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A "National Health Board" would identify a uniform minimal benefit package, certify plans that offer tax-deductible coverage through "accountable health plans" (AHPs), develop standards and guidelines for "health plan purchasing cooperatives" (HPPCs)--more recently termed "Health Alliances"--and establish a national health outcomes database essential for effective competition between AHPs. Within today''s health care system, a wide range of models exist and are frequently only referred to by acronym. This "alphabet soup" adds to the confusion and frustrations consumers encounter when attempting to "wade through" the health care system. A brief list of commonly used terms or acronyms and their meanings follows.HMO (health maintenance organization)--A health plan that contracts with providers for prepaid, employeebenefit comprehensive employeebenefit care for its members. Members are required to obtain care from providers within the HMO. Different models for HMOs include the group model, the IPA model, the network model, and the staff modelPPO (preferred provider organization)--A health plan that allows members to freely choose providers, employeebenefit but the insurance builds in financial incentives for members to select providers within a specific system or group FFS (fee for service)--A traditional system in which the insurer pays for services after they are received, based upon the provider''s fee schedule. Consumers have the freedom to seek care without prior approval from any provider, including employeebenefit specialists. Premature infants, who often did not survive 10 years ago, now may develop into normal children due to the specialized care available in newborn intensive care units across the nation. Many adults have been able to live longer, happier and more productive lives because of specialized surgical procedures (such as heart bypass, laparoscopic techniques, organ transplants, laser surgery, and so on); bioengineering machinery (such as artificial hearts, pacemakers, insulin pumps and so on); enhanced diagnostic procedures (such as ultrasound, CT scan, MRI, and so on); improved medications (such as various vaccines, chemotherapy, prescription and nonprescription drugs, and so on); and the employeebenefit knowledge, experience, and skills of a wide range of health care providers. Products can be custom designed to meet specific employeebenefit needs and can also be purchased in a fully insured, or a self-insured configuration. We also serve governmental markets. Our goal in Member Services is to ensure membership retention, growth and education by providing quality, professional and personalized service to all our members. Please use this web page as a resource of information for your health care benefits as well as to request a Primary Care Physician (PCP) change, order a new ID card or change your address. employeebenefit Member Services Department strives to meet your needs by assuring a high level of member satisfaction.utilizes various networks of providers consisting of Physicians, Hospitals, and Ancillary providers to deliver care. ©2003 www.eparamounthealthcare.com. All rights reserved. |