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Secondary capitation is a relationship arranged by a managed care organization between a physician and a secondary or specialist provider, such as an X-ray facility or ancillary facility such as a durable medical equipment supplier whose secondary provider is also paid capitation based on that PCP's enrolled membership.
In the United States, an independent practice association (IPA) is an association of independent physicians, or other organizations that contracts with independent care delivery organizations, and provides services to managed care organizations on a negotiated per capita rate, flat retainer fee, or negotiated fee-for-service basis.
The term accountable care organization was first used by Elliott Fisher in 2006 during a discussion of the Medicare Payment Advisory Commission. In 2009, the term was included in the federal Patient Protection and Affordable Care Act. [2] It resembles the definition of Health Maintenance Organizations (HMO) that emerged in the 1970s. Like an ...
A 1998 report to the Health Care Financing Administration (now known as the Centers for Medicare and Medicaid Services) noted that in the five years of the demonstration project, the seven hospitals would have had expenditures of $438 million for coronary artery bypasses for Medicare beneficiaries, but the change in reimbursement methodology ...
In 1974, On Lok started being reimbursed by Medicaid for its provision of adult day health services. [3] Later, in 1978, these health services were broadened to include comprehensive medical care for older adults certified to be nursing home-eligible. [3] 1979. The Department of Health and Human Services provided a four-year grant to On Lok to ...
In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at ...
On this week's overreaction pod, Dan Wetzel Ross Dellenger and SI's Pat Forde acknowledge what led to home teams handedly winning each matchup. They cover how offensive line and defensive line ...
Easy Baked Brie. All you need is a drizzle of honey and a sprinkling of fresh herbs to make this fancy baked brie. The result is a melty cheese with sweet and savory flavor that's perfect for ...