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Managed Care Programs
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Definition of 'Managed Care Programs'

Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.

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Saturday, November 21, 2009

Medicare managed care enrollment by disability-eligible and age-eligible veterans.

30 Oct 2009 OBJECTIVE: To assess factors associated with enrollment in a Medicare advantage (MA) plan versus Medicare fee-for-service plan in 2000-2004 by Medicare-eligible veterans. We also assessed whether these factors differed between disability-eligible ... Read more...


Outcomes, health policy, and managed care: relationships between patient-reported outcome measures and clinical measures in outpatients with heart failure.

29 Sep 2009 BACKGROUND: Patient-reported outcomes are increasingly used to assess the efficacy of new treatments. Understanding relationships between these and clinical measures can facilitate their interpretation. We examined associations between ... Read more...


Correlates for completion of 3-dose regimen of HPV vaccine in female members of a managed care organization.

29 Sep 2009 OBJECTIVE: To examine the rate and correlates of completion of the quadrivalent human papillomavirus vaccine (HPV4) 3-dose regimen because nonadherence to the regimen may adversely affect vaccine efficacy. PARTICIPANTS AND METHODS: Female members of ... Read more...

 

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Technical information about 'Managed Care Programs'

Definition: Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.

Descriptor UI: D008329

Alternative terms: Managed Care Programs; Managed Care Program; Program, Managed Care; Programs, Managed Care; Managed Health Care Insurance Plans; Managed Care; Care, Managed; Insurance Case Management; Case Management, Insurance; Management, Insurance Case;

Allowable Qualifiers: classification; economics; history; legislation & jurisprudence; manpower; organization & administration; standards; trends; utilization; statistics & numerical data; ethics;

Tree Number: N03.219.521.576.343.800; N04.590.374.410;

History Note: 90(88); was see under DELIVERY OF HEALTH CARE 1988-89

Technical Notes: specify geog

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