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ch 3 UHI


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
Created by: Mika42016