implementation of advanced technologies like CPOE, one of a series of initiatives to create a statewide medical information technology infrastructure," says Dr. Feinbloom. (the-hospitalist.org)
- 1. SB 1004 Palliative Care Implementation: Updates on Who Is Being Served and How (45 min. (chcf.org)
- What did implementation of SB 1004 palliative care look like in year two? (chcf.org)
- 2. SB 1004 Palliative Care Implementation: Looking Ahead (45 min. (chcf.org)
- ALBANY - Building on its work to address the risk of sepsis-related death, injury and health care cost drivers, the Home Care Association of New York State (HCA) has been awarded a prestigious grant from the New York State Health Foundation (NYSHealth) for training and implementation of HCA's first-in-the-nation sepsis-intervention protocols in home care provider settings across New York State. (hca-nys.org)
- Shepherded by two administrations against a well organized coalition of health care associations eager to amend and delay implementation of the act, HIPAA has been steadily gathering steam as it heads down the track toward the final deadlines for compliance. (managedcaremag.com)
- But over the past few months - with the health care industry entering the final 12-month stretch before the first round of deadlines - it has grown increasingly clear that the timetable for implementation is likely to leave many companies far behind. (managedcaremag.com)
- Amerigroup Tennessee helps improve health care access and quality for approximately 436,000 Tennessee residents who participate in the state's various Medicaid programs. (businesswire.com)
- If the administration's idea of reform is bringing in out-of-state corporations so they can profit by limiting North Carolina patients' access to health care and cutting critical medical services to our state's most vulnerable citizens, that is not change we can support," North Carolina Medical Society CEO Robert Seligson said in a statement. (blueridgenow.com)
- Yale Preferred Health already has enrolled more than 14,000 people in its plan for the state's managed care program for Medicaid. (courant.com)
- The MBHO became responsible for screening PSH applications for Medicaid eligibility, coordinating applications and housing placements with the state housing agency, and managing tenant-landlord relationships, in part due to the state's desire to have a single entity centralize these processes. (hhs.gov)
- The Community Paramedicine partnership is administered by Mount Sinai Health System's DSRIP (Delivery System Reform Incentive Payment) initiative through the Mount Sinai Performing Provider System (MSPPS), part of the statewide DSRIP initiative designed to reduce New York State's hospital readmission rates. (vnsny.org)
- Summit Community Care has been licensed and certified as a Provider-led Arkansas Shared Savings Entity (PASSE) under the state's new model of managed care, which is designed to address complex and costly health care challenges. (businesswire.com)
- Through a unique collaboration among our provider coalitions and the Medicaid alliance team at Amerigroup, we are delivering quality, integrated and effective care to some of the state's most vulnerable residents. (businesswire.com)
- The Arkansas Department of Human Services estimates around 30,000 Medicaid consumers in Arkansas will be eligible to participate in the state's PASSE care coordination program and have the opportunity to enroll in Summit Community Care. (businesswire.com)
- After completing her residency in Family Practice and fulfilling a National Health Services Corps obligation, she pursued her interest in rural health care, including health care planning and delivery to the under-insured, and poor. (nih.gov)
- The department funded a survey of health care employers that showed a growing demand for a qualified unlicensed workforce to provide navigation services in urban and rural areas of Colorado. (colorado.gov)
- This year, Medicaid will finance health and long-term care services to more than 35 million low-income Americans. (kff.org)
- In its role as a purchaser of health services for low-income families, Medicaid increasingly relies on managed care to deliver care. (kff.org)
- Some Medicaid managed care programs are also directed at services for beneficiaries with specific conditions such as AIDS, high-risk pregnancy, substance abuse, mental illness, and diabetes. (kff.org)
- Two states with statewide Medicaid demonstrations, Tennessee and Oregon, include in their mandatory managed care programs acute care services for the SSI disabled and elderly populations who are not in long term care institutions. (kff.org)
- 2) Provide essential preventive, evaluative, and early intervention services for children at risk for or having special health care needs, in order to prevent or reduce long-term disabilities. (flsenate.gov)
- 1) "Children's Medical Services network" or "network" means a statewide managed care service system that includes health care providers, as defined in this section. (flsenate.gov)
- 2) "Children with special health care needs" means those children younger than 21 years of age who have chronic and serious physical, developmental, behavioral, or emotional conditions and who require health care and related services of a type or amount beyond that which is generally required by children. (flsenate.gov)
- 5) "Health care provider" means a health care professional, health care facility, or entity licensed or certified to provide health services in this state that meets the criteria as established by the department. (flsenate.gov)
- a) Plans must include all providers in the region that are classified by the agency as essential Medicaid providers, unless the agency approves, in writing, an alternative arrangement for securing the types of services offered by the essential providers. (flsenate.gov)
- Payments for services rendered by a nonparticipating essential provider shall be made at the applicable Medicaid rate as of the first day of the contract between the agency and the plan. (flsenate.gov)
- After 1 year, managed care plans that are unable to contract with essential providers shall notify the agency and propose an alternative arrangement for securing the essential services for Medicaid enrollees. (flsenate.gov)
- 4. Accredited and integrated systems serving medically complex children that are comprised of separately licensed, but commonly owned, health care providers delivering at least the following services: medical group home, in-home and outpatient nursing care and therapies, pharmacy services, durable medical equipment, and Prescribed Pediatric Extended Care. (flsenate.gov)
- Amerigroup serves Tennesseans by developing and delivering innovative care management programs and services. (businesswire.com)
- Given Illinois' state budget woes, the AIDS Foundation of Chicago (AFC) seeks to protect and preserve vital HIV/AIDS prevention, education, housing and treatment services, and ensure that providers are fully paid for services rendered under contract with the state during the budget impasse. (aidschicago.org)
- Furthermore, AFC aims to ensure adequate funding for critical services including mental health and substance abuse treatment, supportive housing and child care. (aidschicago.org)
- CareStar is the contracted case management administrator of the Ohio Home Care Program and HOME Choice through the Ohio Department of Job and Family Services (ODJFS). (wikipedia.org)
- In a news release, CareStar said it will become the sole statewide provider of home health case management services, overseeing about 11,000 consumers. (wikipedia.org)
- This added transparency, will translate into greater levels of competition among providers and the ability of patients to consume services in the same way they consume all other products and services. (wilmingtonbiz.com)
- This policy brief was prepared under contract #HHS-100-97-0019 between the U.S. Department of Health and Human Services (HHS), Office of Disability, Aging and Long-Term Care Policy (DALTCP) and the MEDSTAT Group. (hhs.gov)
- A decade ago, managed long-term care appeared poised for dramatic growth, but despite significant activity in a handful of states, today only 2.3% of persons using public long-term care services are receiving those services in managed care programs, and Arizona remains the only state that provides all long-term care through managed care. (hhs.gov)
- Studies of managed long-term care programs have been largely positive, finding high consumer satisfaction levels, lower utilization of institutional services and increased access to home- and community-based services. (hhs.gov)
- In 2003, about 3.1 million older persons and persons with physical disabilities received Medicaid-financed longterm care services ( Table 1 ). (hhs.gov)
