The objective of this study is to make health insurance plans more responsive to the needs of people by identifying plan characteristics that are important to consumers during their enrollment decisions. Employees from three companies were surveyed. Factor analysis indicated four dimensions of plans ...
Health plans, in turn, may influence the behaviors of providers and enrollees. About 60% of Americans have employer-based health insurance, largely through... Constance M. Horgan Sc.D,Deborah W. Garnick Sc.D,Elizabeth L. Merrick Ph.D. M.S.W,... - 《Journal of General Internal Medicine...
FFS model has come under intense scrutiny for overutilization of services and overburdened third-party payers involving health insurance companies or government programs (e.g., Medicare and Medicaid). Even though policymakers and government agencies favor a shift away from fee-for-service towards a ...
Medicare Advantage PFFS plans differ in many ways from otherMedicare Advantageplans. One significant difference is that the insurance company, not Medicare, determines how much it pays the provider and how much the beneficiary pays for a covered health service. ...
Fee-for-service (FFS) is a payment model in which doctors, hospitals, and medical practices charge separately for each service they perform. In this model, the patient or insurance company is responsible for paying whatever amount the healthcare provider charges for the service. ...
Medicaid and Children’s Health Insurance Program Managed Care Access, Finance, and Quality Final Rule Thisruleaims to increase access to Medicaid and CHIP managed care plans. CMS established maximum appointment wait time standards, including 15 business days for routine prim...
In the 1960s and 1970s, health policy makers were concerned about access and institutionalized a system that expanded insurance for patients (thus separating them from the true costs of care) and organized a reimbursement system based on fee for service (FFS) and costs incurred. As access ...
The sponsors include Humana Inc., the United Health Group, Blue Cross Blue Shield of Tennessee, and Sterling Life Insurance Co. In connection, when marketing begins for the 2008 benefit year on October 1, 2007, all PFFS plans will be subject to the CMS standards....
It introduced insurance plans for prescription drug coverage for all Medicare beneficiaries, whether they were enrolled in FFS or managed care (Medicare Advantage) plans. The availability of drug coverage beginning in 2006 served to free up budgets for FFS Medicare enrollees that could be used to ...
The study examines the likelihood of adverse outcomes associated with selected hospital safety events for two groups of Medicare patients: those enrolled in health maintenance organizations (HMOs) versus those enrolled in fee-for-service (FFS) insurance plans. The authors hypothesize that HMO patients ...