A small group of providers that have negotiated the price of medical services for a given insurance plan. A health plan within a narrow network only allows for payment of services within a relatively short list of designated providers. Due to the limited choice of providers, these plans typically have lower premiums.
A nonprofit association whose members comprise the insurance commissioners of the individual states and territories. NAIC members are elected or appointed state government officials who regulate the conduct of insurance agencies and agents. NAIC was delegated significant responsibilities under the Affordable Care Act (ACA), including developing uniform definitions for calculating medical loss ratios and assisting HHS with establishing rate review procedures.
An independent national organization that reviews and accredits managed care plans and measures the quality of care offered by managed care plans and other entities.
Created in response to the health care crisis in the 1950s and 1960s, NHSC offers loan repayment and scholarships to primary care physicians and students serving in federally designated Health Professional Shortage Areas (HPSAs).
A part of the National Institutes of Health, NIMHD is a government agency that leads scientific research to improve minority health and eliminate health disparities.
A part of the U.S. Department of Health and Human Services, the primary federal agency for conducting and supporting medical research. NIH scientists investigate ways to prevent disease as well as the causes, treatments, and cures for common and rare diseases.
A health maintenance organization (HMO) that contracts with more than one independent physician group to provide health services. The providers may see patients who are not members of the HMO. (Also see group-model HMO and staff-model HMO.)
28 occurrences that the National Quality Forum has identified as events that should never happen in a hospital and can be prevented. These events include surgical events, product or device events, and criminal events. The Centers for Medicare and Medicaid Services (CMS) announced in January 2009 that Medicare would stop paying for three never events — wrong invasive procedures, invasive procedures performed on the wrong body part and invasive procedures performed on the wrong patient.
After the clinical phase of trials, a manufacturer files an NDA with the Food & Drug Administration for approval. This application can be approved or rejected, or the FDA can request further study.
A registered nurse with advanced academic and clinical experience who diagnoses and manages most common and many chronic illnesses, either independently or as part of a health care team. A nurse practitioner provides some care previously offered only by physicians and in most states has the ability to prescribe medications.
Incorporated into the Affordable Care Act (ACA), this act improves nursing home transparency by allowing consumers and regulators to hold providers accountable for compliance with federal requirements.