POLICY AND POLICYMAKING
A system of laws, regulatory measures, courses of action, and funding priorities concerning a given topic promulgated by a governmental entity or its representatives
What is public policy?
Assessment, Assurance, Policy Development
What are the three core functions of public health?
Improve the patient experience of care, improve population health, reduce costs, improve provider well-being, improve patient engagement
What are the components of the Quintuple Aim
Physician or Hospital paid one sum for all services during one illness or procedure.
What is episode-based payment?
Autonomy, justice, non-maleficence, beneficence
What are the four principles of medical ethics?
The most important aspect of having a policy pass
What is a policy window?
Control of infectious diseases, family planning, healthier mothers and babies, tobacco, motor vehicle safety, heart disease and stroke deaths reduced, fluoridation of water, immunization, safer and healthier foods, workplace safety
What are the top 10 Public Health Achievements?
A network of doctors and hospitals that shares financial and medical responsibility for providing coordinated care to patients in hopes of limiting unnecessary spending.
What is an accountable care organization?
______ should be broad, not segmented
What are health insurance risk pools?
Capital, operational, cash, master
What are the 4 types of budgets?
Government, community, media, academia, employers, businesses, health care delivery systems
What are stakeholders in the policymaking process?
1910 report that transformed the nature and process of medical education in America with a resulting elimination of proprietary schools and the establishment of the biomedical model as the gold standard of medical training.
What is the Flexner Report?
Early 1970’s - Prepaid Group Practices:Restricted MD Networks; Prepaid enrollment; Hired staff, doctors receive salaries
What are 1st generation HMOs?
Historically, healthcare payment in the United States has been driven by a ______model; however, payment reform has resulted in a shift to a _____ model to improve clinical quality and outcomes, while also containing or reducing healthcare costs.
What is fee-for-service (or volume-based) and value-based?
Fee-For-Service contributes to the quality problems of ______ while capitation payment encourages physicians to provide fewer services leading to the quality problems of _____
What is Overuse and Underuse?
Situational, structural, cultural, international
What are Buse's contextual factors?
Federal legislation in support (millions of dollars) of building community hospitals and training health care professionals
What is the Hill Burton Act?
Nature of demand, consumer knowledge, price sensitivity, value measurement, ethical concerns, public good component
What is ways healthcare services differ from consumable goods?
Pay for performance, bundled payments, ACOs, and care coordination
What is Value-Based Care Payment Reform?
Safe, Timely, Efficient, Equitable, Effective, Patient-centered
What are the Six Domains of Health Care Quality?
Expansion of infrastructure, expansion of access, cost control, public health safety, healthcare research, and retrenchment in access
What are the US federal public health and health policy goals?
Created to test innovative approaches to delivering and financing Medicaid services.
What are 1115 waivers?
Network Model: More choice for patients; Virtual Integration ; Tiered network allowing patients to see out of network providers; Improved utilization management and focus to outcomes
What is a 2nd Generation HMO?
Roughly ___ % of healthcare spending is wasted (i.e., administrative waste, pricing failures, prevention failures, unnecessary services, fraud, inefficient care delivery)
What is 23%?
_______ is setting objectives, measuring and reporting progress towards those objectives and ______ is engaging in activities to ensure desired progress is being made on a continuous and ongoing basis; typically, a defined process
What is Performance Management (PM) and Quality Improvement (QI)?