Steerage
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The steerage was one of the lowest decks of a ship. This section was used to accommodate immigrants in the 18th and 19th century, as they couldn't afford to travel with the higher class passengers. Steerage offered limited toilet facilities, no privacy and poor food. All of these things made traveling steerage a little difficult. The name "steerage" came from the fact that the control strings of the rudder ran on this level of the ship.
Also a term used in relation to preferred provider agreements between service providers (such as hospitals or physician groups) and employers (or more generally, payors of health benefits). The service provider will agree to offer a discount on services in exchange for the employer/payor's promise that it will encourage its employees/members (patients) to use the provider's services. This encouragement is sometimes referred to as "direction" or "steerage" and is usually in the form of financial incentives like lower copayments or deductibles for the patients. Patients are told that they will receive a discounted rate if they use the preferred provider.
