健康界了解到,同样是为了降低急诊就诊量,UHC是为被保险人限定报销范围,而其他保险公司则是使用基于价值的护理模式(value-based care models),从而减少急诊和住院患者。 例如,美国保险公司哈门那(Humana)在联邦医保优势计划(Medicare Advantage plans)中使用了价值护理模式,从而降低了疫情之前的急诊住院率。价值护理包含很多...
According to California law, health plans are required to cover emergency room services, unless the health plan can prove that the emergency procedure never took place or if the member did not require emergency care services and reasonably should have known it. The court found that 93...