by paying physicians a fixed amount per enrollee
per year, regardless of how much medical care the enrollee
Among the many benefits, an enrollee
of an Academy has access to resources, support and tools and obtains prestigious "Fellow" status.
Between 1985 and 1998, HCFA's reimbursement rate for HMOs was set at 95 percent of the cost of serving an enrollee
in Medicare's fee-for-service (FFS) sector.
It is appropriate when the enrollee
is given a choice between higher- and lower-cost options.
The Federal Employees Health Benefits Program (FEHBP) recently began offering high-deductible health plans (HDHP) coupled with tax-advantaged health savings accounts (HSA) that enrollees
use to pay for health care.
Once it is determined that the enrollee
appears in both the MSIS and EDB data sets, it is necessary to determine if the enrollee
was eligible for both programs at the same time.
The PACE model provides a great deal of flexibility for both the provider and the elder enrollee
0 if the subject is an FFS enrollee
on April 1, 1993 or an FFS pseudo-disenrollee in the second analysis;
For each of the dependent variables described above, we calculated prescriptions filled and spending in each class per member per quarter (combining BCBS spending and enrollee
Thus, the pre-SCHIP experiences of the recent enrollee
sample serve as a counterfactual for the SCHIP experiences of the established enrollee
, who are covered by Medicare and Medicaid, are among the most medically-vulnerable populations.
Select a topic that is important to the health plan, the provider, and the enrollee
The sponsoring organization pays providers based on either a fixed sum or a per enrollee
satisfaction with the APWU CDHP was mixed compared to enrollee
satisfaction with the other FEHBP plans.
with IHD or CHF have lower incomes and lower levels of educational attainment than the overall M+C enrollee
population, placing them at increased risk of encountering both financial and nonfinancial barriers to care.