Federal and State Funded Healthcare
The Centers of Medicare and Medicaid.
What agency administers Medicare and Medi-caid?
Used to be the staple of healthcare service plans; providers billed and were paid for each individual service rendered; often conducted without pre-approval from insurance agency.
What is Fee-For-Service?
The comprehensive value of goods and services generated in a country.
What is the Gross Domestic Product (GDP)?
Programs to assist with costs of healthcare for those unable to provide adequate healthcare coverage for themselves, due to poverty, age or disability.
What is a special population?
Safe, effective, efficient, equitable, timely, patient centered, and integrated.
What are the seven pillars of "High Quality Healthcare"?
Covers hospitalizations, skilled nursing homes, some skilled nursing home health after hospitalization and hospice.
What is Medicare Part A?
Approximately 60% of Americans have this insurance through their employer; considered a perk for employees; employers charge the employee for the plan and fee is usually deducted from pay check.
What is private insurance?
The United States in relation to healthcare costs.
What country has one of the highest healthcare costs and not the best healthcare outcomes?
Adults and children with disabilities; incarcerated; the elderly; military veterans, Native Americans.
What are some of the special populations that the U.S. healthcare system provides healthcare benefits to?
The Joint Commission , National Committee for Quality Assurance, Utilization Review Accreditation Commission.
What are three healthcare accrediting agencies?
Covers physicians office visits, outpatient care, home health visits without prior hospitalization, medical supplies, and preventive services.
What does Medicare Part B cover?
Providers receive pre-determined fee-for-service rendered; contractual agreements between medical facilities and healthcare providers; has helped to curtail increasing healthcare costs
What is managed care?
Population growth, population aging, disease prevalence, service utilization, service price and intensity.
What are the five factors associated with increases in healthcare spending?
Many adults with disabilities are able to work and earn a livable wage thank largely to this act.
What is the American with Disabilities Act?
Look at what is the process or protocol in a clinical setting. See how it can be made better; Determine how it can be prevented from happening again.
What do Quality Improvement Programs do?
Became effective in 2006. Provides coverage for prescription drugs, a separate plan that recipients pay a monthly premium for.
What is Medicare Part D?
A contractual agreement with large groups of providers; predetermined costs, enrollees can us in-network or out-of-network providers; no referral needed; higher cost
What are Preferred Provider Organizations?
The practice of physicians ordering excessive diagnostics for patients and refusing to treat high risk clients.
What is defensive medicine?
This special population is more likely to have infectious diseases, such as TB, hepatitis C and HIV.
What diseases are the people who are incarcerated more likely to have?
High quality care that minimizes harm, including preventable injuries and medical errors.
What is "safe" high quality healthcare?
Hospital Insurance Trust Fund and Supplemental Medical Insurance Trust fund.
What are the two trust funds that pay or support Medicare?
This type of private insurance has a larger networker, patient can go outside of service area and no referral is needed.
What are the pros related to PPO's?
Provides financial incentives for providers to electronic healthcare records.
What is the HITECH Act?
The role of Medicare, Medicaid, Social Security, correctional health programs, and the VA in supporting the health needs of special populations.
How does the U.S. government fund programs for special populations?
An agency that regulates the quality of healthcare in the U.S.
What is the Joint Commission? Or Utilization Review Accreditation Commission? Or National Committee for Quality Assurance? Or Commission on Accreditation of Rehabilitation Facilities? Or Council on Accreditation?