Carve-Out Program

A program by a payer—e.g., Medicare—which transfers the responsibility for mental health services to specialty behavioural health organisations; such programs are designed to reduce costs
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.
References in periodicals archive ?
An executive group life carve-out program is one such "double duty beauty," providing key executives with enhanced, permanent life insurance that does double duty as a potential tax-efficient savings vehicle.
An executive group term carve-out program can help address this issue by working on two fronts.
"There have been a lot of other carriers that have come into this space and gone from it," said John Laprade, who heads the sales unit of MassMutual's Executive Group Life Carve-Out Program. "We are the only two with staying power.
Of these, 53 million (including both public and private insurance) are enrolled in some type of carve-out program. A carve-out plan refers to the choice by a buyer of health insurance to separate the health insurance function by disease or service category and seek separate contracts for managing those risks.
Deciding to design a carve-out program is the first step; finding the right product to meet your clients' needs is next.
A group carve-out program works just as it sounds: Key executives are "carved out" of the group life insurance plan and benefits above $50,000 are replaced with permanent individual life insurance policies.
Furthermore, carve-out programs were associated with greater unmet mental health care need as compared with FFS models.
In particular, 10 out of 16 states implemented carve-out programs in 1995 or later.
A recent California Department of Insurance document claims that "several carve-out programs, specifically those with an ombudsman, have had demonstrated success in reducing the level of litigation, returning workers to work more quickly, and reducing the overall cost burden on the system." Consequentially, California's "Garamendi Plan" for workers' compensation reform features legislation making it easier to form carve-outs.
Employers will need to take a preemptive strike at health care inflation through effective design, cost sharing with employees, self-funding arrangements, carve-out programs, vendor performance guarantees, and other initiatives to minimize the impact of increased health care costs.
Quality of mental health care was perceived to be lower for patients who were referred to mental health carve-out programs compared to those referred to individual mental health providers (55.7% fair/poor for MH carve-outs vs.
In many states, none of the licensure options really makes sense for mental health carve-out programs. The regulatory tangle makes it difficult for employers and providers to develop the programs, even where all parties would be willing to comply with any sensible regulatory requirements.