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Washington Apple Health is the Medicaid and State Children's Health Insurance Programs offered in Washington state. The program was initiated on January 1, 2014. [1] It was preceded in 2008 by a children's health plan run by the Washington State Department of Social and Health Services (DSHS) called "Apple Health for Kids". [2]
The Exchange sustainability is tied to three funding sources established in statute: (1) the existing 2 percent tax on health insurance premiums sold through Washington Healthplanfinder; (2) reimbursement for activities performed on behalf of Washington Apple Health (the state's Medicaid program), and; (3) an agreed upon carrier assessment. The ...
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 ...
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Open network plans provide some coverage when an enrollee uses non-network provider, generally at a lower benefit level to encourage the use of network providers. Most preferred provider organization plans are open-network (those that are not are often described as exclusive provider organizations, or EPOs), as are point of service (POS) plans.
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Five factors that can be used to assess the advancement level of a particular IDN include provider alignment, continuum of care, regional presence, clinical integration, and reimbursement. [5] Between 2013 and 2017, healthcare providers created 11 new integrated delivery systems from joint ventures with insurance companies. [6]
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