By Leroy Jones, Jr. on September 4, 2009 8:00 AM
Definition: Establishes a reimbursement mechanism to support the provision of primary care services in rural areas.
Public Law 95-210 was enacted in 1977 and authorizes the expanded use of physician assistants, nurse practitioners and certified nurse practitioners; extends Medicare and Medicaid reimbursement to designated clinics; and raises Medicaid reimbursement levels to those set by Medicare.
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By Leroy Jones, Jr. on September 3, 2009 9:41 AM
Definition: A pool of money that is at risk for being used for defined expenses. Commonly, if the pool money that is put at risk is not expended by the end of the year, some or all of it is returned to those managing the risk.
Two different definitions are in use:
1) A pool of funds set aside as reserves to be used for defined expenses. Under capitation, if all of the risk pool is not used by the end of the contract year, it is usually disseminated to participating providers, and,
2) Legislatively created programs that group individuals who cannot secure coverage in the private market. Funding comes from government or assessment on insurers.
By Leroy Jones, Jr. on September 1, 2009 8:58 AM
Long-Term Care (LTC)
Definition: A set of health care, personal care and social services required by persons who have lost, or never acquired, some degree of functional capacity (e.g., the chronically ill, aged, disabled, or retarded) in an institution or at home, on a long-term basis.
The term is often used more narrowly to refer only to long-term institutional care such as that provided in nursing homes, homes for the retarded and mental hospitals.
Long-term care can be provided at home, in the community, or in various types of facilities, including nursing homes and assisted living facilities. Most long-term care is custodial care.
Medicare doesn't pay for this type of care if this is the only kind of care a person needs.
However, Medicaid and long-term care insurance plans do provide some coverage for long-term care.
Ambulatory services such home health care, which can also be provided on a long-term basis, are seen as alternatives to long-term institutional care.