Chapter 9 Flashcards
(12 cards)
concept of managed care and integrated delivery systems
delivers array of healthcare services to a group of enrolled members through management of services needed by members and negotiation of prices w/ providers
accountable care organization (ACO)
healthcare organization that seeks to tie provider reimbursements to quality metrics and reductions in the total cost of care for an assigned population of patients
fee schedule
index of charges listing individual fees for each type of service
concurrent utilization review
determine on a daily basis the length of stay necessary in a hospital monitors use of ancillary services and ensures that treatment is appropriate
retrospective utilization review
review of utilization after services have been delivered
examination of medical records is undertaken to assess the appropriateness of care
HMO
health maintenance organization
PPO
preferred provider organization
MSO
management services organizations
PSO
provider sponsored organization
PHO
physician hospital organization
POS
point of service plan???
MCO
managed care organization
