Healthcare Crisis

3. The amount paid periodically to buy health insurance coverage. Employers and employees usually share the cost of premiums.
4. A contractual agreement between a managed care organization and a provider that restricts what the provider can say about the managed care company
5. access The ability to see a doctor or receive a medical service without a referral from your primary care physician.
6. Flat fees or payments (often $5-10) that a patient pays for each doctor visit or prescription.
7. The person enrolled in a health plan.
10. Law requiring that a health plan or insurance carrier must offer a particular procedure or type of coverage.
13. People who do not have health insurance of any type. Over 80 percent of the uninsured are working adults and their family members.
17. A "cap" or limit on the amount of services that may be provided. It may be the maximum cost or number of days that a service or treatment is covered.
18. Measures of the effectiveness of particular kinds of medical treatment. This refers to what is quantified to determine if a specific treatment or type of service works.
19. The responsibility for profiting or losing money based on the cost of healthcare services provided. Traditionally, health insurance companies have carried the risk. Under capitation, healthcare providers bear risk.
20. An account that lets workers set aside pretax dollars to pay for medical benefits, childcare, and other services.

1. A person who has been admitted to a hospital or other health facility, for a period of at least 24 hours.
2. The specific services and procedures covered by a health plan or insurer.
8. A medical condition that starts suddenly and requires immediate care.
9. An individual or institution who provides medical care, including a physician, hospital, skilled nursing facility, or intensive care facility.
11. A group of affiliated contracted healthcare providers (physicians, hospitals, testing centers, rehabilitation centers etc.), such as an HMO, PPO, or Point of Service plan.
12. A person's ability to obtain healthcare services
14. A list of medications that a managed care company encourages or requires physicians to prescribe as necessary in order to reduce costs.
15. A percentage of providers' fees that managed care companies hold back from providers which is only given to them if the amount of care they provide (or that the entire plan provides) is under a budgeted amount for each quarter or the whole year.
16. How many times people use particular healthcare services during particular periods of time.