3 categories of health care facilities
Which of the following healthcare facilities receive federal, state, and local tax exemptions for providing community benefit?(voluntary nonprofit, proprietary, government)
Voluntary nonprofit institution
Which part of Medicare includes everything Original Medicare does and more?
Medicare Part C
True/False Government hospitals are primarily funded by public tax dollars and government budgets.
True
A classification system used by Medicare and Medicaid to determine payment for health services
Diagnostic Related Groups (DRGs)
What is the goal of health care cost containment?
It aims to create an affordable health care system for all Americans
Who are proprietary institutions usually owned by?
Healthcare corporations
What is one advantage of an EPO (Exclusive Provider Organization) plan?
Usually more pocket-friendly than a PPO plan, lower monthly premiums, no referral
What institution are the following facilities apart of; VA Hospitals,Military treatment facilities, State mental hospitals, State rehabilitation facilities.
Government Institution.
What is a for-profit health care facility usually owned by a corporation?
Proprietary Institution
All health care workers need to ask themselves how they can best use health care resources. This is called ________ ___________
Resource Utilization
What type of healthcare facility is responsible for paying local, state, and federal taxes?
Proprietary institution
List three things which are covered by Medicare Part B
Outpatient care, Doctor’s office visits, Preventative Care, Scans, Diagnostic Tests
How do proprietary hospitals balance profit generation with providing quality patient care?
Proprietary hospitals balance profit and quality by controlling costs, offering high-revenue services, and maintaining good patient outcomes to attract patients and ensure financial success.
This act was signed into law in 2010 and is still in place
The Affordable Care Act (ACA)
Medicare and Medicaid use what classification system to determine payment for health services?
Diagnostic related group (DRG)
What are some examples of government institutions?
Military treatment facilities
Veterans affairs(VA) hospitals
Public or government funded hospitals
State mental hospitals
State rehabilitation facilities
List the four types of Government Plans
Medicare, Medicaid, TRICARE, and CHIP
What's a disadvantage of Proprietary Institutions?
Higher costs and lower ratios of staff to patients.
This health insurance system pays the healthcare provider a fixed amount based on the medical diagnosis or specific procedure
Prospective Payment System
Health care reform aims to contain costs through strategies such as (Give at least two examples)
Promotion population-based payments, controlling prescription drug prices, improving efficiency in healthcare, encouraging value-based payments
How do voluntary non-profit institutions qualify for tax exemptions?
They must show that they operate for a charitable purpose.
Why is a POS (Point-of-Service) plan considered the middle ground between an HMO and a PPO plan?
A POS plan has an HMO base with a PPO option to go out of network for care
How do voluntary nonprofit hospitals balance their mission to provide community benefit with the financial pressures of operating in today’s healthcare environment?
They reinvest the money into patient care, facility improvements, and community health programs rather than distributing profits to shareholders.
What is a flexible spending account (FSA)
A monetary account offered through an employer into which money is put through payroll deductions.
With a DRG, patients’ diagnoses, treatments, surgical procedures, and any follow up care are paid in ________ ____
Standard fees