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Family physicians and the future of fee-for-service payment plans.
The Journal of family practice, 1986The mechanisms by which health care providers in the United States are reimbursed for their services are undergoing dynamic and rapid changes. Traditional fee-for-service payment schemes as the predominant reimbursement methods are declining and are being supplanted by a plethora of different schemes that incorporate prepayment as the mode of ...
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Psychiatric Services, 2010
This study identified Medicaid beneficiaries using mental health or substance abuse services in fee-for-service plans in 13 states in 2003 (N=1,380,190) and examined their use of medical services.Administrative and fee-for-service claims data from Medicaid Analytic eXtract files were analyzed to identify mutually exclusive groups of beneficiaries who ...
Henry T, Ireys +5 more
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This study identified Medicaid beneficiaries using mental health or substance abuse services in fee-for-service plans in 13 states in 2003 (N=1,380,190) and examined their use of medical services.Administrative and fee-for-service claims data from Medicaid Analytic eXtract files were analyzed to identify mutually exclusive groups of beneficiaries who ...
Henry T, Ireys +5 more
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Professional Case Management, 2019
Beginning in 2019, the Centers for Medicare & Medicaid Services is expanding the definition of “primarily health-related.” Under the new definition, Medicare Advantage Plans allow beneficiaries supplemental benefits if they compensate for physical impairments, diminish the impact of injuries or health conditions, and/or reduce avoidable emergency ...
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Beginning in 2019, the Centers for Medicare & Medicaid Services is expanding the definition of “primarily health-related.” Under the new definition, Medicare Advantage Plans allow beneficiaries supplemental benefits if they compensate for physical impairments, diminish the impact of injuries or health conditions, and/or reduce avoidable emergency ...
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Difference in the use of preventive services between fee-for-service plans and HMOs: is more better?
The American journal of managed care, 2003Based on the US Preventive Services Task Force recommendations, we studied how health insurance type, ie, fee-for-service (FFS) or health maintenance organization (HMO), affects the utilization of preventive services of differing effectiveness.Household survey data from the 1993 and 1994 National Health Interview Surveys.We compared the use of ...
Y Richard, Wang, Mark V, Pauly
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Medical group management journal, 2001
A large, integrated health system in St. Louis acquired a primary care, health maintenance organization staff model group practice with 55 physicians. Health system leadership positioned the acquired physician group to diversify and expand its fee-for-service patient base to increase revenue and support the expansive fixed cost structure of the health ...
J A, Deane, S R, Nussbaum
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A large, integrated health system in St. Louis acquired a primary care, health maintenance organization staff model group practice with 55 physicians. Health system leadership positioned the acquired physician group to diversify and expand its fee-for-service patient base to increase revenue and support the expansive fixed cost structure of the health ...
J A, Deane, S R, Nussbaum
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Issue brief (Commonwealth Fund), 2008
Like the private managed care plans offered under Medicare Advantage, private fee-for-service (PFFS) plans are paid more per beneficiary than those individuals would be expected to cost if they were enrolled in traditional fee-for-service Medicare. However, PFFS plans are not required to provide the same type of coordinated care required of Medicare ...
Brian, Biles +2 more
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Like the private managed care plans offered under Medicare Advantage, private fee-for-service (PFFS) plans are paid more per beneficiary than those individuals would be expected to cost if they were enrolled in traditional fee-for-service Medicare. However, PFFS plans are not required to provide the same type of coordinated care required of Medicare ...
Brian, Biles +2 more
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Rural policy brief, 2007
Enrollment in Medicare Advantage (MA) plans has more than tripled since the inception of the MA program at the beginning of 2006. However, rural enrollment remains well below urban enrollment as a percentage of the eligible population. This policy brief provides findings about enrollment in the newly designed MA program in rural and urban areas across ...
Timothy D, McBride +2 more
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Enrollment in Medicare Advantage (MA) plans has more than tripled since the inception of the MA program at the beginning of 2006. However, rural enrollment remains well below urban enrollment as a percentage of the eligible population. This policy brief provides findings about enrollment in the newly designed MA program in rural and urban areas across ...
Timothy D, McBride +2 more
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Outcomes management, 2003
This study sought to determine if differences in quality of care existed between fee-for-service and health maintenance organization insurance plans (N = 154) for patients with congestive heart failure. There were no statistically significant differences in outcomes between the insurance plans.
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This study sought to determine if differences in quality of care existed between fee-for-service and health maintenance organization insurance plans (N = 154) for patients with congestive heart failure. There were no statistically significant differences in outcomes between the insurance plans.
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