Popular term for “phased-down state contribution” that describes how the federal government is recovering (o r”clawing” back, from the states’ perspective) money spent on Medicare-covered drugs for persons dually eligible for Medicare and...
A term that describes health plans in which enrollees are permitted to receive non-emergency services only through specified providers. Group- and staff-model HMOs are examples of closed panel plans.
A medical condition that exists at the same time as the primary condition in the same patient (e.g., hypertension is a co-morbidity of many conditions such as heart disease, end-stage renal disease and diabetes).
A portion of the bill for a medical service that is not covered by the patient’s health insurance policy and therefore must be paid out of pocket by the patient. Coinsurance refers to a percentage, for example 10 percent of the total charge up to a specified...
A state plan option under Medicaid that encourages primary care practices to provide home- and community-based care to chronically-ill Medicare patients. States that take up this option receive a 6 percentage point increase in federal matching payments for costs...