Health Care Systems and Providing Care
Methods of Payment
Government Sponsored Health Programs
Common Types of Insurance for Reimbursement
Effects of Managed Care and Impacts on Nursing Care Delivery
100

This country spends more per capita on health care than any other nation.

What is the U.S.?

100

Payment provided from personal resources.

What the Self-Payment method?

100

U.S. Veterans qualify

What is the Department of Veterans Affairs?

100

The amount the client pays before the insurance begins to pay for treatment.

What is Deductible?

100

Aligns reimbursement to provider for client outcomes.

What is pay for performance?

200

the 5 key areas addressed when providing health care services: How Clients access health care, Who pays for services, How it is paid, Future trends and challenges, and ...

What is Cost of Service?

200

Insurance contracts people buy themselves.

What is Individual or Private Insurance?

200

Pays retirement, disability, and survivors benefits.

Social Security Administration

200
Monthly payment to have insurance coverage.

What is a premium?

200

Provide quality client care.

What is the primary focus of an LPN?
300

Stockholders are paid from payments received for providing care.

Re-invest or donate income.

What is For-Profit Organizations?

What is Non-Profit Organizations?

300

Benefit Insurance

What is Employer Insurance?

300

American Indian Tribes and Alaska Natives relationship with the U.S.

What is Indian Health Services?

300

Amount the client pays at the time of service.

What is co-pay?

300

Services rarely covered, independent of necessary surgical procedures.

What are Cosmetic/Aesthetic services?
400

Have purchased hospitals to develop statewide or national healthcare networks in an effort to make money and contain costs.

What are health care corporations?

400

Insurance provided through a trade or professional organization.

What is Association-Based Insurance?

400

Medical Insurance program for persons over 65, disabilities, or critical health conditions.

Medical Insurance program for eligible low-income, medically- or physically-disabled clients.

What is Medicare?

What is Medicaid?

400

Pay a deductible and a co-pay for some services. Generally more choices for providers and allowed services.

What is Preferred Provider Organization (PPO)?

400

Levels of needed care.

What is Client Acuity Levels?

500

Systems that offer health care services for a fixed fee, encourage wellness, and limit referrals.

What are Managed Care Systems?

500

Insurance for those with serious medical conditions that prevent them from standard insurance.

What are High-Risk Pools?

500

Food handling and licensing, STD/AIDS testing, and other medical services

What is the Health Department?

500
Limits choice of doctors and hospitals. Pay co-pay and premium but there is no deductible. Designated list of providers.

What is Health Maintenance Organization (HMO)?

500

Enhances efficiency, contains costs, and provides MEDICALLY NECESSARY services.

What is the goal of Managed Care?

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