In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a significant portion of their funding. States are not required to participate in the program, although all have since 1982.
A Federally Qualified Health Center (FQHC) is a community-based health care organization that provides comprehensive primary care and support services to underserved populations in the United States. These centers serve patients regardless of immigration status, insurance coverage, or ability to pay. FQHCs are a key component of the nation's primary care safety net and aim to reduce barriers to health care access for low/moderate-income and minority populations. The majority of FQHCs are local health centers operated by non-profits, but public agencies, such as municipal governments, also operate clinics, accounting for 7% of all FQHCS. Consumer governance is a defining feature of FQHCs, mandating that at least 51% of governing board members must be patients of the center.
A free clinic or walk in clinic is a health care facility in the United States offering services to economically disadvantaged individuals for free or at a nominal cost. The need for such a clinic arises in societies where there is no universal healthcare, and therefore a social safety net has arisen in its place. Core staff members may hold full-time paid positions, however, most of the staff a patient will encounter are volunteers drawn from the local medical community.
A practice-based research network (PBRN) is a group of practices devoted principally to the care of patients and affiliated for the purpose of examining the health care processes that occur in practices. PBRNs are characterized by an organizational framework that transcends a single practice or study. They provide a "laboratory" for studying broad populations of patients and care providers in community-based settings.
Tricare is a health care program of the United States Department of Defense Military Health System. Tricare provides civilian health benefits for U.S Armed Forces military personnel, military retirees, and their dependents, including some members of the Reserve Component. Tricare is the civilian care component of the Military Health System, although historically it also included health care delivered in military medical treatment facilities.
A public hospital, or government hospital, is a hospital which is government owned and is predominantly funded by the government and operates predominantly off the money that is collected from taxpayers to fund healthcare initiatives. In almost all the developed countries but the United States of America, and in most of the developing countries, this type of hospital provides medical care almost free of charge to patients, covering expenses and wages by government reimbursement.
The Oregon Health Plan is Oregon's state Medicaid program. It is overseen by the Oregon Health Authority.
The Accreditation Commission for Health Care (ACHC) is a United States-based non-profit health care accrediting organization. It represents an alternative to the Joint Commission and CHAP, The Community Health Accreditation Program.
In the United States, health insurance helps pay for medical expenses through privately purchased insurance, social insurance, or a social welfare program funded by the government. Synonyms for this usage include "health coverage", "health care coverage", and "health benefits". In a more technical sense, the term "health insurance" is used to describe any form of insurance providing protection against the costs of medical services. This usage includes both private insurance programs and social insurance programs such as Medicare, which pools resources and spreads the financial risk associated with major medical expenses across the entire population to protect everyone, as well as social welfare programs like Medicaid and the Children's Health Insurance Program, which both provide assistance to people who cannot afford health coverage.
Independence Blue Cross (Independence) is a health insurer based in Philadelphia, Pennsylvania, in the United States. Independence is the largest health insurer in the Philadelphia area, serving people in the region and seven million nationwide.
Jeffrey Linde "Jeff" McWaters is an American businessman and former member of the Senate of Virginia as a Republican. He represented the 8th district, which includes a portion of Virginia Beach. He was first elected in a special election in January 2010, and re-elected the following year. He left office after the 2015 elections, serving six years.
The community health center (CHC) in the United States is the dominant model for providing integrated primary care and public health services for the low-income and uninsured, and represents one use of federal grant funding as part of the country's health care safety net. The health care safety net can be defined as a group of health centers, hospitals, and providers willing to provide services to the nation's uninsured and underserved population, thus ensuring that comprehensive care is available to all, regardless of income or insurance status. According to the U.S. Census Bureau, 29 million people in the country were uninsured in 2015. Many more Americans lack adequate coverage or access to health care. These groups are sometimes called "underinsured". CHCs represent one method of accessing or receiving health and medical care for both underinsured and uninsured communities.
