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Essential Health Benefits (EHB)

The Affordable Care Act requires that health plans on the individual and small group market, including all plans sold on the exchanges, contain a package of items and services. Required care services include: emergency services, ambulatory patient services, maternity care, pediatric care, mental health care, laboratory services, prescription drugs, and others.

Capitation

A payment based on the individual (for a set period of time) rather than a per-service payment. Insurance plans tend to pay a physician network…