Health and fitness support, including gym memberships, weight loss programs, smoking cessation and diabetes management, encourage activities to help you live well. Most health plans offer
Payment structures linked to quality and outcomes, which reward both efficiency and effectiveness. The overall goals of VBP programs are to (1) provide better care to individuals, (2) improve the overall health of a population, and (3) reduce healthcare costs. Examples include
In this type of contract between healthcare providers and insurers, providers are rewarded and share in savings if actual treatment costs are lower than the contracted target, but are not penalized if spending exceeds the target.
The carrier’s loss incurred when claim claim
The carrier's gain incurred when claim claim
The three goals of value-based payment structures: (1) provide better care to individuals, (2) improve the overall health of a population and (3) reduce healthcare costs.
An organization that administers group insurance policies for an employer. The TPA is responsible for processing insurance claims and membership eligibility eligibility
A document provided by your health plan administrator that details health insurance benefits, coverage of dependents, the services that require co-pays, and when an employer may change or terminate a health plan. A
Documentation from your insurance company that includes information on your covered benefits, how to access plan assistance or information and how to use your benefits to access care. Some words have special meanings, so definitions are typically included.
Substance use disorder Substance use disorder