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Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
Blue Cross Blue Shield insurers offer some form of health insurance coverage in every U.S. state, and also act as administrators of Medicare in many states or regions of the United States, and provide coverage to state government employees as well as to federal government employees under a nationwide option of the Federal Employees Health ...
The five largest carriers in the small group market, when combined, represented three quarters or more of the market in 34 of the 39 states supplying this information, and they represented 90% or more in 23 of these states....the median market share of all the BCBS carriers in 38 states reporting this information in 2008 was about 51%, compared ...
BCBS 239 is the Basel Committee on Banking Supervision's standard number 239. The subject title of the standard is: "Principles for effective risk data aggregation ...
Healthcare reform in the United States has had a long history.Reforms have often been proposed but have rarely been accomplished. In 2010, landmark reform was passed through two federal statutes: the Patient Protection and Affordable Care Act (PPACA), signed March 23, 2010, [1] [2] and the Health Care and Education Reconciliation Act of 2010 (), which amended the PPACA and became law on March ...
Premera Blue Cross is a not-for-profit Blue Cross Blue Shield licensed health insurance company based in Mountlake Terrace, Washington, United States. It sells health insurance plans under the Blue Cross license in Washington state except Clark County and under both of the Blue Cross and Blue Shield licenses in Alaska .
There were a number of different health care reforms proposed during the Obama administration.Key reforms address cost and coverage and include obesity, prevention and treatment of chronic conditions, defensive medicine or tort reform, incentives that reward more care instead of better care, redundant payment systems, tax policy, rationing, a shortage of doctors and nurses, intervention vs ...
In parliamentary procedure, reconsideration of a motion (or reconsideration of a question) may be done on a matter previously decided. The motion to "reconsider" is used for this purpose. This motion originated in the United States and is generally not used in parliaments. [1] [2] A special form of this motion is reconsider and enter on the ...