- 1 Just over half (55%) were in nursing homes and the remainder received services in community-based settings, either through the Medicaid home and community-based waiver services program or through a state Medicaid plan benefit, such as personal care services. (hhs.gov)
- News that the state plans to suspend Medicaid copays for services including prescription drugs, doctors' visits and hospital stays was greeted with surprise and relief among health care providers Friday. (courier-journal.com)
- Medi-Cal expansion is part of the overall objective of everyone having some minimum amount of care," said Diana Dooley , secretary of the California Health and Human Services Agency. (bizjournals.com)
- The LSU Health Sciences Center (LSUHSC) Department of Psychiatry Infant Team has been continuously funded to provide infant mental health services to all children ages 0-5 years in foster care in Orleans parish since May 1998. (lsuhsc.edu)
- We provide member-focused services through locally based staff by assisting in accessing care, coordinating referrals to related health and social services and addressing member concerns and questions. (dailystocks.com)
- We believe our local approach to managing our health plans, including member and provider services, enables us to provide accessible, quality, culturally-sensitive healthcare coverage to our communities. (dailystocks.com)
- We operate in two segments: Medicaid Managed Care and Specialty Services. (dailystocks.com)
- Our health plans in Arizona, operated by our long-term care company, and Massachusetts, operated by our individual health insurance provider, are included in the Specialty Services segment. (dailystocks.com)
- We provide our services to the uninsured primarily through Medicaid, CHIP, LTC, Foster Care, ABD, Medicare and other state programs for the uninsured. (dailystocks.com)
- The agency shall purchase goods and services for Medicaid recipients in the most cost-effective manner consistent with the delivery of quality medical care. (flsenate.gov)
- This section does not restrict access to emergency services or poststabilization care services as defined in 42 C.F.R. part 438.114. (flsenate.gov)
- The agency shall maximize the use of prepaid per capita and prepaid aggregate fixed-sum basis services when appropriate and other alternative service delivery and reimbursement methodologies, including competitive bidding pursuant to s. 287.057 , designed to facilitate the cost-effective purchase of a case-managed continuum of care. (flsenate.gov)
- The agency shall also require providers to minimize the exposure of recipients to the need for acute inpatient, custodial, and other institutional care and the inappropriate or unnecessary use of high-cost services. (flsenate.gov)
- a) An entity that provides no prepaid health care services other than Medicaid services under contract with the agency and which is owned and operated by a county, county health department, or county-owned and operated hospital to provide health care services on a prepaid or fixed-sum basis to recipients, which entity may provide such prepaid services either directly or through arrangements with other providers. (flsenate.gov)
- Since 1991, Rx Staffing and Home Care has served the Greater Sacramento Area by providing at-home healthcare services as well as nursing professionals to medical facilities. (caring.com)
- Our in-home care services and the caregivers who provide them are the finest in the industry. (caring.com)
- Clients primary and preventive Medicaid dental services are provided statewide through Medicaid managed care dental plans. (tmhp.com)
- Clients who receive their dental services through a Medicaid managed care dental plan are required to select a dental plan and a Main Dentist (or Main Dental Home provider or Dental Home). (tmhp.com)
- Medi‑Cal and Medicare Jointly Provide Health Care and Long‑Term Services and Supports (LTSS) to Many Seniors and Persons With Disabilities (SPDs). (ca.gov)
- LTSS include, among other supports and services, institutional care in skilled nursing facilities and home‑ and community‑based services (HCBS) such as those provided by the In‑Home Supportive Services (IHSS) program. (ca.gov)
- About two‑thirds of SPDs are also eligible for Medicare, the federal program that provides health care services to qualifying persons over age 65 and certain persons with disabilities. (ca.gov)
- Brown most recently was the vice president of marketing and new business development for a large integrated health services provider in Kansas that provides a wide range of behavioral health services. (behavioral.net)
- She also worked for the state of Kansas as the Director of Managed Care for Behavioral Health helping to implement a statewide comprehensive managed care system in 2012 that covered all services, including physical health, behavioral health, and long term services and supports. (behavioral.net)
- The Massachusetts Child Psychiatry Access Program (MCPAP) is a statewide program that offers primary care providers free telephone consultation with child psychiatrists and other behavioral health education services. (masspartnership.com)
- The Massachusetts Behavioral Health Access website allows medical and behavioral health providers, individuals and families, state agency staff, and others to locate services available through the Children's Behavioral Health Initiative. (masspartnership.com)
- Commercial insurance providers are private companies that contract with businesses or individuals to cover certain health care services outlined in a health plan. (ncsl.org)
- In many states and communities, housing supports and behavioral health services are delivered through different agencies that do not coordinate with each other or with physical health providers. (hhs.gov)
- Louisiana's Permanent Supportive Housing (PSH) program subsidizes about 3,300 private rental units and offers Medicaid-covered behavioral health and long-term care services. (hhs.gov)
- The state also shifted management of PSH to its single statewide managed behavioral health organization (MBHO), which manages all specialty behavioral health services. (hhs.gov)
- Wiberg asserts the merged company is the largest independent provider of home care services in Washington, and one of the largest in the U.S. (spokanejournal.com)
- The statewide collaborative, Virginia Area Agencies on Aging Cares (VAAACares), has provided a one-stop shop approach for developing contracts with health insurance plans participating in Virginia's Managed Long-Term Services and Supports (MLTSS) initiative. (asaging.org)
- Vesely-Massey also currently serves as CEO of VAAACares, which provides comprehensive care coordination, care transitions, and many other services to support the health and well-being of Commonwealth Coordinated Care Plus enrollees in Virginia. (asaging.org)
- According to the federal agency in charge of administering the grant program-the Health Resources and Services Administration, "It is expected that the training standards established under these State grants would be utilized as a 'Gold Standard' for future training of personal and home care. (phinational.org)
- Adequate reimbursement for personal care aide training expenses for providers delivering Medicaid-funded long-term services and supports. (phinational.org)
- This program provides care management services by a social worker or registered nurse for high risk women during pregnancy and for two months after delivery. (forsyth.cc)
- If you have certain conditions you may qualify for Pregnancy Care Management services. (forsyth.cc)
- Co-chaired by the secretaries of health and human services and labor, the Commission was charged with developing a broader understanding of issues facing the rapidly evolving health care delivery system and building consensus on ways to assure and improve the quality of health care. (unt.edu)
- Projects will be jointly managed by PMC and Amgen, with PMC performing research services funded by Amgen. (worldpharmanews.com)
- Pharmacy Management Consultants, managed by the University of Oklahoma College of Pharmacy, provides operational, consultant and educational services to OHCA through a professional services contract with the University of Oklahoma College of Pharmacy. (worldpharmanews.com)
- The plan offers comprehensive coverage, including (but not limited to) that for well-child services, doctor and hospital visits, dental care, and prescription drugs. (publicsectorconsultants.com)
- How are SB 1004 palliative care services likely to evolve? (chcf.org)
- What can we learn about the SB 1004 palliative care recipients and services, and how can that inform efforts to assess and improve quality? (chcf.org)
- All health care providers licensed to provide health care services in Oregon are welcome to enroll as authorized users of ALERT IIS. (oregon.gov)
