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Entitlements
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Ch3 Delivery Systems
Evolution of OT Delivery Systems
| Question | Answer |
|---|---|
| Capitation | A fixed amount periodically paid to a provider for delivery of services for each person covered under a contract or policy |
| Entitlements | Government payments that are made through legislatively specified programs to individuals having certain designated characteristics and circumstances, such as age or need |
| Health Maintenance Organization (HMO) | A prepaid organized delivery system where the organization and the primary care physicians assume some financial risk for the care provided to its enrolled members |
| Indemnity | The standard fee-for-service insurance policies provided by employers, organizations, or individuals. Usually the most expensive type, this insurance covers service from any provider |
| Managed Care | A synonym for all kinds of integrated delivery systems, in contrast with unmanaged, fee-for-service care. |
| Medigap insurance | Medicare supplemental insurance policies that are available through private companies |
| Point of service plan (POS) | An open-access plan similar to an HMO that provides limited coverage for self-referral outside the network |
| Preferred provider organization (PPO) | An entity that acts as a broker between the purchaser of care and the provider in which consumers have the option of using the preferred providers available with the plan or not |
Created by:
dbarb702
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