Whether an individual is covered by a health insurance plan for plan services in a given time period, based on a pre-set list of requirements.
In a contract that include downside risk, providers can typically earn a reward, usually an agreed-upon percentage of achieved savings (managing the medical expense of the relevant population so that it comes in lower than an agreed-upon target value), but must pay a share of the added costs if actual costs are higher than the target.
An alternative fully-insured funding arrangement that includes an annual settlement using group-specific
Services that provide support to individuals with chronic health conditions, such as asthma, diabetes and heart disease, so they can improve their health and reduce health care costs.
The amount your health insurance plan requires you to pay for health care services and supplies before they begin to pay. For example, if your
A shift in health care where health plans, information and tools are designed to help educate and empower you to make more informed health care decisions. This type of health care promotes better access to information about the cost and quality of care of health care services from different providers.
CAHPS surveys ask consumers and patients to report on and evaluate their health care experiences. These surveys cover topics important to consumers and focus on aspects of quality that consumers are best qualified to assess. CAHPS and guidance documents are free to anyone who wants to use them. “CAHPS” is a registered trademark of the federal Agency for Healthcare Research and Quality (AHRQ).
A federal law that provides employees with the right to pay premiums to continue coverage in a group health plan that they otherwise would have lost after reducing their work hours, quitting their jobs, losing their jobs, or experiencing a