- HHSC is required to monitor changes in the availability of therapy providers and notify the Legislature if covered children are unable to access covered services as a result of the rate cut. (healthmanagement.com)
- Federal officials said Florida needed to address quality-of-care and transparency issues and is requiring the state to report data that captures what services are being provided and denied. (washingtontimes.com)
- Requirements for providing emergency services and care. (flsenate.gov)
- Through its connection with MedlinePlus, users of the site can get information about conditions, diseases and wellness, and find web sites of local health services, programs and providers throughout North Carolina. (nnlm.gov)
- expanding eligibility for long-term care services to include hospital level of care for certain individuals diagnosed with cystic fibrosis, etc. (flsenate.gov)
- The 125-year-old health system provides about a half-million inpatient and outpatient health and behavioral health services annually, and the toolkit recently was spotlighted by the Center for Care Innovations. (countyofriverside.us)
- and offers providers options for quick referral to the chronic pain pharmacist or behavioral health services. (countyofriverside.us)
- As such, health care services are provided by a statewide network of participating health care providers. (iowa.gov)
- Benefits for covered services are available only when received from Wellmark Health Plan Network providers. (iowa.gov)
- It is your responsibility to ensure that providers you seek services from are part of the Wellmark Health Plan managed care network. (iowa.gov)
- Services received from non-participating providers will not be paid by Wellmark. (iowa.gov)
- Services received from out-of-network providers may be covered in the case of accidental injuries or emergencies. (iowa.gov)
- The Section 298 Initiative is a statewide effort to improve the coordination of physical health services and behavioral health services in Michigan. (acmh-mi.org)
- Seniors participating in the ADvantage Program can access a variety of long term care services, such as personal care and assistance, home modifications for increased safety and access, and adult day care. (payingforseniorcare.com)
- Participants in this program have the option of letting the state manage the care services they receive or self-directing their own care. (payingforseniorcare.com)
- Family members are eligible to be hired and paid to provide personal care services for the participant. (payingforseniorcare.com)
- The SoonerCare income limit for long term care services, as of 2020, for a single applicant is $2,349 per month. (payingforseniorcare.com)
- Certain unskilled services, most relevantly personal care, are available for self-direction. (payingforseniorcare.com)
- The House Health & Human Services Committee passed House Bill 7113 by Representative Jason Brodeur (R-Sanford) after adopting a strike all amendment that includes provisions on health care topics previously addressed in separate bills. (adamsandreese.com)
- Previously addressed in House Bill 751 by Representative Travis Cummings (R-Orange Park), House Bill 7113 would permit all licensed health professionals to use telehealth to deliver health care services within their respective areas of specialty. (adamsandreese.com)
- HCP provides services to children and youth with special health care needs from birth to 21 living in Colorado, who have, or are at risk for, physical developmental, behavioral or emotional conditions. (riograndecounty.org)
- Recent initiatives were implemented to improve access to health and wellness-oriented services, redesign managed care programs to improve engagement and retention of high-need individuals, and raise the bar on quality while lowering costs. (nyaprs.org)
- MonashHeart provides cardiology related services and cardiac care at the Monash Medical Centre, Clayton, and at Dandenong Hospital. (wikipedia.org)
- It is the statewide provider of Thalassemia services, for both children and adult populations. (wikipedia.org)
- Based on survey responses from Medi-Cal managed care plans and contracted SB 1004 palliative care providers, this webinar focused on program sustainability, planned program enhancements for 2020, self-perceptions of strengths and challenges, as well as collaboration practices and opportunities. (chcf.org)
- C2X provides a forum for healthcare providers to learn and stay on the cutting edge of healthcare practices. (hanys.org)
- Participating healthcare providers demonstrate their commitment through involvement in educational and quality improvement actions, having quality improvement programs with governing board and/or senior leadership oversight, using evidence-based practices, analyzing performance data and sharing success stories. (hanys.org)
- By connecting South Carolina's research institutions and large hospital systems, the state could expand the scale of research, capitalize on unique resources, and more broadly share the results to inform patient care and improve practices statewide and beyond. (dukeendowment.org)
- In 2004, South Carolina began to support a statewide collaborative among leading universities and health systems to improve public health and economic well-being through research, and to help educate and train South Carolina's health care providers on the use of new evidence-based practices. (dukeendowment.org)
- Twenty-two percent of the nonelderly population lives in rural areas in North Carolina (compared to a national average of 19 percent), and research shows that Americans in rural areas often face unique challenges in health care coverage and access, including low density of providers and longer travel times to care, limited access to employer-sponsored coverage, and greater health care needs due to older age and lower income. (kff.org)
- The federal government took an initial step in this direction in 2010, when six states-California, Iowa, Maine, Massachusetts, Michigan, and North Carolina-were awarded three-year grants through the Personal and Home Care Aide State Training (PHCAST) program to develop competency-based training and credentialing systems for personal care aides in their states. (phinational.org)
- Care Management for High Risk Pregnancies (CMHRP), previously Pregnancy Care Management, is a statewide Medicaid program in North Carolina promoting healthy mothers and healthy babies. (forsyth.cc)
- North Carolina 2020 Health Objectives - A statewide agenda that provides a direction for improving the health and well being of North Carolinians over the next decade. (nnlm.gov)
- The bill requires the state to directly test a sample of each Medicaid managed care plan's provider network to ensure contact information is accurate, that the providers listed are participating and accepting new patients, and determine the wait time to obtain an initial appointment. (aidschicago.org)
- The plan's Medicaid program has a network of 2,300 health care providers, including more than 500 primary care doctors. (courant.com)
- In contrast, a PPO plan allows patients to see any health care provider within the plan's network of providers without first being seen by a PCP. (ncsl.org)
- If you are a member of a managed care plan, click here to visit your plan's website. (dentaquest.com)
- States with plans to add managed long-term care initiatives in the near future include California (San Diego County), Washington, Hawaii and Maryland. (hhs.gov)
- Already in the throes of Medi-Cal transition into managed care, California will proceed with expansion in an effort to grapple with rising costs and improve access to care. (bizjournals.com)
- Any bump in federal pay for Medi-Cal is a good thing for California, which ranks close to the bottom in the nation in terms of provider reimbursement. (bizjournals.com)
- Mindful of the California budget challenge, Melody sees expansion under federal reform and state programs to fold seniors, people with disabilities and those who qualify for both Medicare and Medicaid into Medi-Cal managed care as opportunity to use volume and efficiency to provide better care at a better price. (bizjournals.com)
- The six Medicaid managed care programs studied for this report - Massachusettes, New Jersey, Tennessee, Texas, San Francisco (California) and Orange County (California) - cope with overseeing changes in HIV/AIDS treatment in different ways. (nashp.org)
- ituated between Los Angeles and San Diego, the Orange County health care market is shaped, on the one hand, by being a part of Southern California, where statewide purchasing pools and large regional employers influence the strategies of health plans and providers. (hschange.org)
- The US c-section rate has risen 50% over the past 15 years, according to the California Maternal Quality Care Collaborative (CMQCC). (chcf.org)
- CHCF and the Coalition for Compassionate Care of California presented a three-webinar series on "Driving Improvement in Palliative Care in Medi-Cal (SB 1004)" on April 7, 2020. (chcf.org)
