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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 |