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Friday, October 24

Underinsured

Individuals who have health insurance but cannot access needed providers or cannot afford the cost sharing requirements.

Thursday, October 23

Direct Access

A provision of some health insurance plans that allows policy holders to see doctors or specialists without a referral from a primary care physician or 'gatekeeper.'

Wednesday, October 22

Staff Model HMO

A form of HMO in which the health care providers are employees of the HMO.

Tuesday, October 21

Small Business Health Options Program (SHOP)

Similar to the individual market exchanges (or marketplaces) the SHOP exchanges allow small businesses to select health plans for their employees (or contribute to employee selected health plans). As with the individual market exchanges, the SHOP exchanges can be run by the federal government or by the individual states.

Monday, October 20

Payment Bundling

A mechanism of provider payment where providers or hospitals receive a single payment for all of the care provided for an episode of illness, rather than per service. Total care provided for an episode of illness may include both acute and post-acute care.

Biopsy

Medical process of removing tissue for testing.