Finding Your Way Through Health Care Terminology
Capitation? Case management? Managed care? What does it all mean?
Wading through health insurance industry lingo is no picnic. In fact, whether you are changing plans, or acquiring healthcare coverage for the first time, any newcomer looking into health insurance coverage may soon find themselves wondering what all the new terminology means.
Well, take a step back. Relax. Every industry has its own specific lingo, and the health insurance industry is no different. Learn more about capitation, case management and managed care below.
1. Capitation refers to a set dollar limit you or your employer pay to a health maintenance organization (HMO), regardless of how much you use the services offered by the healthcare provider—whether a dentist, hospital, doctor or chiropractor.
2. Case management is a system embraced by employers and insurance companies that make certain individuals receive fair, reasonable health care services.
3. Managed care is a medical delivery system that attempts to manage the quality and cost of medical services you and your loved ones receive. Some managed care plans even attempt to improve health quality through preventative care, by emphasizing disease prevention.
This is only a small sample of the industry-specific lingo out there. But don't waste your energy attempting to master it all. What is more important is whether or not you have an adequate guidance to help you and your loved ones understand the complex terminology.
While it's true health insurance has its own language, that doesn't stop you from asking a good question. Ask your health insurance provider about anything you're unclear about. Your health insurance provider will be more than willing to help you. Or learn more health terminology on our Glossary page.
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