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Healthcare reform advocacy groups in the United States are non-profit organizations in the US who have as one of their primary goals healthcare reform in the United States. These notable organizations address issues such as universal healthcare , national health insurance , and single-payer healthcare .
Clinical peer review, also known as medical peer review is the process by which health care professionals, including those in nursing and pharmacy, evaluate each other's clinical performance. [ 1 ] [ 2 ] A discipline-specific process may be referenced accordingly (e.g., physician peer review , nursing peer review ).
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 ...
Global Healthcare Accreditation (GHA) [5] Healthcare Facilities Accreditation Program (HFAP) Healthcare Quality Association on Accreditation (HQAA) Institute for Medical Quality (IMQ) Joint Commission (TJC) National Committee for Quality Assurance (NCQA) National Dialysis Accreditation Commission (NDAC) [6] The Compliance Team, "Exemplary ...
Aging populations, a changing disease spectrum, and the progress and change in technology of health care become the major problems which lead to increasing of health care costs. [4] Then, how to use drug utilization evaluation and drug economy evaluation to improve and optimize the allocation of medical and health resources is a major problem ...
An independent medical review (IMR) is the process where physicians review medical cases in order to provide claims determinations for health insurance payers, workers compensation insurance payers or disability insurance payers. Peer review also is used in order to define the review of sentinel events in a hospital environment for quality ...
Comparative effectiveness research (CER) is the direct comparison of existing health care interventions to determine which work best for which patients and which pose the greatest benefits and harms. The core question of comparative effectiveness research is which treatment works best, for whom, and under what circumstances. [ 1 ]
Introduced in the House as H.R. 1628 by Diane Black (R-TN) on March 20, 2017; Committee consideration by House Energy and Commerce Committee: passed as "Budget Reconciliation Legislative Recommendations Relating to Repeal and Replace of the Patient Protection and Affordable Care Act" on March 9, 2017 (); House Ways and Means Committee: passed on March 9, 2017 as "Budget Reconciliation ...