Word of the day

Friday, July 24

Gainsharing

Healthcare providers that are able to reduce costs while still meeting quality standards are allowed to share in the savings.

Thursday, July 23

Family Glitch

An unintended consequence of the Affordable Care Act when an employee is offered affordable ESI through their work place but the coverage offer is not extended to the employees’ family, or is unaffordable for the family. This leaves the employees’ spouse and/or children both ineligible for exchange subsidies and without access to other affordable coverage.

Tuesday, July 21

Excise Tax

A tax paid by the manufacturer or retailer of a good or service, as opposed to directly by the consumer (as in a sales tax).

Monday, July 13

ADT

Admissions, discharges and transfers (as in ADT orders)

Thursday, July 9

Withhold

A portion of payments that an insurance company does not pay to health care providers unless that particular provider keeps costs under an agreed upon amount.

Tuesday, July 7

Deductible

The amount of expenses that must be paid out of pocket before an insurer will pay any expenses.

Monday, July 6

Advance Directive

Patients and their doctors occasionally craft plans for future care in the event that the patient is unable to direct their care (in case of incapacitation or advanced illness).

Thursday, July 2

End-Stage Renal Disease

Kidney failure that requires dialysis treatments or a kidney transplant; patients with ESRD qualify for Medicare regardless of age.

Wednesday, July 1

Adult Dependent Coverage to Age 26

A provision allowing adults up to age 26 to remain on their parents'/guardians' insurance plan.

Tuesday, June 30

MEDI-MEDI

Another term for dual eligibles.

Out-of-area Coverage

Insurance coverage sometimes provided by health plans for services outside the enrollee's geographical coverage area.