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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, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. [1] It is an organization that provides or arranges managed care for health insurance , self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care ...
Policies may vary from low cost to all-inclusive to meet different demands of customers, depending on needs, preferences, and budget. Fee-for-service is a traditional kind of health care policy: insurance companies pay medical staff fees for each service provided to an insured patient. Such plans offer a wide choice of doctors and hospitals.
HMO. Health Maintenance Organization plans are often considered the most affordable insurance option. With low deductibles and low copays for doctor visits and pharmaceuticals, HMOs are affordable ...
Currently, managed care is the most common health care delivery system in Medicaid. In 2007, nearly two-thirds of all Medicaid beneficiaries are enrolled in some form of managed care – mostly, traditional health maintenance organizations (HMO) and primary care case management (PCCM) arrangements.
A health savings account (HSA) and a health maintenance organization (HMO) are both intended to help people cover the costs of medical care. However, they take very different approaches.
Like an HMO, an ACO is "an entity that will be 'held accountable' for providing comprehensive health services to a population." [ 3 ] The model builds on the Medicare Physician Group [ 4 ] [ 5 ] Practice Demonstration and the Medicare Health Care Quality Demonstration, [ 6 ] [ 7 ] established by the 2003 Medicare Prescription Drug, Improvement ...
The Health Maintenance Organization Act of 1973 (Pub. L. 93-222 codified as 42 U.S.C. §300e) is a United States statute enacted on December 29, 1973. The Health Maintenance Organization Act, informally known as the federal HMO Act, is a federal law that provides for a trial federal program to promote and encourage the development of health maintenance organizations (HMOs).