Financiing Health Care

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Across
  1. 3. The amount the insured person must first pay before their insurance plan begins to pay
  2. 5. individuals that are insured by a private health insurance plan
  3. 8. A group of providers and suppliers of health care, health-related services, and others involved in caring for Medicare patients that voluntarily work together to coordinate care for the patients they serve under the original Medicare program
  4. 9. A managed care reimbursement method that prepays providers for services on a per-member per-month basis whether or not services are used.
  5. 13. An individual who qualifies to receive both Medicare and Medicaid benefits
  6. 15. a model through which physicians and other healthcare providers accept a measure of financial risk and are reimbursed based upon prudent resource use and the quality of patient outcomes rather than on a piecemeal fee-for-service basis
  7. 16. A strategy to control health service utilization and costs
  8. 17. increases the role consumers play in seeking or shopping for services
Down
  1. 1. individuals who are insured by a public health insurance plan because they are receiving a benefit from the government
  2. 2. extended healthcare coverage to uninsured children with a major funding allocation to a new Children's Health Insurance Program and proposed to reduce growth in Medicare and Medicaid spending by $125.2 billion in 5 years
  3. 4. A fixed payment amount an insured individual pays for healthcare services after the deductible has been paid or met
  4. 6. requires hospitals to treat everyone who presents in their emergency departments regardless of ability to pay
  5. 7. a legal document that is used to regulate the American healthcare system
  6. 8. excessive or improper use of a thing, or to use something in a manner contrary to the natural or legal rules for its use. Abuse can occur in financial or non-financial settings
  7. 10. adjusted annually based on a state's average personal income compared with the national average; The formula provides higher matching or reimbursements to states with lower per capita incomes compared with the national average
  8. 11. targets uninsured, eligible children for Medicaid enrollment
  9. 12. A percentage an insured individual pays for healthcare services after the deductible has been paid or met
  10. 13. provided incentives for the hospital to spend only what was needed to achieve optimal patient outcomes
  11. 14. recognizes that separate Medicare fee-for-service payments for individual services provided during a beneficiary's single illness result in fragmented care with minimal coordination across providers and settings, rewarding service quantity rather than quality