Managed Care Crossword

The ____ Model hires providers to work at a local physician location
(Acronym) The oldest type of managed care. Includes staff model, group model, network model, and independent practice association (IPS).
A healthcare delivery system organized to manage cost, utilization, and quality.
Medicare Part C is also commonly called ____, and offers managed care options to enrollees
This HMO model, known as ______ Practice Associations, contract with a group of physicians who are in private practice and see MCO members at a prepaid rate per visit. Was a result of the HMO Act of 1973.
_____ ______ Organizations are currently the most popular type of plan and agree to a relative value-based schedule or discounted fee to see members. Members do not need a referral to see a specialist.
Coordinates all secondary or tertiary care and is responsible for the case management of a patient.
Increased the cost of healthcare because there were no controls on how much to charge for the provider's service.
The _____ ______ Plan was developed in 1933 as a result of providing care to construction, shipyard, and steel workers for Kaiser Industries.
Individual providers that agree to Primary Care _____ ______ act as an individual's primary care provider and receive a small monthly payment for helping to coordinate referrals and other medical services.
(Acronym) Agree to provide most Medicaid benefits to people in exchange for a monthly payment from the state.
(Acronym) Established in 1990 to maintain the quality of care in health plans.
Unauthorized third parties outside the contract between the MCO and the physician that gain access to MCO discount rates.
(Acronym) Similar to PPOs, but restrict members to a list of preferred or exclusive providers.
(Acronym) Physician hospitals, surgical centers, and other medical providers that contract with a managed care to provide health services.