| A | B |
|---|
| Medicare | The federal government's health insurance program for people older than 65 years of age or those with certain disabilities or conditions |
| Managed Care | A system of health care delivery aimed at managing the cost and quality of access to health care |
| Case Management | Patient care approach aimed at coordinating the care of patients who are vulnerable, at-risk, or cost-intensive so that their specific needs are met in the most cost-effective manner while still bringing them to optimum health |
| Medicaid | A federall and state-funded health insurance program for individuals who are poor and medically indigent, pregnant women, individuals with disabilities, and children meeting income level requirements |
| Third-pary payer | The insurace company that finances health care provided to a beneficiary |
| Health maintenance organization | A cost-containment program featuring a primary care physician (PCP) as the gatekeeper to eliminate unnecessary testing and procedures |
| Diagnosis related groups | A classification of illnesses and diseases that are then used to determine the amount of money pain to a hospital by Medicare |
| Preferred provider organization | A group of health care providers who contract with a health insurance company to provide services to a specific group of patients on a discounted basis |
| Point of service | A type of insurance program where a primary care physician serves as gatekeeper but the members are not capitated; insured people can seek care from physicians who are both in and out of the network |
| Primary Care Physician | The "gatekeeper" for access to medical services |
