News / Profession

The New Health Care Lexicon

Dynamic Chiropractic Staff

As our world changes, so does our language. This column presents definitions of terms that are part of the new health care reform lexicon.

HMO vs. PPO

Health-Maintenance Organization (HMO). A prepaid health plan in which doctors are paid a fixed fee to treat patients covered by the plan (see capitation). HMOs may employ physicians as salaried staff members or they may contract with a specific physician group (a closed panel) or with any physician in a community who can accept capitation (an open panel).

Preferred-Provider Organization (PPO). An organization that contracts with "preferred" physicians who agree to provide health care to subscribers for a discounted fee. Some PPOs require doctors to put part of their discounted fee into a risk pool. They get all or part of this money back if their charges don't exceed an annual limit.

------------------------ These definitions are reprinted with permission from the glossary of Revolution -- The New Health Care Takes Shape, authored by noted health-care futurist Russell C. Coile Jr. The published is Whittle Direct Books, 1993.
January 1996
Trending
Diagnosis & Diagnostic Equip
When Radiculopathy Isn’t Radiculopathy: A Clinical Series (Pt. 6): Differential Diagnosis
When Radiculopathy Isn’t Radiculopathy

While cervical disc pathology can unquestionably produce radiculopathy, many patients presenting with arm pain, paresthesia or perceived weakness do not exhibit the clinical behavior of true nerve-root compromise. In these cases, failure to differentiate the primary pain generator may lead to unnecessary spinal injections, nerve ablation procedures or surgical consultation despite limited likelihood of benefit.

Ken Kaufman, DC
X-ray / Imaging / MRI
A National Turning Point: N.J. Board Rejects Insurer Medical X-Ray Rules for DCs
A National Turning Point: N.J. Board Rejects Insurer Medical X-Ray Rules for DCs

The New Jersey Board of Chiropractic Examiners has made a precedential decision, concurring with the Association of New Jersey Chiropractors' (ANJC) position paper on chiropractic X-ray guidelines. In plain terms, the board ruled, consistent with the ANJC position, that insurance companies cannot use medical X-ray rules or recommendations, like those written by the American College of Radiology (ACR), to decide whether a chiropractor's X-ray was necessary.

 |  Digital Exclusive
Jeff Randolph, Esq.
Your Practice / Business
The Relationship Behind the Referral
The Relationship Behind the Referral

For decades, chiropractors have been told the answer to more professional referrals is simple: educate medical doctors about chiropractic. There is some truth in that advice; but it is also incomplete. The modern challenge is not simply getting another healthcare professional to know that chiropractors exist. It is becoming the kind of clinician (and building the kind of professional relationship) that makes collaboration easy and sustainable.

 |  Digital Exclusive
Dynamic Chiropractic Staff