Study guide for the final, part 11 Flashcards
Role of research in policy development
Documentation: gathering, cataloging, correlating of facts
Analysis: feasibility, efficacy, practicality of an intervention
Prescription: research that shows a course of action
Demographic changes and effects and future change
Demographic changes: becoming bigger, older, and ethnically diverse
Effects on:
-The need for health care
-How the needs will be met
-The nation’s ability to afford HC: expanding gov’t programs on an unsustainable financial path
-Implications for supply of health professionals
Cultural factors will create ongoing challenges
Uninsured immigrants without documents tap into resources
Personal lifestyle choices cannot be fully incentivized
Ecological forces and future change
Major implications for PH
-New dzs
-Natural disasters
-Bioterrorism
World pop growth
-Intensify human-animal-ecosystems interface
-Probability of engendering new dzs
Dealing with new ecological threats
-Will divert resources from routine HC
Concerns and challenges from MA plan
Concerns on cost and waiting time
In the Connector (exchange), premium increases surpass inflation; the state had to set limits on the rise in premiums
Some mixed results on ability to meet HC needs
ED use has continued to rise
Income tax hikes are proposed
Implementing the medical home model
Information exchange outside the medical home
Reimbursement that captures critical nonclinical activities, such as care coordination
Lessons from the Vermont Blueprint
A pilot program launched in 2006
Shifted to a statewide program after the passage of the ACA
Integration of medical home and COPC models
Medical homes supported by community health teams and an integrated IT infrastructure
Community health teams offer individual care coordination, health and wellness coaching, and behavioral health counseling for a defined pop
Reduced ED use and hospitalizations are necessary for financial viability
Pt activation and SES
Considerable difference in activation levels across socioeconomic and health status characteristics
-Lowest among Medicaid enrollees
Definition of pt-centered care
Respecting and responding to pts’ wants, needs, and preferences, so that they can make choices in their care that best fit their individual circumstances
The role of pt-centered care
Promotes pt activation
Positive impact on pt satisfaction, adherence to tx regimens, and self management of chronic conditions
Training in geriatrics
Critical shortage and worse shortage expected in the future
Better outcomes by geriatric professionals without cost increases
Recommendations (IOM, 2008): residency training, better recruitment and retention, and financial incentives for specialists, better pay and benefits for direct care workers in geriatric settings
Six areas of concern in LTC
Financing: reform needed in both public and private financing
Resources
Infrastructure
Workforce: a deficit of direct care workers is projected
Regulation
Information tech: interoperable IT systems are needed
What is HEDIS? What does it report?
Healthcare Effectiveness Data and Information Set
A tool used by >90% of US health plans to measure performance on important dimensions of care and service.
What are the major provisions of the ACA?
Guaranteed issue
Minimum standards
Individual mandate
Health insurance exchanges
Low-income subsidies
Medicaid expansion
Medicare payment reforms
What are the core functions of PH?
Assessment
Policy development
Assurance
What essential functions are part of assessment?
Monitor health status to identify and solve community health issues
Diagnose and investigate health problems and health hazards in the community
