Designed for health care organizations and providers that are already experienced in coordinating care for patients across care settings. It allows these provider groups to move more rapidly from a shared savings payment model to a population-based payment model on a...
A managed care plan that combines features of both prepaid and fee-for-service insurance. POS plan enrollees decide whether to use network or non-network providers at the time care is needed, but sometimes require referrals and usually are subject to reduced coverage...
A statement of the known benefits, risks and costs of particular courses of medical action, developed to give physicians information about treatment alternatives.
A physical or mental condition of an individual which is known to the individual before an insurance policy is issued. Before the Affordable Care Act (ACA), insurers could choose not to cover treatment for such a condition, at least for a period, raise rates because...