- A health navigator is a trained, unlicensed member of the health care team who helps patients overcome barriers to health care and navigate the complex health care system. (colorado.gov)
- and work with patients to maintain a healthy lifestyle and manage their own health care. (colorado.gov)
- This study aimed to leverage a comprehensive range of patient-level diagnostic, behavioral, and demographic data, as well as past visit history data from a statewide health information exchange to build decision models capable of predicting the need of advanced care for depression across patients presenting at Eskenazi Health, the public safety net health system for Marion County, Indianapolis, Indiana. (jmir.org)
- A total of 6992 (8.29%) of these patients were in need of advanced care for depression. (jmir.org)
- Our experience has been that many patients cannot pay the out-of-pocket expenses, so they wind up as "bad debt," which is another category of care we are not paid for. (wilmingtonbiz.com)
- And there are more patients with access to health care. (wilmingtonbiz.com)
- If the ACA assists the physician community in harnessing its collective intellect and passionately pursuing the goals of increasing the health of the populations we serve, reducing the per capita cost of care and improving the patient experience there is little doubt that the patients served in our communities will reap the benefit. (wilmingtonbiz.com)
- The copays caught health providers by surprise and caused alarm among patients who didn't know about or understand the changes. (courier-journal.com)
- Those cuts caused an outcry among providers and patients - especially those in need of treatment for urgent dental problems including decay and abscesses. (courier-journal.com)
- Patients with atrial fibrillation receiving routine medical care within a large managed care organization were found to have suboptimal anticoagulation control. (ajmc.com)
- And primary-care doctors see a temporary increase in pay as incentive to take more patients but wonder how it will play out long term. (bizjournals.com)
- We are creating the knowledge that changes lives through clinical breakthroughs and specialty expertise that continually improves our ability to care for patients. (mcw.edu)
- A Main Dentist means a provider who has agreed with a Dental Contractor to provide a Dental Home to Members and who is responsible for providing routine preventive, diagnostic, urgent, therapeutic, initial, and primary care to patients, maintaining the continuity of patient care, and initiating referral for care. (tmhp.com)
- The Massachusetts Consultation Service for Treatment and Addiction of Pain (MCSTAP ) is a statewide program that offers primary care providers free telephone consultation on safe prescribing and managing care for patients with chronic pain, substance use disorder, or both. (masspartnership.com)
- From the point of injury throughout the continuum of en-route care, the new TBI Dashboard™ on ZOLL's Propaq ® M and Propaq ® MD monitor/defibrillators supports rapid treatment and effective management of TBI patients. (zoll.com)
- We look forward to providing our clinicians with a system that is designed to help them deliver safer and more reliable care to our patients. (cerner.com)
- The Eastern Virginia Care Transitions Partnership (EVCTP) is a unique formal collaborative of area agencies on aging, health systems, and clinical providers that served more than 25,000 Medicare patients through the federal Community-based Care Transitions Program (CCTP). (asaging.org)
- Doc-tors and hos-pi-tals are promised a flow of new patients, and the MCO gets cheap-er care and doesn't have to pay for the most expen-sive inter-ven-tion possible. (inthesetimes.com)
- Principles of Pediatric Nursing helps students visualize how to care for children and understand the ways caring for pediatric patients is similar to, and different from, adult patients. (ecampus.com)
- The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) was founded in 1985 to recognize the many health disciplines responsible for care of patients with cardiac and pulmonary disease and to provide a platform for professional development for its members. (redorbit.com)
- And patients want the convenience of an urgent-care center that can take care of their bumps, bruises and colds without the time and expense of going to an emergency room, he said. (modernhealthcare.com)
- She said if the system can touch patients through a gamut of entry points in the care continuum, then they will remain loyal. (modernhealthcare.com)
- myPRES also has helpful features for Presbyterian patients, such as emailing your care team and paying your medical bills. (phs.org)
- We are the experts on inpatient care and hospital systems, and we understand how important information technology is for managing complicated patients during an acute hospitalization. (the-hospitalist.org)
- Part of the statewide recall process is giving medical providers an opportunity to review the patients on the recall list in order to update patient demographics and immunizations. (oregon.gov)
- Health advocates have worried about lapses in care during the transition, especially because the program is built on a controversial five-county pilot where many insurance companies dropped out and patients struggled to access doctors and treatments. (washingtontimes.com)
- Under Medicaid privatization, the state gives insurance companies a set amount of money each month (between $300 and $428 a month for a woman between 14 and 54-years-old) to care for a patient, giving the insurer broad authority to care for the patients, including which doctors they can see and what treatments can be prescribed. (washingtontimes.com)
- Insurance companies say they have an incentive to control costs by linking patients up with primary care doctors early on instead of treating them in more expensive setting like emergency rooms. (washingtontimes.com)
- So Clinton sought to cage managed care inside managed competition, which would regulate the behavior of insurers and force them to compete for patients. (washingtonpost.com)
- The chart is based on data collected on patients and hospital discharges in the Statewide Planning and Research Cooperative System (SPARCS). (ny.gov)
- This coordinated in-home consultation is the centerpiece of a new Community Paramedicine collaboration between VNSNY and MSHS, in which specially trained community paramedics call on patients requiring immediate care-often avoiding the need for a trip to the ED that may otherwise have occurred. (vnsny.org)
- Of the 11 patients who have received Community Paramedicine visits since the program's launch this past April, all but three were successfully managed through the collaborative efforts of the VNSNY call center nurse, community paramedic and Mount Sinai physician. (vnsny.org)
- In the coming months, VNSNY will be extending the program to its Bronx home care patients who have been discharged from Mount Sinai. (vnsny.org)
- Home care providers in New York State deliver care at home to 400,000 patients annually," said HCA Executive Vice President Al Cardillo. (hca-nys.org)
- As a result, when an individual institution made a significant finding that improved patient care, that knowledge, for the most part, only immediately benefited patients served by that institution. (dukeendowment.org)
- This is a big problem not only for patients but also for payers, which end up footing the bill for what could be suboptimal care. (bcg.com)
- Long-term care patients will be the first to enroll in the statewide program starting in October 2013. (blogspot.com)
- Due to its large refugee population in its catchment area, Monash Medical Centre, Clayton provides specialist care for a large number of patients with tuberculosis and non tubercolous mycobacterial infections. (wikipedia.org)
- There is a weekly TB clinic that is run every Wednesday, as well as an inpatient service that cares for patients who need to be isolated and treated as an inpatient. (wikipedia.org)
- The hospital provide specialist care for many patients with tuberculosis, and nontuberculous mycobacterial infections, including infections due to Mycobacterium avium complex, Mycobacterium leprae and Mycobacterium ulcerans. (wikipedia.org)
- Along with the Western Hospital, which hosts the migrant screening clinic, Monash Medical Centre, Clayton arguably cares for the highest number of inpatient TB patients in the state. (wikipedia.org)
- The Massachusetts Technology Collaborative and New England Healthcare Institute are coordinating statewide efforts to remove barriers to inpatient CPOE. (the-hospitalist.org)
