Biomaterial Database

The struggle between managed care and fee-for-service practice. 1994

J K Iglehart

UI	MeSH Term	Description	Entries
D008329	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.	Case Management, Insurance,Insurance Case Management,Managed Health Care Insurance Plans,Managed Care,Care, Managed,Managed Care Program,Management, Insurance Case,Program, Managed Care,Programs, Managed Care
D005251	Fees, Medical	Amounts charged to the patient as payer for medical services.	Fee, Medical,Medical Fee,Medical Fees
D006279	Health Maintenance Organizations	Organized systems for providing comprehensive prepaid health care that have five basic attributes: (1) provide care in a defined geographic area; (2) provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; (3) provide care to a voluntarily enrolled group of persons; (4) require their enrollees to use the services of designated providers; and (5) receive reimbursement through a predetermined, fixed, periodic prepayment made by the enrollee without regard to the degree of services provided. (From Facts on File Dictionary of Health Care Management, 1988)	Group Health Organizations, Prepaid,HMO,Prepaid Group Health Organizations,Health Maintenance Organization,Organizations, Health Maintenance,Organization, Health Maintenance
D000574	American Medical Association	Professional society representing the field of medicine.	AMA - American Medical Association,AMA American Medical Association,Association, American Medical,Medical Association, American
D012456	Salaries and Fringe Benefits	The remuneration paid or benefits granted to an employee.	Fringe Benefits,Wages,Paternity Benefits,Pay Equity,Salaries,Benefit, Fringe,Benefit, Paternity,Benefits, Fringe,Benefits, Paternity,Equities, Pay,Equity, Pay,Fringe Benefit,Paternity Benefit,Pay Equities,Salary,Wage
D014481	United States	A country in NORTH AMERICA between CANADA and MEXICO.
D018166	Health Care Reform	Innovation and improvement of the health care system by reappraisal, amendment of services, and removal of faults and abuses in providing and distributing health services to patients. It includes a re-alignment of health services and health insurance to maximum demographic elements (the unemployed, indigent, uninsured, elderly, inner cities, rural areas) with reference to coverage, hospitalization, pricing and cost containment, insurers' and employers' costs, pre-existing medical conditions, prescribed drugs, equipment, and services.	Healthcare Reform,Health Care Reforms,Healthcare Reforms,Reform, Health Care,Reform, Healthcare,Reforms, Health Care,Reforms, Healthcare