Buildingblocksofhealthreform.org

Healthcare Management Strategies

WEBDisease Management. Policy Definition: Disease management is a system of coordinated health care interventions and communications for populations with conditions in which …

Actived: 7 days ago

URL: http://buildingblocksofhealthreform.org/healthcare-management-strategies.html

Consumer Decision Making

WEBHealth Insurance Exchange. Policy Definition: A health insurance exchange, or marketplace, is a service that helps individuals, families, and small businesses shop for …

Category: Health Go Health

Access & Coverage Structure

WEBPolicy Definition: Underwriting and rate setting are methodologies that risk bearing entities use to determine costs associated with covered benefits to beneficiaries by utilizing …

Category: Health Go Health

Self-Directed Tools

WEBOutcome Evidence. Medicare publishes a plan finder tool to support consumers with decision making. The tool has helped consumers save on annual health care spending, …

Category: Health Go Health

Covered Benefits

WEBEmployee Retirement Income Security Act of 1974 (ERISA) Policy Definition: ERISA outlines a minimum set of standards to establish protections for enrollees in health …

Category: Health Go Health

Market Concentration

WEBOutcome Evidence. Concentration of providers is rampant and increasing. In 2016, using the Herfindahl-Hirschman Index (HHI), 90 percent of metropolitan areas were highly or …

Category: Health Go Health

Risk Pooling & Plan Funding

WEBRisk Pool. Policy Definition: A health insurance risk pool is a method to group individuals whose medical costs are combined to calculate premiums. Pooling risk allows the higher …

Category: Medical Go Health

Medical Underwriting

WEBOutcome Evidence. A 2018 nationwide survey of adults, age 20 to 59, with diabetes saw a 4% decline in prevalence rate of those with private insurance prior to prohibiting medical …

Category: Medical Go Health

Benefit Administration & Organization

WEBAccreditation. Policy Definition: Accreditation is a comprehensive evaluation process in which a health care organization’s systems, processes and performance are examined …

Category: Health Go Health

Market Competition

WEBMarket Consolidation. Policy Definition: Market consolidation is the practice of two or more health systems, hospitals, clinics or other healthcare entities coming together through …

Category: Health Go Health

Public Group Exchange

WEBPolicy Examples. The Utah Health Exchange, Avenue H, was created prior to the enactment of the ACA and was the only state-run Small Business Health Options …

Category: Health Go Health

Alternative Payment Models

WEBPolicy Examples. Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to ensure that patients …

Category: Health Go Health

Convenience Care

WEBOutcome Evidence. There are an estimated 8,100 urgent care locations (in 2018) and 2,805 retail clinic locations (in 2017) across the country. source & source; A “workplace,” or …

Category: Health Go Health

Provider Payment Setting

WEBPayor/Provider Negotiation. Policy Definition: Payer/provider negotiation is the approach typically used by commercial insurers to determine how much they will pay providers. In …

Category: Health Go Health