- To increase the development and sharing of knowledge that helps improve personal health and patient care in South Carolina, The Duke Endowment awarded more than $32 million between 2006 and 2013 to support Health Sciences South Carolina, the nation's first statewide, research-oriented health collaborative. (dukeendowment.org)
- In 2010, AnMed Health, McLeod Health and Self Regional Healthcare also joined the effort, making HSSC the nation's first statewide research collaborative of independent integrated health systems and research-intense universities. (dukeendowment.org)
- About 2.1 million SPDs are enrolled in Medi‑Cal, the state‑federal program providing health care and LTSS to low‑income persons. (ca.gov)
- Based on survey responses from Medi-Cal managed care plans and contracted SB 1004 palliative care providers, this webinar focused on plan and provider organizational characteristics, the number of individuals referred and served, the care models used to deliver SB 1004 palliative care, as well as contracting and payment issues. (chcf.org)
- While low-income adults and children accounted for 73 percent of the 32.1 million Medicaid beneficiaries, their health care costs accounted for 27 percent of total program spending in 1993. (kff.org)
- Concerning updating managed care provisions in the medical assistance program, and, in connection therewith, aligning managed care provisions with new federal managed care regulations, removing obsolete or duplicative statutory language and programs, and updating and aligning statutory provisions to reflect the current statewide managed care system. (colorado.gov)
- In addition to the requirements of s. 409.967 , plans and providers participating in the managed medical assistance program shall comply with the requirements of this section. (flsenate.gov)
- RALEIGH (AP) - North Carolina's $13 billion Medicaid program needs a big dose of private competition that will come from paying a handful of statewide managed-care providers to deliver medical, mental, and dental care to the elderly and disabled for a stable cost, Gov. Pat McCrory said Wednesday. (blueridgenow.com)
- The Indiana Home and Hospice Care Foundation is partnered with CareStar Learning (CareStar business venture which offers continuing education for providers) to provide the online testing for its Caregiver Train-the-Trainer program. (wikipedia.org)
- Several factors have contributed to the slow growth of managed long-term care, including complex program design choices (including payment methodology), relatively long planning and start-up periods, resistance of long-term care providers and advocates, difficult state-federal policy issues, the need for a substantial population base, limited interest among potential suppliers, and inadequate state infrastructure in an era of government downsizing. (hhs.gov)
- Our Medicaid Managed Care segment provides Medicaid and Medicaid-related health plan coverage to individuals through government subsidized programs, including Medicaid, the State Children's Health Insurance Program (CHIP), long-term care (LTC), Foster Care, dual eligible individuals in Medicare Special Needs Plans and the Supplemental Security Income Program, also known as the Aged, Blind or Disabled Program, or collectively ABD. (dailystocks.com)
- On a statewide basis, the CCI replaced counties' historical 35 percent share of nonfederal costs of the IHSS program with a maintenance of effort (IHSS MOE) that required counties to maintain their 2011‑12 IHSS expenditure levels, with the addition of an annual growth factor of 3.5 percent and the costs of locally negotiated IHSS wage increases. (ca.gov)
- Most recently, Vesely-Massey led the development of the state and national award-winning Eastern Virginia Care Transitions Partnership (EVCTP), a CMS-certified healthcare program. (asaging.org)
- Plagued by a poorly designed medical reimbursement process that rewards health care professionals for providing medically unnecessary care and yet doesn't pay enough for many specialists or small providers to deal with burdensome administration, the popular program has been a target of reform for decades. (inthesetimes.com)
- According to this group, the most important requirements of a population health management program are that it "facilitates care across the health continuum" and that it "supports providing the highest quality of care at the lowest cost. (histalkpractice.com)
- The second program OHCA operates is Insure Oklahoma, which assists qualifying adults and small business employees in obtaining health care coverage for themselves and their families. (worldpharmanews.com)
- With a year's example to show, director Fabert will seek out new investors to grow the program, which she would like to see statewide. (feedreader.com)
- MIAMI (AP) - More than three million Medicaid recipients around the state are transitioning into managed care under Florida's massive overhaul to privatize its Medicaid program. (washingtontimes.com)
- Other states have privatized their Medicaid program but the Sunshine State is one of the first to enroll the more vulnerable long-term care group. (washingtontimes.com)
- Critics worry the state is abdicating care of its most vulnerable residents to for-profit companies with little oversight of how the money is being spent and say there's little evidence the pilot program improved patient care or saved money. (washingtontimes.com)
- Any patient discharged from Mount Sinai's Manhattan facilities to VNSNY Home Care in Manhattan is eligible for the program," explains Lorna Canlas, Project Manager with VNSNY's Solution Development group, who is overseeing the initiative along with Yaffa Vinikoor, Quality Manager for Strategy. (vnsny.org)
- As the first home care agency to participate in this program, VNSNY has worked closely with Mount Sinai to design guidelines and procedures. (vnsny.org)
- We're thrilled to be partnering with VNSNY on this innovative program that combines home care and emergency medical service capabilities," says Dr. Kevin Munjal, Associate Medical Director of Prehospital Care and Clinical Champion for Care Transitions for MSPPS. (vnsny.org)
- For more information about the PASSE program, participating health plans and the Summit Community Care approach, visit www.medicaid.state.ar.us/General/programs/passe.aspx . (businesswire.com)
- The Alabama Medicaid Advisory Commission overwhelmingly voted this afternoon to recommend the state go with a community care approach -- instead of statewide commercial managed care -- to try to control spending in the healthcare program for the poor. (arisecitizens.org)
- Lawmakers said the program was overwhelming the state budget and needed to be privatized to rein in costs and improve patient care. (blogspot.com)
- Under the CD-PASS program option, participants are free to choose their own personal care providers. (payingforseniorcare.com)
- Originally not available statewide, the program became available in all Oklahoma counties as of November 2015. (payingforseniorcare.com)
- By June 1996, in an effort to meet those challenges, 35 states (including the District of Columbia) reported enrolling at least some people living with HIV/AIDS (PLWHIV) in their risk-based Medicaid managed care programs. (nashp.org)
- The principal populations enrolled in Medicaid managed care have been children and adults in poor single-parent families who receive Aid to Families with Dependent Children (AFDC) and low-income pregnant women and children, rather than the elderly or disabled. (kff.org)
- Earning Multicultural Health Care Distinction shows that an organization is making a breakthrough in providing excellent health care to diverse populations. (businesswire.com)
- The act was designed to ensure that more Americans had coverage and that the focus of providers was on improving the health of populations, reducing the per capita cost and improving the patient experience. (wilmingtonbiz.com)
- SUPPORT the development of strategies that would allow local governments to work with the state and federal government to serve target populations: the chronically homeless, veterans, and families and children, with particular emphasis on children aging out of the foster care system. (fl-counties.com)
- Several topics covered are specific to state Medicaid programs and include payment reform, managing high-need, high-cost populations, and practice transformation models that integrate physical and behavioral health. (ncsl.org)
- One hospital initiated a plan to increase vaccination among those populations through targeted community benefit activities and increased efforts to vaccinate the managed care population. (histalkpractice.com)
- For many years, physical therapists have been accepted by both the health care community and the public at large as being qualified to provide safe and effective exercise programs to a wide variety of patient populations. (redorbit.com)
- These children must enroll in a Managed Medical Assistance plan. (docplayer.net)
