Healthcare Marketing +Information Technology
Addressing Health Disparities: Cultural Proficiency
Managing Costs and Revenue + Financing Healthcare and Health Insurance
Ethics and Law
Fraud and Abuse
100
The process of dividing the total market into groups or segments that have relatively similar needs for products and services (e.g. Demographic, Geographic, Psychographic, Situational, Behavioral)
What is Segmentation?
100
Decreased turnover, less lawsuits, greater access for the underserved and greater cultural competency
What are the benefits of a diverse healthcare workforce?
100
The amount of money a policy holder is required to pay per month to purchase health insurance.
What is Premium?
100
Personal beliefs, family traditions, community culture, religion
What are the primary sources of ethics?
100
The President's newest tool against Fraud and abuse concerning Medicare and Medicaid claims
What is HEAT (The Health Care Fraud Prevention and Enforcement Action Team)?
200
It seeks to satisfy customer needs through profitable relationships by creating, communicating, and delivering customer value in selected markets.
What is Strategic Healthcare Marketing?
200
Heart Disease, Stroke, Obesity, Cancer, Infant Mortality
What are the common health disparity problems?
200
Billing for services rendered but no payment is received
What is Bad Debt?
200
Confidentiality, Right to refuse care, Self-determination, Emergency treatment in a facility covered by EMTALA
What are the rights of patients?
200
Primary civil remedy for fraudulent and improper healthcare claims
What is The False Acts Claim?
300
Application of commercial marketing principles and techniques to influence behavioral change, of a specific target audience, in order to promote public health for the benefit of society as a whole.
What is Social Marketing?
300
A term that can be used interchangeably with Cultural Proficiency, Cultural Sensitivity and Cultural Conditioning.
What is Cultural Competency?
300
Expansion of services of many types, rising unemployment and increase in the number of uninsured individuals
What are the causes for increased Medicaid spending?
300
Federal law trumps state law
What is Federal Preemption?
300
Sherman Act, Clayton Act and Federal Trade Commission (FTC) Act
Which Acts form the basis of the Antitrust Laws?
400
Coordination between tasks and processes.
What does "Integrative" (a role of Health IT) mean?
400
Workforce Diversity, Public Policy, Multilingual Services and Support Materials, and Evaluation and Research
What are the Cultural Proficiency Initiatives?
400
They delay seeking care, eventually ending up in emergency rooms.
How do the uninsured misuse the EMTALA?
400
Requires hospitals that participate in Medicare must provide screening examinations and treatment in their ER unless they can prove that a patient requested transfer after being fully informed of the provisions of this act
What is Emergency Medical Treatment & Labor Act (EMTALA)?
400
Protection for coming forward against their organization or employer, Monetary incentives, Shelter from prosecution in many instances
What are the provisions of qui tam?
500
Digitized X-rays, CT scans, etc through picture archiving and communications systems
What is an example of "Informational" role of Health IT?
500
Recruitment of diverse staff , respectful care that is compatible with the patients’ cultural health beliefs, language assistance services
What are some of the provisions of CLAS (The National Standards on Culturally and Linguistically Appropriate Services)?
500
Independent Practice Association
What is the most flexible HMO for participating physicians?
500
The right to be treated with fairness and dignity by their employers, be protected from sexual or other types of harassment, generally be able to excuse themselves from patient care with which they disagree (although this is under litigation at present)
What are the rights of the healthcare provider?
500
Billing for services not performed, billing duplicate times for one service, falsifying a diagnosis, billing for a more costly service than performed, ordering excessive or inappropriate tests
What are the Major Types of Healthcare Provider Fraud?
M
e
n
u