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Primary Care Case Management (PCCM) is a system of managed care in the US used by state Medicaid agencies, in which a primary care provider is responsible for approving and monitoring the care of enrolled Medicaid beneficiaries, typically for a small monthly case management fee in addition to fee-for-service reimbursement for treatment. [1]
Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States, providing free health insurance to 85 million low-income and disabled people as of 2022; [3] in 2019, the program paid for half of all U.S. births. [4]
The Texas Health and Human Services Commission, which operates these programs — called STAR and CHIP — shocked many pediatric providers in Tarrant County in March when it decided not to award ...
Primary Care Case Management (PCCM), is a program of the United States government healthcare service Medicaid.It oversees the United States system of managed care used by state Medicaid agencies in which a primary care provider is responsible for approving and monitoring the care of enrolled Medicaid beneficiaries, typically for a small monthly case management fee in addition to fee-for ...
Fee-for-service. Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately. [1] In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care. However evidence of the effectiveness of FFS in improving health ...
In 2008, Public Health Service Act grants comprised 18.3% of all CHC revenues. [4] The expansion of CHCs has instead been largely funded by the growth in Medicaid resulting from eligibility expansions, coverage reforms, and modified payment rules. In 1985, Medicaid patients made up 28% of all CHC patients but only 15% of CHC revenues. [5]
The Texas Health and Human Services Commission is standing by its decision not to award a large Medicaid contract to Cook Children’s Health Plan, a major provider of Medicaid health insurance to ...
Federally Qualified Health Center. A Federally Qualified Health Center (FQHC) is a reimbursement designation from the Bureau of Primary Health Care and the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services. This designation is significant for several health programs funded under the Health ...