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  2. Centers for Medicare & Medicaid Services - Wikipedia

    en.wikipedia.org/wiki/Centers_for_Medicare...

    The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.

  3. Medicare Prescription Drug, Improvement, and Modernization Act

    en.wikipedia.org/wiki/Medicare_Prescription_Drug...

    Medicare Personal Plan Finder at Medicare.gov — more detailed information about Medicare Advantage Plans; includes ability to do tailored searches based on specified criteria; Landscape of plans — state-by-state breakdown of all plans available an area, both Stand-alone Part D plans, as well as Medicare Advantage plans; Official Medicare ...

  4. Transtheoretical model - Wikipedia

    en.wikipedia.org/wiki/Transtheoretical_model

    Stages of change, according to the transtheoretical model. The transtheoretical model of behavior change is an integrative theory of therapy that assesses an individual's readiness to act on a new healthier behavior, and provides strategies, or processes of change to guide the individual. [1]

  5. Inclusion and exclusion criteria - Wikipedia

    en.wikipedia.org/wiki/Inclusion_and_exclusion...

    Inclusion criteria may include factors such as type and stage of disease, the subject’s previous treatment history, age, sex, race, ethnicity. Exclusion criteria concern properties of the study sample, defining reasons for which patients from the target population are to be excluded from the current study sample. Typical exclusion criteria ...

  6. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    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 ...

  7. Consumer Assessment of Healthcare Providers and Systems

    en.wikipedia.org/wiki/Consumer_Assessment_of...

    They focus on aspects of healthcare quality that patients find important and are well-equipped to assess, such as the communication skills of providers and ease of access to healthcare services. [2] To customize a standardized CAHPS survey, users can add questions on a variety of topics.

  8. Medicare Advantage - Wikipedia

    en.wikipedia.org/wiki/Medicare_Advantage

    Medicare.gov logo. Medicare Advantage (Medicare Part C, MA) is a type of health plan offered by private companies which was established by the Balanced Budget Act (BBA) in 1997. This created a private insurance option that wraps around traditional Medicare. Medicare Advantage plans may fill some coverage gaps and offer alternative coverage ...

  9. Provisions of the Affordable Care Act - Wikipedia

    en.wikipedia.org/wiki/Provisions_of_the...

    Together, these 2,217 hospitals will forfeit more than $280 million in Medicare funds over the next year, i.e., until October 2013, as Medicare and Medicaid begin a wide-ranging push to start paying health care providers based on the quality of care they provide.