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  2. Healthcare Common Procedure Coding System - Wikipedia

    en.wikipedia.org/wiki/Healthcare_Common...

    HCPCS was established in 1978 to provide a standardized coding system for describing the specific items and services provided in the delivery of health care. Such coding is necessary for Medicare , Medicaid , and other health insurance programs to ensure that insurance claims are processed in an orderly and consistent manner.

  3. Healthcare Quality Improvement Act - Wikipedia

    en.wikipedia.org/wiki/Healthcare_Quality...

    The Healthcare Quality Improvement Act of 1986 (HCQIA) of the United States was introduced by Congressman Ron Wyden from Oregon. ( Title 42 of the United States Code , Sections 11101 - 11152) It followed a federal antitrust suit by a surgeon against an Astoria hospital and members of its clinic in which he claimed antitrust actions were ...

  4. Case management (US healthcare system) - Wikipedia

    en.wikipedia.org/wiki/Case_management_(US...

    The generic model used in the United States is the chronic care model, which holds that health care does not only involve change in the patient and that high-quality disease care counts the community, the health system, self-management support, delivery system design, decision support, and clinical information systems as important elements in ...

  5. Infection prevention and control - Wikipedia

    en.wikipedia.org/wiki/Infection_prevention_and...

    The U.S. Centers for Disease Control and Prevention (CDC) state that "It is well documented that the most important measure for preventing the spread of pathogens is effective handwashing". [7] In the developed world, hand washing is mandatory in most health care settings and required by many different regulators. [citation needed]

  6. Healthcare in the United States - Wikipedia

    en.wikipedia.org/.../Healthcare_in_the_United_States

    State governments maintain their own health departments, and local governments (counties and municipalities) often have health departments that are branches of the state health department. State boards may have executive and police authority to enforce state health laws, with all members required to be healthcare professionals in some states.

  7. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...

  8. Clinton health care plan of 1993 - Wikipedia

    en.wikipedia.org/wiki/Clinton_health_care_plan...

    First Lady Hillary Clinton at her presentation on health care in September 1993. According to an address to Congress by then-President Bill Clinton on September 22, 1993, the proposed bill would provide a "health care security card" to every citizen that would irrevocably entitle them to medical treatment and preventative services, including for pre-existing conditions. [2]

  9. Healthcare reform in the United States - Wikipedia

    en.wikipedia.org/wiki/Healthcare_reform_in_the...

    CMMI initiatives like the 2016 "Accountable Health Communities" (AHC) model have been created to focus on connecting Medicare and Medicaid beneficiaries with community services to address health-related social needs, while providing funds to organizations so that they can systematically identify and address the health-related social needs of ...