Category: A

An alternative to the fee-for-service (FFS) payment system, such as a health care organization (HCO), health maintenance organization (HMO), or competitive medical plan (CMP) in which some other mechanism, usually capitation, is the method of payment to the organization and sometimes to the physician.  

A non-profit, private research organization focusing on health care financing and organizational issues. The Alpha Center also conducts a health care program for the uninsured in conjunction with the Robert Wood Johnson Foundation.  

In common usage, any one of a variety of collaborative arrangements among individuals or institutions. In the past, hospitals have formed alliances or affiliations, for example, between those furnishing primary, secondary, and tertiary care.  

A payment policy under which the same payment method is applied to patients of all payers. Today, the term “all-payer plan” really means applying the prospective payment system (PPS) to all patients, rather than Medicare patients only. (Medicare patients are the only patients to which the PPS applies under the present federal regulations.)  

A part of state or federal government, created by the legislature, which has specific administrative duties and functions, often including regulation of a profession or industry. A state board of medical examiners, for example, is an administrative agency. There is a body of law (administrative law) which governs the powers of administrative agencies, the process…

A statement executed by a person while of sound mind as to that person’s wishes about the use of medical interventions for him or her self in case of the loss of his or her own decision-making capacity. A number of forms of advance directives have been proposed and are used; some are described below.…

Medical and other health care services provided to patients whose condition permits them to return home or to another facility at night. When such care is regularly scheduled, it may be termed partial hospitalization.  

The body of law which governs the powers of administrative agencies, the process of agency decision-making, and the procedures by which a party can challenge an adverse decision of an agency. The body of law which governs the powers of administrative agencies, the process of agency decision-making, and the procedures by which a party can…

A proposed form of health care plan which would be accountable for meeting certain federal requirements for providing certain standardized health services. Synonym(s): accountable health partnership (AHP), approved health plan (AHP).  

The ability to obtain health care. Access includes available physicians and facilities, transportation, acceptance by the facility, and means of payment. “Access” is often used specifically to mean eligibility for (access to) insurance benefits, since lack of insurance can be a formidable barrier to receiving health care. Individuals who are above a given state’s definition…