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  2. All-payer rate setting - Wikipedia

    en.wikipedia.org/wiki/All-payer_rate_setting

    All-payer rate setting is a price setting mechanism in which all third parties pay the same price for services at a given hospital. [1] It can be used to increase the market power of payers (such as private and/or public insurance companies) versus providers, such as hospital systems , in order to control costs.

  3. Affordable Care Act - Wikipedia

    en.wikipedia.org/wiki/Affordable_Care_Act

    The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act (PPACA) and informally as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010.

  4. Case management (US healthcare system) - Wikipedia

    en.wikipedia.org/wiki/Case_management_(US...

    The generic model used in the United States is the chronic care model, which holds that health care does not only involve change in the patient and that high-quality disease care counts the community, the health system, self-management support, delivery system design, decision support, and clinical information systems as important elements in ...

  5. Bundled payment - Wikipedia

    en.wikipedia.org/wiki/Bundled_payment

    In July 2009, a Special Commission on the Health Care Payment System in Massachusetts distinguished between episode-based payments (i.e., bundled payments) and "global payments" that were defined as "fixed-dollar payments for the care that patients may receive in a given time period... plac[ing] providers at financial risk for both the ...

  6. 'Health insurance companies are always going to need a PBM ...

    www.aol.com/finance/health-insurance-companies...

    CVS Health group president and executive vice president Prem Shah told Yahoo Finance that PBMs, used by a majority of Fortune 500 companies, endeavor to lower costs of branded drugs — yet just ...

  7. Single-payer healthcare - Wikipedia

    en.wikipedia.org/wiki/Singlepayer_healthcare_in...

    Single-payer contrasts with other funding mechanisms like "multi-payer" (multiple public and/or private sources), "two-tiered" (defined either as a public source with the option to use qualifying private coverage as a substitute, or as a public source for catastrophic care backed by private insurance for common medical care), and "insurance ...

  8. Healthcare reform in the United States - Wikipedia

    en.wikipedia.org/wiki/Healthcare_reform_in_the...

    More recently, however, polling support has declined for that sort of health care system, [57] [58] with a 2007 Yahoo/AP poll showing 54% of respondents considered themselves supporters of "single-payer health care," [62] a majority in favor of a number of reforms according to a joint poll with the Los Angeles Times and Bloomberg, [63] and a ...

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