Also called open access, a self-referral arrangement allowing health plan enrollees to see participating providers for specialty care without a referral from a primary care physician or other doctor.
An orphan drug is a pharmaceutical that remains commercially undeveloped owing to limited potential for profitability. The Food & Drug Administration Orphan Drug Designation program designates orphan status to drugs and biologics intended for treatment, diagnosis...
An annual limit on how much an individual has to pay in deductibles, coinsurance and copayments, excluding the premium. The Affordable Care Act (ACA) requires new plans offered beginning in 2014 to include an out-of-pocket maximum set at the current maximum level for...
Research that attempts to evaluate particular health services by tracking and analyzing clinical results (e.g., death, illness, ability to function) of various treatments. (See also Patient-Centered Outcomes Research Institute.)