- Texas Medicaid and CHIP coverage is available statewide. (dentaquest.com)
- Key staff members from Tennessee's Department of Intellectual and Developmental Disabilities and the Bureau of TennCare, the state Medicaid agency, will review their CMS-approved statewide HCBS transition plan and discuss their road to this approval. (lutheranservices.org)
- Tennessee is the first and only state to receive approval of their statewide transition plan to comply with the HCBS Settings Rule from CMS. (lutheranservices.org)
- But how will providers actually make that transition? (histalkpractice.com)
- In addition, these technologies have proven indispensable for communicating among care providers and managing the transition from the inpatient to the outpatient setting-a process that is notorious for errors. (the-hospitalist.org)
- Although 18 states offered managed care plans for disabled or elderly beneficiaries eligible for Supplemental Security Income (SSI) in 1993, only a small fraction of this population is enrolled in managed care. (kff.org)
- 4) "Eligible individual" means a child with a special health care need or a female with a high-risk pregnancy, who meets the financial and medical eligibility standards established in s. 391.029. (flsenate.gov)
- Many items that have long been part of the HHS platform remain in the legislative package, although the committee considered and approved a handful of new items, including support for minimum regulatory standards for sober homes/recovery residences as well as supporting efforts to steer veterans who are eligible for federal health care benefits into the appropriate programs. (fl-counties.com)
- This Plan is available to eligible families statewide without litigation. (floir.com)
- As of December 31, 2012 , Medicaid accounted for 77% of our at-risk membership, while CHIP (also including Foster Care) and ABD (also including Medicare) accounted for 9% and 12% , respectively. (dailystocks.com)
- Plans sold on the private market are sold by commercial insurance providers and are considered any kind of health insurance plan not offered by the government, such as Medicare or Medicaid. (ncsl.org)
- Coordinated Care Initiative (CCI) Implemented to Improve Coordination of Health Care and LTSS for SPDs and Reduce Overall Costs. (ca.gov)
- Dr. Feinbloom was part of a panel of Massachusetts' healthcare and information systems leaders advocating for additional funding of a statewide initiative to install Computerized Physician Order Entry (CPOE) systems and other advanced information technologies in each hospital across Massachusetts. (the-hospitalist.org)
- This grant will allow HCA to substantially extend our reach in giving home care clinicians the tools necessary to address what the CDC has already identified as an urgent health crisis," said HCA President Joanne Cunningham. (hca-nys.org)
- We thank NYSHealth for recognizing this powerful opportunity allowing home care clinicians to hone their expertise by elevating the unique and dangerous risks of undetected sepsis - and addressing those risks head-on in a focused, targeted manner. (hca-nys.org)
- More than 40 percent of payers and providers hadn't even staffed their compliance committees to start drawing up a plan to meet mandated deadlines. (managedcaremag.com)
- This assumes an average health-care cost of €2,000 per individual covered for payers in the developed world. (bcg.com)
- 6. Implement the statewide plan. (cdc.gov)
- She has extensive experience in research, clinical trials, community outreach and teaching direct care delivery. (nih.gov)
- and coordinate clinical, behavioral and emergency health care. (colorado.gov)
- Sign up for Insight Alerts highlighting editor-chosen studies with the greatest impact on clinical care. (aappublications.org)
- The integration between Cerner's EHR and practice management solutions will help the care team benefit from one complete workflow and easy navigation to all capabilities in the solutions, from scheduling and clinical care to billing. (cerner.com)
- He is also clinical professor of pediatrics and health care policy at the Harvard Medical School. (unt.edu)
- Clinical decision support tools that offer consumer insights and engagement opportunities can provide critical support for providers who are looking to better manage care coordination, patient engagement, and chronic diseases, which can be too complex for staff with limited time and resources to handle on their own. (histalkpractice.com)
- This collaboration demonstrates how health care professionals across the service provision spectrum can work together to optimize clinical care and patient experience. (vnsny.org)
- For example, HSSC has developed IT systems that allow members to share large numbers of secure patient health records while maintaining patient privacy, as well as systems that make it easier for researchers to find willing participants for clinical trials and manage those clinical trials more efficiently. (dukeendowment.org)
- Statewide data showed a pneumonia vaccination rate of 61 percent for men age 65 or higher, and a vaccination rate among Filipinos age 65 or higher of just 51 percent - much lower than the Healthy People 2020 target of 90 percent set by HHS. (histalkpractice.com)
- MultiCare's urgent-care expansion and the acquisition of Immediate Clinic is part of a grand strategy that projects the system will grow unique patient visits from 294,000 in 2014 to 1.3 million by 2020, she said. (modernhealthcare.com)
- The CCI is a joint state‑federal demonstration project that was implemented beginning in 2012‑13, and designed to improve the coordination of health care and LTSS and reduce the overall costs of providing care for SPDs. (ca.gov)
- The steps taken under the CCI to enhance the coordination and integration of health care and LTSS are steps in the right direction. (ca.gov)
- Jackson Health System, the area s largest safety net provider, is struggling financially, which, coupled with a lack of coordination among safety net providers, undermines the community s ability to respond to the prolonged economic downturn. (hschange.org)
- This brief does not assess the success of these strategies, but instead focuses on the mechanisms the states are using to improve care coordination for individuals with both behavioral health and housing needs. (hhs.gov)
- The study examined the mechanisms that states are using to improve care coordination for adult Medicaid beneficiaries with behavioral health conditions. (hhs.gov)
- This work not only draws on the home care clinician's unique capabilities to screen for sepsis, but it rightly envisions home care as a hub for physician or hospital interventions to treat a condition where timely coordination can truly mean the difference between life and death. (hca-nys.org)
- The Summit Community Care service model focuses on empowering consumers and families through one-on-one support and customized care plans," said Doug Stadter, Summit Community Care's vice president of Care Coordination. (businesswire.com)
- There's another carrot: Medicaid reimbursement for primary care will increase for two years, 2013 and 2014. (bizjournals.com)
- Editor's Note: In the rest of this chapter, we outline (on the left hand pages) the step-by-step process for developing and implementing a statewide screening plan and provide a discussion of those steps on the facing right hand pages. (cdc.gov)
- 1) Provide to children with special health care needs a family-centered, comprehensive, and coordinated statewide managed system of care that links community-based health care with multidisciplinary, regional, and tertiary pediatric specialty care. (flsenate.gov)
- MCCP works with individuals, private providers and public agencies in the Twin Cities metropolitan area to prevent crises and provide appropriate behavioral interventions and support. (lutheranservices.org)
- As one of SAMHSA's 10 Regional Administrators, she will provide expertise on behavioral health and information on SAMHSA's programs to federal, state, and other behavioral health service providers within the four-state area. (behavioral.net)
- We provide dental benefits for Texas Medicaid and CHIP that cover a full range of care. (dentaquest.com)
- In the United States, NBS programs typically provide carrier results to the child's primary care provider (PCP) for disclosure to the parent. (pubmedcentralcanada.ca)
- While some exceptions exist, in some conditions spouses and legal guardians can be paid to provide care. (payingforseniorcare.com)
- Appropriately called Partners HealthCare System, the union of Massachusetts General Hospital and Brigham and Women's Hospital responded to the call for downsizing and consolidation of expenses in a market in which 30% to 40% of acute-care beds were projected to be closed during the next five years, says Samuel Thier, system president and CEO. (modernhealthcare.com)
