After an historical review of the advent of managed care in the USA, this article presents cost-control mechanisms, changes in the medical practice and consequences on patient health. The article also explains the development of the HMO using the transaction costs theory and the subsequent ...
then it may cover other types of long-term care. These states may choose to use Medicaid funding to support in-home care or adult daycare. If you aren't interested in moving and establishing residency elsewhere, you may want to look intoalternatives to assisted living, for which your state ...
摘要: Managed care is the health insurance buzz phrase for the mid-1990s. Although Medicare beneficiaries and elderly and disabled Medicaid beneficiaries have not participated in managed care programs to the degree the rest of the population has in the last 15 years...
Dennis Wiesner, senior director of privacy, regulatory, government and industry affairs and pharmacy managed care at H-E-B Grocery, recently testified on behalf of the National Association of Chain Drug Stores (NACDS). He testified May 14 on key Medicare and Medicaid regulations before the US ...
Enhanced Mental Healthcare: Coverage has expanded to include intensive outpatient program services provided by hospitals, community mental health centers, and other facilities. More Enrollment Opportunities: If you are losing Medicaid or facing other specific situations, you may have additional opportunities...
On December 9, the Centers for Medicare & Medicaid Services (CMS) published revised regulations implementing the so-called 60-day rule, under which healthcare providers and other parties generally must report and return any...more Holland & Knight Health Dose: December 17, 2024 ...
Medicare doesn’t cover most dental care, hearing aids, eyeglasses, dentures, and overseas medical care, among other things. Medicare also doesn’t cover long-term care. (The federal health program Medicaid pays for long-term care, but is typically reserved for those with low income and littl...
Addressing geographic challenges, such as those that rural and tribal communities face, should be another area of focus and can include the use of expanded networks, transportation support, and mobile-healthcare services. Payers should also collaborate with Medicaid managed-care organizations, supplementa...
Medicare, Medicaid, and CHIP, the three major public insurance programs overseen by CMS, often set the tone for the large private health payer industry. CMS is using all three programs to actively encourage the movement towards value-based care in an effort to reduce costs and raise q...
Health Care Financing Administration's new regulations for financial incentives in Medicaid and Medicare managed care: one step forward? (1998). Health Care Financing Administration's new regulations for financial incentives in Medicaid and Medicare managed care: one step forward? Am J Med, 105, ...