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Specifically, most ratings are determined from multivariate logistic regressions of medical outcomes at a given healthcare provider to risk-adjust the patients and 1-, 3- and 5-star awards are given to providers whose negative outcomes are worse than expected, near predicted levels, and better than expected, respectively.
As of December 2015, there are more than 2,000 retail clinics located in 41 states and Washington, DC in the United States. [2] Retail clinics are staffed by physician assistants or nurse practitioners and most are open seven days a week – twelve hours a day during the workweek and eight hours a day on the weekend. [3]
Implementation of the individual exchanges changed the practice of insuring individuals. The expansion of this market was a major focus of ACA. [33] Over 1.3 million people had selected plans for 2015 marketplace coverage in the first three weeks of the year's open enrollment period, including people who renewed their coverage and new customers ...
The Federally Facilitated Marketplace is established in a state by the HHS Secretary for states that chose not to set up their own marketplace or did not get approval for one. [2] Individuals (i.e. citizens of a state) and employers will have the ability to find and purchase Qualified Health Plans through the FFM and its partners. [1]
Molina Healthcare was founded in 1980 by C. David Molina, an emergency room physician in Long Beach, California. [4] He had seen an influx of patients using the emergency room for common illnesses such as a sore throat or the flu because they were being turned away by doctors who would not accept Medi-Cal.
Physician's Management. 19, no. 1: 42–6. 2002. "LATE - REGULATORY PRECEDENT - The FTC OKs a Deal That Would Allow a Physician Independent Practice Association to Contract with Health Plans on Behalf of Its Competing Physicians". Modern Healthcare. 32, no. 8: 6.
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Around 1939, state medical societies created Blue Shield plans to cover physician services, as Blue Cross covered only hospital services. These prepaid plans burgeoned during the Great Depression as a method for providers to ensure constant and steady revenue. In 1970, the number of HMOs declined to fewer than 40.
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