Glossary |
Our glossary of terms explains the jargon and defines the common acronyms you will come across at Health Care Reform Plans. Please email us at editor@reformplans.com to make comments or with suggestions about the Glossary.
|
|
You can always search for entries. |
|
|
|
| All |
| Page: «1 2 3 4 5 6 7 8 » |
| payor | A payor (or payer) is the entity (or entities) responsible for funding an individual’s healthcare. There are different types of payors. Under a single-payor system, for example, payment to doctors and hospitals (healthcare providers) comes from a single source. (See Single-payor system.)The source may be federal-, state-, or community-based; it may be an insurance company or a governmental institution, as in the case of U.S. Medicare (health insurance for the elderly) and the Veterans Administration system.
|
| Point of Service (POS) plans. | Point of Service (POS) plans. (See Managed care plans.)
|
| Preferred Provider Organization (PPO) | A Preferred Provider Organization (PPO) is an organization that is part of a managed care network. It is a group of doctors and hospitals (and other healthcare providers) that has an agreement with an insurance company or third-party administrator to provide care at reduced rates to its members. PPOs are different from HMOs (Health Maintenance Organizations) in that they are generally more flexible and will cover costs when members get out-of-network care, though in such cases members will generally have a higher co-payment.
|
| premium | A premium is the amount paid or payable for an insurance policy.
|
| Prevention | Prevention (see Preventive health).
|
| Preventive health | Preventive health services, according to the National Library of Medicine, are services designed for the promotion of health and the prevention of disease. Preventive health measures usually require patients to make positive behavior and lifestyle changes that typically include exercising, eating a healthful diet, and quitting smoking in order to prevent medical problems such as heart disease and stroke. According to the American Heart Association, preventive health measures, such as making patients aware of their risk factors for disease and giving them guidelines for change, have contributed to a significant decline in deaths from cardiovascular disease in the United States. (See Disease management [DM] and Wellness.)
|
| provider | A healthcare provider is a regulated medical institution, such as a hospital or clinic--or a licensed individual, such as a doctor, nurse, or other medical professional--that delivers healthcare to patients in a professional and systematic way.
|
| purchasing pool | A purchasing pool arrangement is one in which groups of individual or employers or other organizations come together to collectively buy health insurance in order to obtain lower premiums. (See Premium.)
|
| Regional Healthcare Market | The Regional Healthcare Market concept is part of John Edwards’ proposed plan for universal health coverage in the United States. Edwards describes these Markets as “non-profit purchasing pools” that would offer “a choice of competing insurance plans.” Regional government agencies would be appointed to negotiate rates with private insurers, to enroll members, and to collect premiums. The Markets, according to Edwards, would cut administrative costs and allow individuals to buy affordable, high-quality care.
|
| Reimbursement | Reimbursement is the act of compensating an individual or institution for an expense. In healthcare, a Health Reimbursement Arrangement (HRA) is a medical insurance plan in which the employee/patient, the employer, and the insurance company are responsible, to different degrees, for covering healthcare costs. An HRA can be cancelled at any time by an employer. Proponents of HRAs characterize these accounts as part of consumer-driven healthcare because they believe they offer patients a great degree of control over their care. (See Consumer-driven healthcare [CDHC] and Health Reimbursement Arrangement [HRA].)
|
|
