Transformation of the American Health Care System

Question 1

Why is US care so expensive?

Answer 1

1. lower percent paid by gov
2. more complex care provided
3. high administrative costs
4. limited negotiation of prices
5. more specialists, more drugs
6. currently pay for volume, not quality

Question 2

What is the triple aim?

Answer 2

better health
better care
lower cost

Question 3

What are the three aspects of the -pay-for-value formaul?

Answer 3

better quality
population health management
lower cost

Question 4

What are four basic assumptions on how healthcare will be paid in the future?

Answer 4

1. decline in payment rates
2. quality and efficiency rewarded
3. readmissions and low quality will be penalized
4. population health will be incentivized

Question 5

WHat is an accountable care organization?

Answer 5

group of hospitals or physicians that manage the complete health care needs and costs of a group of 5,000 or more Medicare recipients

if the total cost of care for this group is lower than the previous year, with higher quality, the ACO shares the savings with the federal Medicare program