Insurance Occurrence

2. Groups of providers and suppliers who work together to better coordinate care across settings for Medicare patients
3. Where multiple providers are paid one overall sum for a patient's care rather than for each treatment or procedure
9. A rate-setting PPS used by Medicare to determine and provide a flat-rate payment amount for inpatient hospital stays based on admission diagnosis
10. One of the most common MCOs: a network of providers funded by insurance premiums
11. The weekly working status of a staff expressed as a decimal where >1.0 would imply overtime
12. A healthcare financing system in which an intermediary (an insurance company or a government agency) pays the bill
13. A system that attempts to integrate efficiency of, cost of, and access to care

1. A payment system that rewards care quality with payment incentives
4. Incentives paid to providers based on a process or outcome measure associated with a specified patient population
5. A hospital payment system with predetermined reimbursement ratios for services
6. These render services on an FFS-basis, providing incentives to consumers for using a specific hospitals or doctors
7. A reimbursement system where insurance companies reimburse healthcare providers a billed amount for services afterwards
8. The total client illness severities divided by the total patients