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e. In the United States, an exclusive provider organization ( EPO) is a hybrid health insurance plan in which a primary care provider is not necessary, but health care providers must be seen within a predetermined network. Out-of-network care is not provided, and visits require pre-authorization. Doctors are paid as a function of care provided ...
Self-funded health care, also known as Administrative Services Only ( ASO ), is a self insurance arrangement in the United States whereby an employer provides health or disability benefits to employees using the company's own funds. [1] This is different from fully insured plans where the employer contracts an insurance company to cover the ...
t. e. Consumer-driven healthcare ( CDHC ), or consumer-driven health plans ( CDHP) refers to a type of health insurance plan that allows employers and/or employees to utilize pretax money to help pay for medical expenses not covered by their health plan. These plans are linked to health savings accounts (HSAs), health reimbursement accounts ...
Municipal health coverage. v. t. e. In the United States, a high-deductible health plan ( HDHP) is a health insurance plan with lower premiums and higher deductibles than a traditional health plan. It is intended to incentivize consumer-driven healthcare. Being covered by an HDHP is also a requirement for having a health savings account. [1]
t. e. The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("managed care techniques"). It has become the predominant system of delivering and receiving ...
Integrated care, also known as integrated health, coordinated care, comprehensive care, seamless care, interprofessional care or transmural care, is a worldwide trend in health care reforms and new organizational arrangements focusing on more coordinated and integrated forms of care provision. Integrated care may be seen as a response to the ...
In 1994, the plan's first year of operation, nearly 120,000 new members enrolled, and bad debts at Portland hospitals dropped 16%. [1] The cost of the Oregon Health Plan increased from $1.33 billion in 1993–1995 to $2.36 billion in 1999–2001, leading to budget-tightening measures in the early 2000s; [1] significant cuts would follow in 2003.
Municipal health coverage. v. t. e. An accountable care organization ( ACO) is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs in the United States are formed from a group of coordinated health-care practitioners. They use alternative payment models, normally, capitation.