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Glossary of Managed Care Terms
[ A
| B | C
| D | E
| F | G
| H | I
| J | K | L |
| M | N
| O | P
| Q | R
| S | T
| U | V | W
]
| W |
| Waiting
periods |
Top |
The
length of time an individual must wait to become
eligible for benefits for a specific condition
after overall coverage has begun. |
| Wellness |
Top |
Preventive
medicine associated with lifestyle and
preventive care that can reduce health-care
utilization and costs. |
| Withhold |
Top |
The
portion of the monthly capitation payment to
physicians withheld by the HMO until the end of
the year or other period to create an incentive
for efficient care. The withhold is at risk;
i.e., if the physician exceeds utilization
norms, he does not receive it. It serves as a
financial incentive for lower utilization. |
| Withhold
pool |
Top |
The
amount withheld from a PCP's capitation payment
or a specialist’s payment amount to cover
excess expenditures of his or a group’s
referral or other pool. |
| Workers'
compensation |
Top |
A
state-mandated program providing insurance
coverage for work-related injuries and
disabilities. |
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