| A | B |
|---|
| PMPM | per member per month: the capitated (prepaid)rate of prepayment determined by a predicted amount of health care each person in control group will need |
| EOC option | Episode of Care Option:a flat fee negotiated with a specialist for all services for a particular treatment |
| HMO | Health Maintenance Organization:combines coverage of medical costs and delivery of health care for a prepaid premium |
| IPA | Independent Practice Association: physician-led HMO that contracts with a central administrative group of providers that has its own contracts with individual physicians or practices. |
| POS | Point of Service Option: an HMO that allows members to choose providers who are not in the HMO's network of providers |
| PCP | "gatekeeper" to coordinate pats overall care to insure that all services are necessary |
| PPO | Preferred Provider Organization: like an HMO, manages care. Usually contracts with a network of physicians , hospitals and other providers on a fee-for-service basis. Tradeoff for lower fees is seeing more patients |
| HCFA | Health Care Financing Administration:1) Regulates lab testing (except on humans);2)Prevents discrimination based on health status for people buying health insurance;3)conducts research on effectiveness of various methods of health care management, treatment and financing;4)Assesses quality of health care facilities |
| JCAHO | Joint Commission on the Accreditation of Healthcare Organizations |
| PACU | postanesthesia care unit |
| AHIMA | American Health Information Management Association |
