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  • insurers
  • The authors advocate for an approach that partly relies on government to move providers and insurers away from fee-for-service waste. (healthcare-informatics.com)
  • Chief among their ideas is a push to require insurers and providers to negotiate rates within a budget, known as a global spending target, to prevent open-ended fee-for-service arrangements. (healthcare-informatics.com)
  • Meanwhile, insurers responded to public demands and political pressure by beginning to offer other plan options with more comprehensive care networks-according to one analysis, between the years 1970 and 2005 the share of personal health expenditures paid directly out-of-pocket by U.S. consumers fell from about 40 percent to 15 percent. (wikipedia.org)
  • Establishes a Health Insurance Exchange (HIE) within a proposed Health Choices Administration, to provide a market place for insurers to sell qualifying plans on a public web site. (wikipedia.org)
  • Although out-of-pocket costs are reduced for consumers, controlling for other factors, the plans don't affect total expenditures and payments by insurers. (wikipedia.org)
  • There is also a hybrid concierge model where physicians charge a monthly, quarterly, or annual retainer or membership fee for services that Medicare and insurers do not cover. (wikipedia.org)
  • Large providers tend to manage the risk better than do smaller providers because they are better prepared for variations in service demand and costs, but even large providers are inefficient risk managers in comparison to large insurers. (wikipedia.org)
  • 4.25
  • Combine that with a strong 4.25 stars for both customer service and value for price, an 87 percent recommendation rate and 89 percent renewal rate, and Horizon ended up with a solid score of 88.3 in this years survey. (insure.com)
  • The home phone, long distance and Internet services each had a $4.25 fee, while the Sprint and Fido bundles have a $6.95 fee. (wikipedia.org)
  • medical
  • The company was first formed in 1932 as the Associated Hospitals of Essex County, Inc., and ten years later, the Medical-Surgical Plan of New Jersey was combined. (insure.com)
  • Besides the consumer rankings, the book includes how-to material for comparing health plans, keeping medical bills down, choosing a doctor and negotiating with the Medicare system. (sfgate.com)
  • Most importantly, fee-for-service is able to dictate the prices it will pay to medical service providers. (thenewatlantis.com)
  • GEHA traces its roots to 1937, when the Railway Mail Hospital Association was formed in Kansas City, Missouri, to help provide U.S. Railway Mail Service clerks with assistance for their medical expenses. (wikipedia.org)
  • Assessing these conflicting views, pollster Louis Harris concluded, "So deep is the concern about medical care for the aged that the American people would welcome any of a variety of national plans. (washingtonpost.com)
  • Managed care plans are widely credited with subduing medical cost inflation in the late 1980s by reducing unnecessary hospitalizations, forcing providers to discount their rates, and causing the health care industry to become more efficient and competitive. (wikipedia.org)
  • Health services provided by the hospital include general medical care, general surgery, obstetrics, pediatrics and neonatal care. (wikipedia.org)
  • Lower-cost concierge medical business models have also been attempted, such as GreenField Health in Portland, Oregon, which charged an annual fee between $195-$695 depending on age. (wikipedia.org)
  • customary
  • All generally claim to be accessible via telephone or email at any time of day or night or offer some other service above and beyond the customary care. (wikipedia.org)
  • provide
  • Defined benefit pension plans provide employees with guaranteed retirement benefits based on benefit formulas. (bls.gov)
  • The Employee Retirement Income Security Act (ERISA) of 1974 requires defined benefit pension plans that offer an annuity as a payment option to provide a qualified joint-and-survivor annuity (QJSA) as the normal benefit payment for married participants. (bls.gov)
  • Medicare would provide a premium payment to either pay for or offset the premium of the plan chosen by the senior. (wikipedia.org)
  • Traditional brokers in contrast will often provide financial advice and investment planning as well as related wealth management services. (wikipedia.org)
  • Instead of commission they charge one-off fees for their services, but do not provide financial advice. (wikipedia.org)
  • Municipalities may voluntarily or be mandated by law to work together to provide certain services, but elected representatives from the participating groups govern these partnerships. (wikipedia.org)
  • Clinical geropsychologists provide psychological assessment and intervention to older adults and their families, as well as consultation services to other health care professionals. (wikipedia.org)
  • accrued benefits
  • Normal retirement is the age at which plan participants may retire and receive all accrued benefits. (bls.gov)
  • Early retirement is the age (or a combination of age and length of service) at which plan participants may retire and receive all accrued benefits, minus a reduction for the number of years by which their retirement age precedes their normal retirement age. (bls.gov)
  • costs
  • Bush reportedly would offer private health plans, many of which have said that Medicare payments are not enough to cover their costs, additional funds to encourage them to remain in the program. (californiahealthline.org)
  • Previous estimates by the Congressional Budget Office and the chief actuary of the Medicare program confirm that a move in this direction would lower costs in the Medicare program because in many parts of the country efficient managed care models would be able to offer coverage at much less cost than price-controlled fee-for-service. (thenewatlantis.com)
  • This is an attractive feature since costs are managed through fee levels instead of being shifted to employees. (njbia.org)
  • Outlines Administrative standards that reduces costs and improves service, including the ability for Administrators to determine an accurate total financial estimate at the point of service as well as enabling real time electronic transfer of funds to take place if possible (mirrors currently existing laws). (wikipedia.org)
