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Ch3 Delivery Systems

Evolution of OT Delivery Systems

Capitation A fixed amount periodically paid to a provider for delivery of services for each person covered under a contract or policy
Entitlements Government payments that are made through legislatively specified programs to individuals having certain designated characteristics and circumstances, such as age or need
Health Maintenance Organization (HMO) A prepaid organized delivery system where the organization and the primary care physicians assume some financial risk for the care provided to its enrolled members
Indemnity The standard fee-for-service insurance policies provided by employers, organizations, or individuals. Usually the most expensive type, this insurance covers service from any provider
Managed Care A synonym for all kinds of integrated delivery systems, in contrast with unmanaged, fee-for-service care.
Medigap insurance Medicare supplemental insurance policies that are available through private companies
Point of service plan (POS) An open-access plan similar to an HMO that provides limited coverage for self-referral outside the network
Preferred provider organization (PPO) An entity that acts as a broker between the purchaser of care and the provider in which consumers have the option of using the preferred providers available with the plan or not
Created by: dbarb702