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HHN (Hospitals & Health Networks) Magazine. Archived from the original on 2011-07-11; Pham HH, Ginsburg PB, Lake TK, Maxfield MM (January 2010). "Episode-based payments: charting a course for health care payment reform" (PDF). Washington, DC: National Institute for Health Care Reform. Archived from the original (PDF) on 2010-08-19
A number of factors spurred states to require CONs in the healthcare industry. Chief among these was the concern that the construction of excess hospital capacity would cause competitors in an oversaturated field to cover the costs of a diluted patient pool by overcharging, or by convincing patients to accept hospitalization unnecessarily.
In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at ...
Medicare Advantage. Pros. Cons. Additional benefits. Coverage that extends beyond Original Medicare’s benefits (e.g. dental, vision, fitness). Benefits can vary by ...
The catch-22 associated with health insurance — even with subsidies — is that the low-cost plans that most people can afford come with outrageously high deductibles, leaving the policyholder ...
The drawbacks — and criticisms — of Medicare Advantage. Since private plans for Medicare were introduced in the 1980s, there have been challenges with program funding and beneficiary choice ...
An accountable care organization (ACO) is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs in the United States are formed from a group of coordinated health-care practitioners. They use alternative payment models, normally, capitation. The organization is accountable to ...
A PPO — or preferred provider organization — is a plan that allows you to choose from approved in-network providers and out-of-network providers, with services provided by those out-of-network ...