to redirect some of employees’ payroll taxes that now go into the Social Security system into private retirement accounts. Thus the money would be “carved out†of the Social Security system and not available to pay benefits for current retirees.
The separation of a service from a traditional all service models. For example, an HMO may "carve out" an orthopedic benefit and select another vendor to supply these services just as Medicaid "carves out" its mental health and substance abuse services to Behavioral Health Partnership.
To seperately purchase services that are typically part of a managed care package. For example, an HMO may "carve out" the vision care benefit and select a specialized vendor to supply these services on a stand-alone basis.
When services are “carved out,†managed care plans are not contractually obligated to provide them. States may establish a separate, capitated system for these services or allow beneficiaries to visit any other Medicaid provider to receive these services.
Accessing coverage for a specific type of service through a contract separate from that established with the primary providers.
A program separate from the primary group health plan designed to provide a specialized type of care, such as a retiree health carve-out.
an arrangement where a health plan or employer cuts out coverage for a specific type of service, such as mental health, and subcontracts it to a separate company
One or more services excluded from those required to be provided under the capitation rates. These services may be paid on a fee-for-service or other basis.
Practice of excluding specific services from a managed care organization's capitated rate. In some instances, the same provider will still provide the service, but they will be reimbursed on a fee-for-service basis. In other instances, carved out services will be provided by an entirely different provider. Because of great variations in cost from one patient to the next, HIV care, mental health services, and substance abuse treatment are types of services that are often carved out.
A health care delivery and financing arrangement in which certain services are administered and funded separately from the general health care services. Common carve outs include such services as psychiatric, rehabilitation, chemical dependency, and ambulatory services. HMOs and insurers use this strategy when they don't have in-house expertise related to the service that they have "carved out."