Health Care Economics

  1. 1. of service plan a physician coordinated health insurance plan that combines characteristics of both HMO and PPO plans
  2. 5. a flat fee that many health insurance plans require patients to pay each time they have receive a health care service
  3. 7. insurance a health insurance system that allows individuals to obtain group health benefits through an organization such as an employer a union or as an association
  4. 8. provider organization plan a health insurance plan that allows patients to received care from a nonplan provider but requires them to pay a higher out of pocket price if they do so
  5. 9. nonprofit institution community facility that receives federal state and local tax exemptions in exchange for providing a community benefit such as services to medicaid patients and those who are unable to pay
  6. 11. spending account a monetary account offered through an employer into which money is put through payroll deductions before it is taxed funds can be withdrawn for qualified medical expenses as needed but the funds must be spend each year
  7. 12. institution a for profit health care facility usually owned by a corporation
  8. 13. the federally-funded health care program for older Americans
  9. 15. payment system a health care insurance system that pays the health care provider a fixed amount based on the medical diagnosis or specific procedure rather than on the actual cost for care is greater than the fixed amount the provider must absorb the additional expense
  10. 16. payment the act of paying for health care with one's own money
  11. 19. review a process in which a n insurer reviews decisions by physicians and other providers about how much care to provide
  12. 23. a government program that offers health insurance to many lowincome and disabled people
  13. 24. provider a health care provider who has a contract with a managed care insurance plan
  1. 2. a government health insurance system that provides medical coverage for active and retired service personnel and their dependents
  2. 3. care a type of health insurance plan that establishes predetermined rates for services with health care providers such as doctors and hospitals and puts providers in the position o managing patient's use of health care
  3. 4. institution a public health care facility that receives most of its funding from local state or federal sources
  4. 6. a physician who not only delivers primary care services but also makes referrals for specialty care
  5. 10. the portion of the medical costs a patient may still have to pay once an insurance plan's deductible has been met
  6. 14. the money a person must pay before an insurance policy provides benefits
  7. 17. of network provider a health care provider who is not in a particular managed care health insurance plan
  8. 18. related groups a classification system used by Medicare and Medicaid to determine payment for health services based on diagnosis surgical procedures age and other information
  9. 20. savings account a monetary account commonly paired with a highdeductible health insurance plan that allows individuals to pay for qualified medical change using taxfree HSA dollars until they meet their deductibles
  10. 21. utilization making better use of health care resources to cut costs
  11. 22. the monthly amount paid to a private insurance company for health insurance coverage