A healthcare center, health center, or community health center is one of a network of clinics staffed by a group of general practitioners and nurses providing healthcare services to people in a certain area. Typical services covered are family practice and dental care, but some clinics have expanded greatly and can include internal medicine, pediatric, women's care, family planning, pharmacy, optometry, laboratory testing, and more. In countries with universal healthcare, most people use the healthcare centers. In countries without universal healthcare, the clients include the uninsured, underinsured, low-income or those living in areas where little access to primary health care is available. In Central and Eastern Europe, bigger health centers are commonly called policlinics.
The state of North Carolina is undertaking a comprehensive policy shift on how the government budgets for and manages resources for mental health, developmental disability, and substance abuse services. The 1915 (b)(c) Medicaid Waiver Program was chosen by the North Carolina Department of Health & Human Services, Division of Medical Assistance as a way to control and more accurately budget for the rising costs of Medicaid funded services. The 1915 (b)(c) Waiver Program was initially implemented at one pilot site in 2005 and evaluated for several years. Two expansion sites were then added in 2012. Full statewide implementation is expected by July 1, 2013.
BlueCross BlueShield of South Carolina (BlueCross) is an independent licensee of the Blue Cross and Blue Shield Association. BlueCross serves 21.5 million people through private business and government contracts.
Partnership HealthPlan of California, is an independent, public/private organization serving over 950,000 Medi-Cal beneficiaries in 24 northern California counties: Butte County, Colusa County, Del Norte County, Humboldt County, Glenn County, Lake County, Lassen County, Marin County, Mendocino County, Modoc County, Napa County, Nevada County, Placer County, Plumas County, Shasta County, Sierra County, Siskiyou County, Solano County, Sonoma County, Sutter County, Tehama County, Trinity County, Yolo County, Yuba County. It began operations as a County Organized Health System in 1994, and is currently the largest Medi-Cal Managed Care Plan in Northern California.
A safety net hospital is a type of medical center in the United States that by legal obligation or mission provides healthcare for individuals regardless of their insurance status or ability to pay. This legal mandate forces safety net hospitals (SNHs) to serve all populations. Such hospitals typically serve a proportionately higher number of uninsured, Medicaid, Medicare, Children's Health Insurance Program (CHiP), low-income, and other vulnerable individuals than their "non-safety net hospital" counterpart. Safety net hospitals are not defined by their ownership terms; they can be either publicly or privately owned. The mission of safety net hospitals is rather to provide the best possible care for those who are barred from health care due to the various possible adverse circumstances. These circumstances mostly revolve around problems with financial payments, insurance plans, or health conditions. Safety net hospitals are known for maintaining an open-door policy for their services.
Tufts Health Plan was a Massachusetts-based non-profit health insurance company under Tufts Associated Health Plans, Inc. with headquarters in Watertown, Massachusetts. It completed a merger with Harvard Pilgrim Health Care on January 1, 2021, making the then unnamed company the second-largest health insurer in Massachusetts. The merger had been announced on August 14, 2019; the combined company serves 2.4 million members in Massachusetts, Maine, Connecticut, New Hampshire, and Rhode Island. On June 15, 2021, the new name of the parent company was announced as Point32Health, named for the 32 points on a compass.
HealthShare Exchange (HSX) is a membership-dues-supported nonprofit health information exchange formed in 2009 and incorporated in 2012 by Greater Philadelphia's hospitals, health systems, and healthcare insurers.[1][2] It links the electronic medical record (EMR) systems of different hospital health systems and other healthcare providers — and the claims data of healthcare insurers — to make this information accessible at inpatient and outpatient points of care (including medical practice offices) and for care management. HSX services provide recent clinical care information, and alert providers and health plans to care events.[2] Health information exchange makes patient care more informed and coordinated, and reduces unnecessary care and readmissions. HSX serves the greater Delaware Valley region, including southeastern Pennsylvania and southern New Jersey.[2]
Keystone First is a medical assistance managed care health plan based in southeastern Pennsylvania. Keystone focuses on low-income residents in southeastern Pennsylvania counties including, Bucks, Chester, Delaware, Montgomery, and Philadelphia. The healthcare provider currently serves over 400,000 residents in the area.
