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e. Consumer-driven healthcare ( CDHC ), or consumer-driven health plans ( CDHP) refers to a type of health insurance plan that allows employers or employees to utilize pretax money to help pay for medical expenses not covered by their health plan. These plans are linked to health savings accounts (HSAs), health reimbursement accounts (HRAs), or ...
The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("managed care techniques"). It has become the predominant system of delivering and receiving American ...
Donabedian model. The Donabedian model is a conceptual model that provides a framework for examining health services and evaluating quality of health care. [ 1] According to the model, information about quality of care can be drawn from three categories: “structure,” “process,” and “outcomes." [ 2] Structure describes the context in ...
For the period 1998 through 2003, average insurer administrative costs declined from 13% to 12% of premiums. The largest increases in administrative costs were in customer service and information technology, and the largest decreases were in provider services and contracting and in general administration. [226]
In the United States, health insurance marketplaces, [1] also called health exchanges, are organizations in each state through which people can purchase health insurance. People can purchase health insurance that complies with the Patient Protection and Affordable Care Act (ACA, known colloquially as "Obamacare") at ACA health exchanges, where ...
It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers (hospitals, doctors, etc.) on a prepaid basis. The US Health Maintenance Organization Act of 1973 required employers with 25 or more employees ...