Health Insurance
The government health insurance program that primarily covers people age 65 and older
Medicare
The government agency that administers Medicare and Medicaid
CMS
This term describes differences in health outcomes between different groups of people
Health Disparities
This federal law expanded health insurance coverage and created the Marketplace
Affordable Care Act
This type of care focuses on preventing illness and promoting health before disease occurs
Preventive Care
The government program that provides health insurance for eligible low-income individuals
Medicaid
The term for a payment model where physicians are paid for each individual service they provide
Fee for Service
Which of these is an example of a social determinant of health: genetics, housing, or blood type?
Housing
This government program provides healthcare coverage for eligible military veterans
VA (Veterans Health Administration)
A patient skips a doctor's appointment because they cannot afford the copay. What type of barrier is this?
Financial Barrier
The term for the amount a patient pays each month to maintain health insurance coverage
Premium
Under this model, providers receive one payment covering multiple services associated with a defined episode of care.
Bundled Payment
This term describes a patient's ability to understand and use health information to make decisions about their care
Health Literacy
This federal law prohibits hospitals participating in Medicare from refusing emergency evaluation and stabilization based on a patient's ability to pay
EMTALA
This term describes when a patient cannot obtain care because there are too few healthcare providers in their area
Provider Shortage
The amount a patient must pay out-of-pocket before insurance begins to pay for covered services
Deductible
Under this model, a physician or organization receives a predetermined payment per patient over a specified period.
Capitation
This group is generally considered more vulnerable to transportation-related barriers to healthcare.
Rural populations
This the federal program that provides prescription drug coverage to Medicare beneficiaries
Medicare Part D
This process is when an insurance company requires approval before covering certain medications, tests, or treatments
Prior authorization
The maximum amount a patient generally has to pay out-of-pocket for covered services in a plan year
A physician is rewarded financially for keeping a patient population healthy rather than being paid for every individual visit. This model represents a shift toward this philosophy
Value-based care
This term describes the fair opportunity for everyone to achieve their highest level of health
Health Equity
This federal program provides health insurance primarily for children in families who earn too much for Medicaid but may not be able to afford private insurance
CHIP
A patient’s health is affected by their housing, access to food, transportation, and education. What category do these factors fall under?
Social Determinants of Health