Some MCOs permit such visits by all members, while others permit them only for those members who purchase an insurance product that includes this privilege. Members may pay an additional premium for direct access. Persons who qualify for health benefits from two insurance programs. The phrase is used frequently to refer to persons entitled to both Medicare and Medicaid. This database combines and reports hospital and HMO information for the nation's metropolitan statistical areas.
Information is available about revenues, utilization, profits, enrollment, and market penetration.
The database can be purchased from the American Hospital Association and Interstudy. This federal demonstration project enrolls permanent nursing home residents into managed care. Physicians, nurse practitioners, and physician assistants with expertise in geriatrics are assigned to residents to provide additional primary care services and respond more promptly to acute problems. Expanded access to primary care is intended to reduce long-term residents' use of emergency departments and hospital beds. Gain-sharing arrangements typically attempt to align physicians' and hospitals' financial incentives when rendering inpatient care to patients.