Consumer Driven Care Learning Center
The Consumer Driven Care Learning Center and newsletter, brought to you by MCOL, have been developed to provide a resource for health care professionals interested in Consumer Driven Care and related programs.
| Term | Definition |
|---|---|
| HDHP | A health insurance policy with a annual deductible requirement of $1,000 or more. HSA qualified High Deductible Health Plans have numerous other specific requirements, and have minimum single and family deductible requirements which are subject to annual cost of living adjustments. |
| Health Reimbursement Account | See Health Reimbursement Arrangement |
| Health Reimbursement Arrangements | Qualified employer funded health care accounts for covered employees or retirees designated by an Internal Revenue Service Revenue Ruling that allow for rollover from year to year of unspent funds on a tax-free basis. HRAs provide no employee portability and are typically offered in combination with high deductible plans. |
| Health Savings Account (HSA) | Qualified tax favored savings account eligible to any taxpayer opening the account before age 65, in which tax free medical expenditures can be disbursed, as established by The Medicare Prescription Drug, Improvement and Modernization Act of 2003. An HSA provides for portability and investment of account funds, and must be offered in combination with qualified high deductible health plans. |
| High Deductible Health Plans | A health insurance policy with a annual deductible requirement of $1,000 or more. HSA qualified High Deductible Health Plans have numerous other specific requirements, and have minimum single and family deductible requirements which are subject to annual cost of living adjustments. |
| HRA | Qualified employer funded health care accounts for covered employees or retirees designated by an Internal Revenue Service Revenue Ruling that allow for rollover from year to year of unspent funds on a tax-free basis. Such accounts may be included as a feature of a Consumer-Driven health plan. |
| Medical Savings Account | MSAs are tax advantaged savings accounts offered in conjunction with a health policy that were enabled under the federal Health Insurance and Portability and Accountability Act of 1996. No new MSAs can be offered after 2005, although existing accounts may continue. |
| Medical Tourism | The arrangement of health care services for a given patient to be delivered by providers located outside the tradtional referral area for an applicable service; often delivered outside the country by international providers. |
| MSA | MSAs are tax advantaged savings accounts offered in conjunction with a health policy that were enabled under the federal Health Insurance and Portability and Accountability Act of 1996. No new MSAs can be offered after 2005, although existing accounts may continue. |
| Navigation | In context of consumer choice health care, navigation refers to providing consumers the tools to access applicable health care and benefit information, designed in a format with the objective that a layperson should be able to understand where and how to access the information. Navigational tools are often Internet enabled, but could also involve print, video and telephonic information. |
| Price Transparency | Consumer access to the actual prices to be paid to providers under health plan benefit coverage |
| Retail Clinics | Relatively small, limited-service medical clinics located inside grocery stores, pharmacies, and other retail locations, providing a limited menu of basic medical services delivered in a consumer-friendly environment typically by appropriately trained mid-level practitioners rather than physicians. |
| Self Directed Health Plan | Involves a combination of an tax advantaged and funded spending or savings account with a high deductible insurance policy |
| Stacked Accounts | Consumer driven health plan designs that include multiple spending and savings accounts tied to the same high deductible health plan policy |
| Value Based Insurance Design (VBID) | Value Based Insurance Design involves designing benefit cost sharing requirements and coverage based on the ultimate evidence-based value of clinical services as opposed to strictly cost considerations. The objective is for the level of patient cost sharing to be a function of the value that the specific service provides to the specific patient. Under Value Based Insurance Design |