- To prepare today's students to begin thinking and acting like nurses, Principles of Pediatric Nursing , Seventh Edition presents a foundation of core pediatric nursing principles with an emphasis on growth and development, family-centered care, and health promotion and maintenance. (ecampus.com)
- Appendix Table 1 displays the number of Medicaid enrollees in managed care plans by state as of June 1994. (kff.org)
- The number of enrollees in managed long-term care is likely to grow in the next few years. (hhs.gov)
- Managed care plans must develop and maintain provider networks that meet the medical needs of their enrollees in accordance with standards established pursuant to s. 409.967 (2)(c). (flsenate.gov)
- b) Certain providers are statewide resources and essential providers for all managed care plans in all regions. (flsenate.gov)
- All managed care plans must include these essential providers in their networks. (flsenate.gov)
- Whether you drive Boston's billboard bedecked highways, stroll the taxi cluttered avenues or hop the "T"-the popular public transit system-there's no escaping the ads for managed-care plans. (modernhealthcare.com)
- We want the plans engaged with us to make this a success," says Sandra Fenwick, the executive in charge of developing a risk-bearing provider network for CareGroup, one of several regional healthcare systems coming to prominence. (modernhealthcare.com)
- In addition, NCQA also awarded the Multicultural Health Care Distinction to 16 other Medicaid health plans affiliated with Amerigroup's parent company. (businesswire.com)
- The statewide rollout of Medicaid managed care has interrupted health care access for vulnerable Illinoisans because of low health literacy and incomplete information from plans. (aidschicago.org)
- As recommended by the federal government, the bill requires Medicaid managed care plans to report annually on the percentage of their members with undetectable viral loads, meaning their HIV is successfully treated. (aidschicago.org)
- Now, as a licensed commercial HMO, Yale Preferred Health plans to target employers statewide. (courant.com)
- Its plans offer true statewide coverage and access to providers in all areas of the state. (healthplanone.com)
- Numerous health plans and providers serve the Miami market. (hschange.org)
- The chart uses the statewide average rates of all insurance plans. (ny.gov)
- TPAs can also assist their clients with designing and implementing benefit plans, managing plans, and with billing/collecting of funds (or premiums) for distribution to the vendors involved. (docplayer.net)
- Providers who participate in these plans are called Wellmark Health Plan Network providers. (iowa.gov)
- The health department has invested more than $30 million since 2012 to develop a statewide health navigator workforce. (colorado.gov)
- August 2, 2012 marked the beginning of a new way of thinking for their organization that will forever change how Cedar Lake views and supports its direct care workforce. (lutheranservices.org)
- Previously House Bill 7071 by Representative Cary Pigman (R-Sebring) and the Select Committee on Health Care Workforce Innovation, House Bill 7113 now includes provisions that would authorize ARNPs to prescribe controlled substances within the framework of a supervisory protocol with a physician. (adamsandreese.com)
- Statewide coverage among the 177,903 Florida seventh graders enrolled in 617 public schools was substantially lower (59.6%) than that among the 18,171 enrolled in 669 private schools (83.8%) (less than or equal to 0.01). (cdc.gov)
- NICA manages the Florida Birth Related Neurological Injury Compensation Plan (Plan) used to pay for the care of infants born with certain neurological injuries. (floir.com)
- The statewide privatization, a victory for state Republicans, meant Florida had to convince federal health officials that mistakes from the pilot wouldn't be repeated. (washingtontimes.com)
- Florida Gov. Rick Scott signed two historic Medicaid bills Thursday, placing the health care of nearly 3 million Florida residents into the hands of for-profit companies and hospital networks. (blogspot.com)
- It also would establish eligibility requirements for out-of-state providers and would require them to register with the Florida Department of Health that would list all out-of-state providers on their website. (adamsandreese.com)
- The health plan is a collaboration between the Arkansas Provider Coalition and an affiliate of Amerigroup Corporation to serve Medicaid consumers across all of Arkansas who have mental health issues, substance use disorders, and intellectual and developmental disabilities. (businesswire.com)
- It is led by 70 Arkansas community providers who serve individuals with intellectual and developmental disabilities, substance use disorders and mental health disorders. (businesswire.com)
- Summit Community Care is now serving Arkansas Medicaid consumers statewide who struggle with mental health, substance use and disabilities. (businesswire.com)
- Summit Community Care is a joint venture between the Arkansas Provider Coalition and Anthem Partnership Holding Company, LLC, an affiliate of one of the nation's leading health benefits companies. (businesswire.com)
- An analysis of statewide historical hospitalization data in Hawaii revealed high rates of preventable admissions due to bacterial pneumonia. (histalkpractice.com)
- St. Vincent is not a member of the provider network for Baptist's Health Advantage HMO, and Baptist is not a member of the provider network for QCA Health Plan. (gartner.com)
- HRINJ said its provider network will be run by QualCare, a statewide managed care company based in Piscataway. (crainsnewyork.com)
- It also will manage a network of more than 6,500 care providers. (wikipedia.org)
- Welcome to the new and improved AJMC.com, the premier managed markets network. (ajmc.com)
- The agency is authorized to limit the entities it contracts with or enrolls as Medicaid providers by developing a provider network through provider credentialing. (flsenate.gov)
- Benefits includeâ€"preventive care coverage, $5 million lifetime maximum, office visits for illness or injury, lab work and x-rays, hospital stays, prescription drugs, and surgery covered at either 80% or 100% in network after deductible. (healthplanone.com)
- Each Medicaid managed care dental plan is responsible for contracting with general dentists, pediatric dentists, and dental specialists to create a delivery network. (tmhp.com)
- MBHP network providers can view the Provider Manual and performance specifications, submit claims, request service authorizations, and much more. (masspartnership.com)
- The MBHP provider network is one of the largest in Massachusetts. (masspartnership.com)
- McLaren has 22,000 employees and more than 37,500 individual providers in its state-wide provider network. (cerner.com)
- There are also fewer restrictions on seeing out-of-network providers. (ncsl.org)
- An exclusive provider organization (EPO) is an arrangement where coverage only applies if the person receives treatment at facilities and from providers that are in their network. (ncsl.org)
- They are like PPOs in that members are not required to see a PCP first, but they are also like HMOs because enrollees must use a specific network of providers. (ncsl.org)
- Ninety-five percent of an extended network of over 150 healthcare staff polled at the symposium believes their role at their healthcare organization will be impacted by an increasing focus on value-based care within the next two years. (histalkpractice.com)
- The agency contracts with a state-wide network of 46,449 providers. (worldpharmanews.com)
- Under the new agreements, insurance companies are required to honor appointments or treatments that were already scheduled under another insurance company even if the provider is out of network. (washingtontimes.com)
- The column chart shows performance measurement rates for the managed care provider network by payer. (ny.gov)
- Not all providers in the counties sharing a border with Iowa participate in the Iowa Choice network. (iowa.gov)
- Keep in mind with this option you can see any provider you choose, but you will have lower out-of-pocket expenses if you choose a network provider. (iowa.gov)
- As a result, countless Alabamians who otherwise would have suffered neglect have access to health care. (nih.gov)
- In response to pressures to contain the growth of State and Federal Medicaid spending and to concerns about access to health care for low-income individuals, the use of managed care arrangements in Medicaid has grown dramatically in recent years. (kff.org)
- It reflects the widely held belief that managed care can improve health care access as well as promote cost containment and budget control. (kff.org)
