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ch 3 UHI
vocab
Term | Definition |
---|---|
managed care | responsible for health of a group of enrollees |
MCO | managed care organization |
fee-for-service | reimbursement methodology that increases payment if health care service fees increase |
capitation | providers accepts pre-established payments for providing health care services to enrollees over a period of time |
HEDIS | healthcare effectiveness data and information set |
PCP | primary care provider |
Gatekeeper | primary care provider for essential health care services at lowest possible cost |
case management | development of patient care plans to coordinate and provide care for complicated cases |
SSO | second surgical opinion |
POS | place of service |
HMO | health maintenance organization |
PPO | preferred provider organization |
FSA | flexible spending account |
NCQA | national committee for quality assurance |
HSA | health savings account |