Respect for patients’ autonomy and the right to self-determination are essential features of a high-quality health system.
A well-educated and highly skilled workforce is essential to achieving universal and equitable access to health care.
Licensing: Oversight by licensing boards ensures compliance with professional standards.
The Centers for Medicare & Medicaid Services (CMS) uses several approaches to ensure plans provide high-quality care and monitor that this care is regu
More than nine million people are simultaneously eligible for both Medicare and Medicaid and often known as duals or dual-eligibles.
Traditional fee-for-service Medicare covers items and services that are “reasonable and necessary for the diagnosis or treatment of illness or injury, or t
An appeals system is essential for correcting coverage and payment errors.
In many health care systems, the quality of care delivered to consumers has significant deficiencies. Preventable me
Private health plans are entities that contract with Medicare to provide services to enrollees.
The Affordable Care Act modified how Medicare Advantage (MA) plans are paid. This brought MA payments more in line with Traditional Medicare.