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Preventive Care: Services Covered Under the Affordable Care Act
Preventive Care: Services Covered Under the Affordable Care Act

... offered by Harvard Pilgrim and its affiliates, except “grandfathered” plans1. When you obtain these services from an In-Network Plan Provider, they are covered free of charge; there is no Member Cost Sharing required. However, if your plan offers Out-of-Network benefits, you will usually have to pay ...
Paediatrics - East Lancs Hospitals | Department of Postgraduate
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... 3.2.3 Recognising children and young people who are at risk in some way, whether physically, mentally or emotionally 3.2.4 Being aware that consultations about children may be a presentation of a mother’s postnatal depression; and being aware of the effect that postnatal depression may have on her c ...
External Influences On Health Insurance (US)
External Influences On Health Insurance (US)

... MR. KILEY: Yes. Part of the California law that brought into being the Medicaid negotiation also provided that insurance companies could negotiate on the same basis for preferred providers, One carrier in our state is currently negotiating with hospitals on a preferred provider basis, to which they ...
The Value of Pharmaceuticals and Managed Pharmaceutical Care
The Value of Pharmaceuticals and Managed Pharmaceutical Care

... which newly developed drugs have not simply reduced mortality, but have also allowed patients to live much healthier and more productive lives or to return from illness to a higher state of health than would otherwise have been possible. In short, pharmaceutical spending may be offset by many kinds ...
Michigan Department of Health and Human Services
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Executive Summary
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alternate care facilities
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A Need to Transform the US Health Care System: Improving Access
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Patient-Centered Medical Home: A Multidisciplinary Perspective
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Program-Level, Ability-Based Outcomes for Pharm.D. Education
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Population Risk Stratification and Patient Cohort
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... Better Care, Better Health, Lower Costs “Ever rising health care costs are a national challenge. The United States currently spends 16 percent of its GDP on health care which is nearly twice as much as any other nation. At the same time, key health indicators suggest that we are not getting our mone ...
C.S.S.B. No. 680 By: Hancock S.B. No. 680 (In the Senate
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... providers for the volume and complexity of services they provide. Higher intensity of care does not necessarily result in higher-quality care, and can even be harmful. managed care: During the 1990s payers focused on managed care arrangements to reduce excessive or unnecessary care, for example, by ...
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Prosthetic Coverage: Saving Money and Saving Lives

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reconnecting the pieces to optimize care in atrial fibrillation
reconnecting the pieces to optimize care in atrial fibrillation

... than usual”, he didn’t really feel any symptoms and his heart rate was 95bpm. At that time, his hypertension seemed to be under reasonable control on 3 medications. His family doctor changed his amlodipine to diltiazem, to help keep his heart rate under control, and he told Frank that he would arran ...
Stroke 2013 Final - American Heart Association
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... Now for Necessary and Effective Care Technologies (CONNECT) for Health Act (S.2484), which would expand the use of telehealth under Medicare.16  Ensure Medicare and Medicaid provide benefits coverage for all evidence-based telehealth services for cardiovascular and stroke care.  Require third part ...
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Managed care

The term managed care or managed health care is used in the United States to describe a variety of techniques intended to reduce the cost of providing health benefits and improve the quality of care (""managed care techniques""), for organizations that use those techniques or provide them as services to other organizations (""managed care organization"" or ""MCO""), or to describe systems of financing and delivering health care to enrollees organized around managed care techniques and concepts (""managed care delivery systems"")....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.The growth of managed care in the U.S. was spurred by the enactment of the Health Maintenance Organization Act of 1973. While managed care techniques were pioneered by health maintenance organizations, they are now used by a variety of private health benefit programs. Managed care is now nearly ubiquitous in the U.S, but has attracted controversy because it has had mixed results in its overall goal of controlling medical costs. Proponents and critics are also sharply divided on managed care's overall impact on the quality of U.S. health care delivery.
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