Healthcare Spending
What percentage of the US GDP is from healthcare spending?
18%
What act aimed to reduce the number of uninsured individuals in the US?
The Patient Protection and Affordable Care Act of 2010
Define premium
Amount paid to insurance agency from a policy
Name one example of healthcare fraud
Using someone's health information as your own
Difference between individual and group insurance
Individual insurance is purchased by a person, while group insurance is obtained by an employer
What is the total healthcare spending in the U.S.?
3.5 Trillion
What was a major requirement of the ACA for insurance companies?
Cover essential health benefits
Define deductible
Amount paid by the patient before the insurance will make payments
What is the penalty for healthcare fraud?
It's a crime that can have fines and jail time
How does indemnity insurance work?
Patients pay for all healthcare expenses out of pocket and are later reimbursed by the insurance company
What is one reason healthcare spending is growing?
Rising costs of healthcare services and treatments
How did the ACA impact coverage for children?
Cover children and young adults to 26 years old under the parents plan
Define Co Payment
Amount paid by the patient for a certain service
How does healthcare fraud impact costs?
It increases overall healthcare costs for everyone.
What are the key features of managed care?
Promoting good health and practicing preventive medicine.
How does healthcare spending impact the economy?
Contributes significantly to economic growth but places a financial burden on people
What is one financial assistance provided by the ACA?
Cost sharing reductions/ CSR
What are out of pocket expenses?
A medical bill that must be paid by the patient
What is the difference between fraud and abuse?
Fraud involves intentional deceit and abuse may involve improper billing without the intent of deceiving.
What is an advantage of PPOs?
They provide more flexibility in choosing healthcare providers
What is the main burden of healthcare costs?
The financial strain on people due to the costs.
How did the ACA change pre-existing condition coverage?
Required insurance to cover services for pre-existing conditions without higher premiums
What does HIPPA stand for?
Health Insurance Portability and Accountability Act
What is one common method of committing fraud?
Billing for medical services not provided.
What is a disadvantage of HMOs?
They do not cover expenses for out of network providers.