20 Terms
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Managed care
A health care practice intended to streamline services and provide high quality, cost-effective care.
Industry: Health care
Add a new termContributors in Managed care
Managed care
indirect medical education (IME) adjustment
Health care; Managed care
A payment adjustment applied to diagnosis-related groups and outlier payments under a prospective payment system for hospitals that operate an approved graduate medical education program. For ...
disproportionate share adjustment
Health care; Managed care
A payment adjustment made under Medicare’s prospective payment system, or under the Medicaid system, for hospitals that serve a relatively large volume of low-income patients.
reverse capitation
Health care; Managed care
A payment method that capitates medical specialists but pays primary care physicians at some fee-for-service rate.
pension disability
Health care; Managed care
A pension payable in the event that an employee becomes totally and permanently disabled before normal retirement age.
contract year
Health care; Managed care
A period of 12 consecutive months, commencing with each anniversary date. May or may not coincide with a calendar year.
spell of illness
Health care; Managed care
A period of consecutive days, beginning with the first day on which a beneficiary is furnished inpatient hospital or extended care services, and ending with the close of the first period of 60 ...
enrollment period
Health care; Managed care
A period of time certain to join Medicare or some other private health insurance, or managed care plan, either on an individual or group basis.
