Posted on Leave a comment

Medicaid Acronym of the Day – PHP

Prepaid Health Plan –¬†As distinct from an MCO, a PHP is a non-comprehensive health plan that provides only certain services, such as dental services or non-emergency medical transportation.4 Most PHPs are paid on a risk, or capitated, basis. There are several types of PHPs:

Prepaid Ambulatory Health Plan (PAHP): A PAHP is a non-comprehensive prepaid health plan that provides only certain outpatient services, such as dental services or outpatient behavioral health care, and does not cover any inpatient services.5
Prepaid Inpatient Health Plan (PIHP): A PIHP is a non-comprehensive prepaid health plan that provides only inpatient hospital or institutional services, such as inpatient behavioral health care, and does not have a comprehensive risk contract.6

Further reading

https://www.michigan.gov/documents/RevisedPlanforProcurementFinalVersionSenttoHCFA_7983_7.pdf

Leave a Reply