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Wednesday, October 22

Staff Model HMO

A form of HMO in which the health care providers are employees of the HMO.

Tuesday, October 21

Small Business Health Options Program (SHOP)

Similar to the individual market exchanges (or marketplaces) the SHOP exchanges allow small businesses to select health plans for their employees (or contribute to employee selected health plans). As with the individual market exchanges, the SHOP exchanges can be run by the federal government or by the individual states.

Monday, October 20

Payment Bundling

A mechanism of provider payment where providers or hospitals receive a single payment for all of the care provided for an episode of illness, rather than per service. Total care provided for an episode of illness may include both acute and post-acute care.

Friday, October 17

Profit and Loss (P&L)

The revenues, costs and expenses incurred during a specific period of time, usually a fiscal quarter or year.

Thursday, October 16

Automatic Enrollment

Provision of the ACA requiring organizations with more than 200 full time employees to enroll all new full-time employees in a health plan.

Access

The ability to attain medical care which can often be affected by the availability of insurance, price of care and the location of the needed…