- Increased PrEP-related training and support for LHD-based providers could enhance PrEP access, especially in rural and underserved areas. (ovid.com)
- Hospital systems are using acquisitions and joint ventures with urgent-care chains to build out patient access points in their markets that are a lower-cost alternative to emergency rooms for cuts, sprains and flu. (modernhealthcare.com)
- As a Presbyterian Health Plan member, you have access to more than 17,000 providers in more than 500 locations statewide and bordering communities. (phs.org)
- The CDW not only provides a complete electronic health record for all of a patient's health care providers, but also gives researchers access to massive amounts of anonymous, real-time patient data, to allow them to more rapidly and accurately conduct statistical analyses of health-related factors across a broad sample of a specific population. (dukeendowment.org)
- The statewide plan for childhood blood lead screening developed by the health department should, at a minimum, have the input of child health-care providers, insurers, and parents. (cdc.gov)
- The lists of provider networks are also closely monitored - a huge problem with the federal health law - and uncompliant insurers can face financial penalties or potentially lose their contract. (washingtontimes.com)
- Managed care, a new system that was rapidly emerging, envisioned a more central role for insurers. (washingtonpost.com)
- This merger puts us in the top 1 percent in the nation for home care agencies in terms of size. (spokanejournal.com)
- It is being increasingly incorporated by home care agencies in New York. (hca-nys.org)
- Blue Cross affiliates Constitution HealthCare and BlueCare were merged into Blue Cross last year, and a third affiliate -- Community Health Care Plan -- was recently disbanded. (courant.com)
- She lives by the motto, "If you're in healthcare and you're not providing direct patient care, you'd better be supporting those that do. (nevadabusiness.com)
- Elaine is passionate about healthcare, team building and providing excellent patient care. (nevadabusiness.com)
- All of this makes it easier for you to manage your healthcare needs. (phs.org)
- Summit Community Care combines the extensive resources of Amerigroup's family of companies, robust experience as an accredited NCQA Managed Behavioral Healthcare Organization and diverse expertise in developing and managing Medicaid managed care programs along with Arkansas' leading behavioral and disability health experts. (businesswire.com)
- NYAPRS Note: Some groundbreaking work done in NYS in both state operated clinic and primary care settings to improve the integration of medical and behavioral healthcare. (nyaprs.org)
- For the past 125 years it has been the generosity and investment of our supporters and community, the excellence, energy and innovation of the people at MCW, and the contributions of our partners which have propelled us to create the knowledge that is changing lives in education, research and patient care. (mcw.edu)
- State public health officials should develop a statewide plan for childhood blood lead screening. (cdc.gov)
- State health officials should form an advisory committee to develop the statewide plan. (cdc.gov)
- Virtually every state is increasing their reliance on managed care as a health care delivery model for its Medicaid population. (kff.org)
- Due to the growing interest in managed care from both the State and Federal governments, the number of Medicaid beneficiaries enrolled in managed care is expected to continue to rise in the foreseeable future. (kff.org)
- To establish Medicaid managed care programs, a state usually must obtain one of two types of waivers from HCFA - Section 1915(b) freedom-of-choice waivers and Section 1115 research and demonstration waivers. (kff.org)
- In fact, HMOs recently passed along an increase in state-mandated payments for uncompensated care, with little squawking from employers. (modernhealthcare.com)
- Savings notwithstanding, the budget predictability that comes with capitated payments is appealing to state policymakers as growing numbers of long-term care consumers place increasing pressure on Medicaid budgets. (hhs.gov)
- A spokesman for Passport, the Louisville-based managed care company that serves about 320,000 Medicaid enrollees statewide, said it is working to eliminate the copays by Aug. 1, acting under "guidance" it received this week from the state. (courier-journal.com)
- A state-by-state analysis of training requirements for personal care aides. (phinational.org)
- For personal care aides-who constitute the second fastest-growing occupation in the nation-training standards vary considerably from state to state. (phinational.org)
- To identify PCA training standards, we conducted systematic searches of state administrative codes, Medicaid provider manuals, and Medicaid waiver documents. (phinational.org)
- With state bud-gets hol-lowed out by the per-fidy of the mort-gage indus-try and a bud-get régime that cuts invest-ments in health to fund tax breaks for cor-po-ra-tions, leg-is-la-tors across the nation are now look-ing to find ways to cut costs - and if there's time, improve the qual-i-ty of care. (inthesetimes.com)
- Under this sys-tem, pri-vate insur-ance com-pa-nies, or Man-aged Care Orga-ni-za-tions (MCO), receive a fixed month-ly pay-ment from the state per Med-ic-aid patient. (inthesetimes.com)
- Worse still, if MCOs make a patient dri-ve three hours to see an " in-net-work" spe-cial-ist he or she needs, chances are less-ened that the patient will make it to that pro-fes-sion-al at all - and the MCO can keep the funds it receives from the state with-out pay-ing for that person's care. (inthesetimes.com)
- Obtained a federal court dismissal of a State Board of Medical Examiners' disciplinary action against a physician medical director for a national managed care organization. (clarkhill.com)
- Although initially undecided about the full Medicaid expansion scheduled for Jan. 1, 2014, Democratic Gov. John Hickenlooper, backed by a broad coalition of health care providers and advocates, pushed the state Legislature for approval. (hschange.org)
- Down the road, respondents expected RCCOs to assume financial risk for Medicaid enrollees' care and possibly operate in the state insurance exchange. (hschange.org)
- State Health Officer Don Williamson said it would take statewide a model that is already used to some degree in Tuscaloosa, Huntsville, Opelika and Mobile. (arisecitizens.org)
- UCare, its partner businesses and about 370,000 of its clients face uncertain times as a result of a competitive bidding process for state health care contracts. (accesspress.org)
- State officials have said they will award managed care contracts county-by-county, with at least two plan options in most counties. (accesspress.org)
- While admitting that it could be "significant and quite possibly devastating" for UCare to lose its clients through state public programs, Awsumb stated that other providers lost public programs in the past but survived. (accesspress.org)
- The clients are among an estimated 475,000 Minnesotans who must switch public health plan providers in January 2016. (accesspress.org)
- Additionally, HCA and IPRO have partnered to conduct a series of statewide provider webinars on use of the tool. (hca-nys.org)
- There are six steps to developing and implementing the statewide screening plan. (cdc.gov)
- Managed care plan accountability. (flsenate.gov)
- 409.975 Managed care plan accountability. (flsenate.gov)
- A rate schedule for all essential providers shall be attached to the contract between the agency and the plan. (flsenate.gov)
- In particular, a triad of managed-care biggies-Blue Cross and Blue Shield of Massachusetts, Harvard Pilgrim Health Care and Tufts Health Plan-has dominated the HMO market for years. (modernhealthcare.com)
- Aware Care - a traditional plan that gives you independence and security. (healthplanone.com)
- An HMO requires a patient to be evaluated by a primary care provider (PCP) to determine the appropriate plan of care. (ncsl.org)
- Copayments are typically paid at the time of service in the form of a flat fee by the enrollee to cover a portion of the care that is otherwise covered by the plan. (ncsl.org)
- Where Clinton and his team crafted their health-care reform plan in the executive branch, Obama has left the details of his effort almost entirely to Congress. (washingtonpost.com)
- Iowa Choice is a managed care plan. (iowa.gov)
- In fact, the leading HMOs are looking before leaping into capitated contracts, sometimes delaying deals with willing providers deemed not yet up to the task. (modernhealthcare.com)
- It fully aligns with our goal to foster collaboration among public and private individuals and entities to build a responsive health care system for Oklahoma," said Nancy Nesser, J.D., Pharm.D., OHCA Pharmacy director. (worldpharmanews.com)