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CASE MANAGEMENT, INSURANCE
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DeCS
Descriptor
English
:
Managed Care Programs
Descriptor
Spanish
:
Programas Controlados de Atención en Salud
Descriptor
Portuguese
:
Programas de Assistência Gerenciada
Synonyms
English
:
Case Management, Insurance
Insurance Case Management
Managed Health Care Insurance Plans
Tree Number:
N03.219.521.576.343.800
N04.590.374.410
Definition
English
:
Health
insurance
plans intended to reduce unnecessary
health care costs
through a variety of mechanisms, including: economic
incentives
for
physicians
and
patients
to select less costly forms of care;
programs
for reviewing the medical necessity of specific services; increased beneficiary
cost sharing
; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing
incentives
for outpatient
surgery
; selective contracting with
health care providers
; and the intensive
management
of high-cost
health
care cases. The
programs
may be provided in a variety of settings, such as
HEALTH MAINTENANCE ORGANIZATIONS
and
PREFERRED PROVIDER ORGANIZATIONS.
Indexing Annotation
English
:
specify geog
History Note
English
:
90(88); was see under DELIVERY OF HEALTH CARE 1988-89
Allowable Qualifiers
English
:
CL
classification
EC
economics
ES
ethics
HI
history
LJ
legislation & jurisprudence
MA
manpower
OG
organization & administration
ST
standards
SN
statistics & numerical data
TD
trends
UT
utilization
Record Number:
28152
Unique Identifier:
D008329
Occurrence in VHL
:
Similar:
DeCS
CID-10
SciELO
LILACS
LIS