Healthcare Delivery Systems Flashcards
What is capitation?
“The hallmark of managed care”
Pays health plans or providers a fixed amount per enrollee per month and provides a defined set of services based on enrollee needs.
What is moral hazard?
The propensity of insured patients to use more medical services than necessary because of the limited cost to themselves.
What is the purpose of an org chart?
Map the hierarch of decisionmaking authority.
How do you calculate nursing care hours per patient day?
Staff man-hours in a 24 hour period / # of patients cared for.
What drives changes in health care delivery, generally speaking?
Money.
What is the costliest component of healthcare?
Personnel budget
What are some examples of direct costs?
Materials, services, wages (hourly) paid
What are some examples of indirect costs?
Cost of administration, office expense, rent, security, utilities, salaries
What are controllable costs?
Costs that can be influenced by a single person, e.g. materials
What are noncontrollable costs?
Costs that individuals cannot change, e.g. overhead
What are some examples of fixed costs?
Rent, amortization, depreciation, salaries, utilities
What are some examples of variable costs?
Materials, wages (hourly), freight
What is the significance of shared governance in healthcare?
A decentralized structure that gives employees of every level the ability to participate in high-level decisionmaking processes.
What are the characteristics of a magnet hospital?
Well qualified nursing executives
Open, participatory management
High levels of nurse autonomy
Adequate staffing ratios and clinical career opportunities
Magnet hospitals “focus on outcomes”
Describe zero based budgeting
Budget resets every period and every category and expense is reevaluated based on current and predicted conditions
