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Other health care concerns covered by HEDIS are immunizations, cancer screenings, treatment after heart attacks, diabetes, asthma, flu shots, access to services, dental care, alcohol and drug dependence treatment, timeliness of handling phone calls, prenatal and postpartum care, mental health care, well-care or preventive visits, inpatient ...
Medicare managed care plans are also known as Medicare Advantage or Part C plans. They are alternative plans to Original Medicare, which includes parts A and B. Medicare-approved private insurance ...
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.
Managed care plans and strategies proliferated and quickly became nearly ubiquitous in the U.S. However, this rapid growth led to a consumer backlash. Because many managed care health plans are provided by for-profit companies, their cost-control efforts are driven by the need to generate profits and not providing health care. [5]
Medicare.gov logo. Medicare Advantage (Medicare Part C, MA) is a type of health plan offered by private companies which was established by the Balanced Budget Act (BBA) in 1997. This created a private insurance option that wraps around traditional Medicare. Medicare Advantage plans may fill some coverage gaps and offer alternative coverage ...
Keystone First is a medical assistance (Medicaid and Medicare) managed care health plan based in southeastern Pennsylvania. Keystone focuses on low-income residents in southeastern Pennsylvania counties including, Bucks, Chester, Delaware, Montgomery, and Philadelphia. The healthcare provider currently serves over 400,000 residents in the area.
Managed care delivery systems grew rapidly in the Medicaid program during the 1990s. In 1991, 2.7 million beneficiaries were enrolled in some form of managed care. Currently, managed care is the most common health care delivery system in Medicaid. In 2007, nearly two-thirds of all Medicaid beneficiaries are enrolled in some form of managed care ...
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