Integrated network of computers and telecommunication systems that links many providers, payers, employers, and other health care entities within a geographical region. This system permits sharing and communicating clinical, administrative, and financial information. Also called community health information system.
Insurance Encyclopedia
Community health information system
See: community health information network (CHIN).
Community hospital
Facility that gives health care to individuals within a specific locale.
Community mental health center (CMHC)
Facility that provides comprehensive, ambulatory outpatient mental health day services to individuals residing in a specific locale (catchment area). CMHC is defined in the community Mental Health Centers Act (Section 201), which specifies the services to be provided and requirements for the governance, organization, and operation of the centers. The CMHC Act provides for federal financial assistance for the construction, development, and initial operations of CMHCs and, on an ongoing basis, for the costs of their consultation and education services. Health care services may consist of counseling, education, evaluation, development of skills for daily living, vocational rehabilitation, and short-term stabilization services.
Community Property
A special ownership form requiring that one half of all property earned by a husband or wife during marriage belongs to each. Community property laws do not generally apply to property acquired by gift, by will, or by descent.
Community Property, Health
Under this rating system, the charge for insurance to all insureds depends on the medical and hospital costs in the community or area to be covered. Individual characteristics of the insureds are not considered at all.
Community rating
Method for determining premiums for a managed care health insurance plan wherein the premium is based on the average cost of the actual or anticipated health services used by all subscribers in a certain geographical area. Use of this method helps spread the cost of illness evenly for all subscribers to the insurance plan. Individual characteristics of the insured are not considered. Sometimes called pooled rate. See also pooling.
Community rating area (CRA)
Defined geographical region for which each insurance company must determine a single set of health insurance premiums.
Community rating by class (CRC)
See: adjusted community rating (ACR).
Community Rating Laws
Community rating laws relate to state regulation of health insurance. Normally, these laws require insurers to charge the same premium for all applicants regardless of age or health. Thus, rather than consider individual risk factors in underwriting a health insurance policy (age, sex, and health status), premiums are calculated on the risk factors of the population as a whole.