  • Part C is an alternative to the other parts intended to allow experimentation with differently structured plans in an effort to reduce costs to the government and allow patients to choose plans with more benefits. (wikipedia.org)
  • Payments
  • Defined benefit plans determine payments according to a fixed formula based on salary, years of service, and age. (bls.gov)
  • Payments from defined benefit plans may be in the form of a straight life annuity, a joint-and-survivor annuity, a percentage of the unreduced accrued benefit, or a lump sum. (bls.gov)
  • They are just as resistant to subjecting Medicare fee-for-service to a level playing field of competition as they are enthusiastic about cutting Medicare Advantage's administratively determined payments. (thenewatlantis.com)
  • Medicare Part A provides payments for in-patient hospital, hospice, and skilled nursing services, excluding those of physicians and surgeons. (wikipedia.org)
  • offer
  • BCBSNJ has grown over eight decades to offer several plans to best suit the needs of their customers. (insure.com)
  • allowable
  • CHICAGO (Reuters) - U.S. retirement savers dodged a speeding train last week when Republican lawmakers racing toward tax reform dropped their plan to sharply reduce allowable tax-deferred contributions to 401(k) plans. (reuters.com)
  • The dental PPO is similar to the traditional plan, but features a network of dentists who agree not to charge more than the maximum allowable charge determined by the plan. (njbia.org)
  • widely
  • Now, Medicare is widely seen as an important government service, albeit one politicians have used to increase the coffers of their hometown doctors . (washingtonpost.com)
  • The annual fees vary widely, ranging, on average, from US$195 to US$5,000 per year for an individual with incremental savings when additional family members are added. (wikipedia.org)
  • Nearly
  • Nearly a third of those surveyed said they did not get enough information from their health plans to pick a primary care doctor. (sfgate.com)
  • Managed care plans and strategies proliferated and quickly became nearly ubiquitous in the U.S. However, this rapid growth led to a consumer backlash. (wikipedia.org)
  • dual-eligible
  • In addition, dual-eligibles may choose a type of MA plan called a dual-eligible special needs plan (D-SNP), which is designed to target the needs of this population. (wikipedia.org)
  • tend
  • They also tend to be "pretty sophisticated consumers of these services," said Robert Krughoff , president of the Washington research group. (sfgate.com)
  • Traditional plans tend to be more expensive since they do not hold contracts with network dentists to manage fee levels. (njbia.org)
  • Care
  • So you'll save on health care plan you were stuck with the new goals that wealthy relative? (shubertmotors.com)
  • The survey showed that most people are reasonably happy with the quality of their health care, regardless of whether they are enrolled in a huge HMO, a for-profit chain or a traditional fee-for-service plan. (sfgate.com)
  • California Healthline is a service of the California Health Care Foundation produced by Kaiser Health News , an editorially independent program of the Kaiser Family Foundation . (californiahealthline.org)
  • In addition, the concept of a "care plan" is more fully defined. (healthcare-informatics.com)
  • Because many managed care health plans are provided by for-profit companies, their cost-control efforts created widespread perception that they were more interested in saving money than providing health care. (wikipedia.org)
  • Requires the Secretary of Health and Human Services (HHS) to develop quality measures for the delivery of health care services in the United States. (wikipedia.org)
  • Concierge medicine (also known as retainer medicine) is a relationship between a patient and a primary care physician in which the patient pays an annual fee or retainer. (wikipedia.org)
  • The Fee for Care ('FFC') is an annual retainer model, where the patient pays a monthly, quarterly, or annual retainer fee to the physician. (wikipedia.org)
  • Concierge physicians care for fewer patients than those in a conventional practice, ranging from 50 patients per doctor to 1,000, compared to 3,000 to 4,000 patients that the average traditional physician now sees every year. (wikipedia.org)
  • employee
  • The definitions of the major plans, key provisions, and related terms presented in this glossary are those used by the U.S Bureau of Labor Statistics (BLS) National Compensation Survey (NCS) program when conducting its survey of employee benefits. (bls.gov)
  • Under that program, the government contributes a set amount per employee, and individuals who want more expensive plans pay more. (californiahealthline.org)
  • contrast
  • The plans stand in contrast to the 2012 and 2013 budget proposals, outlined by President Barack Obama and the Congressional Progressive Caucus. (wikipedia.org)
  • amounts
  • The bids are compared to the pre-determined benchmark amounts set, which are the maximum amount Medicare will pay a plan in a given county, by law. (wikipedia.org)
  • patients
  • That means they monitor doctors to see if they are performing more services for their patients than other doctors, or fewer. (wikipedia.org)
  • This model allows the physician to continue to see their non-retainer patients while providing their "concierge" patients a fee for the increased or "special" services. (wikipedia.org)
  • cost
  • Only 32 percent of those surveyed said they would recommend the plan to a friend, assuming cost was not an issue. (sfgate.com)
  • In these cases, the women would have to pay a fee, probably in the form of a $10 co-payment, or 20% of the cost of the procedure, depending on the health plan they join. (latimes.com)
  • That's why it's so important for employers to take a close look at dental benefits carriers and their plan designs to ensure that they select the plan that is both cost effective and health effective. (njbia.org)
  • He designed a plan to transform it into an ultra-low-cost carrier. (wikipedia.org)
  • Although businesses pursued the HMO model for its alleged cost containment benefits, some research indicates that private HMO plans don't achieve any significant cost savings over non-HMO plans. (wikipedia.org)