Ch 3 Terms
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| show | A predetermined payment for providers who take care of a designated patient population. Providers work together to provide care. Quality targets must be met.
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| Accreditation | show 🗑
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| show | A voluntary credentialing process whereby applicants who meet specific requirements may receive a certificate.
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| Exclusive Provider Organization (EPO) | show 🗑
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| show | A health plan that combines coverage of health care costs and delivery of health care for a prepaid premium.
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| show | Offered to individuals covered by high-deductible health plans, these accounts let these individuals save money, tax free, to pay for medical expenses.
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| High Deductible Health Plan (HDHP) | show 🗑
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| show | A type of HMO that contracts with groups of physicians who practice in their own offices and receive a per-member payment (capitation) from participating HMOs to provide a full range of health services for HMO members.
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| Licensure | show 🗑
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| show | A system in which financing, administration, and delivery of health care are combined to provide medical services to subscribers for a prepaid fee.
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| show | A corporation that links health care financing, administration, and service delivery.
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| show | A physician group purchases a hospital, which then contracts with employers to provide full health care services.
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| show | Subscribers may see any in network provider without a referral.
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| Patient Centered Medical Home (PCMH) | show 🗑
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| show | A health care plan in which physicians join with hospitals to provide a medical care delivery system and then contract for insurance with a commercial carrier or an HMO.
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| show | A primary care physician determines services for the patients within a network.
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| show | State laws written for the express purpose of governing the practice of a specific health care profession.
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| show | A network of independent physicians, hospitals, and other health care providers who contract with an insurance carrier to provide medical care at a discount rate to patients who are part of the insurer’s plan.
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| Primary Care Physician (PCP) | show 🗑
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| Professional Boards | show 🗑
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| Reciprocity | show 🗑
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| show | Similar to certification, individuals must meet certain educational requirements, as well as possibly successfully completing a nation exam.
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| Scope of Practice | show 🗑
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