C14 Review of US HC Sys Flashcards
(30 cards)
ACA
ACA and its amendments
have focused on primary care as the foundation
for the U.S. healthcare system. Increase affordable healthcare
ACA legislation focused on 6 areas to improve:
-Quality
-Affordable
-Efficient health care
-Public health
-Primary prevention of disease
-HC workforce increases, community health
-Increasing revenue provisions to pay for the reform
ACA mandates?
-Mandates established e-health insurance marketplaces
-Mandate individuals either purchase health insurance if they can afford it or pay a fine
The pandemic created a foundation of?
misinformation and disinformation
The pandemic increased competition of ___ and reduced reimbursement from?
Outpatient services, Medicare and Medicaid (increase financial stability, purchase outpatient facility)
Long term care services include?
A broad range of health,
personal care, and supportive services that
meet the needs of older people and other adults whose capacity for self-care is limited
-Usually not med care but ADLs (friends and family)
Adult who reaches 65 y should expect to?
Live 20 additional years needing LTCS (1 in 5 for >5y)
Reason US HC spending is so high (GDP amnt 2020)
Because of the price of medical care, such as the use of technology and high labor costs (19.7%)
Private health insurance
Provided by companies and typically have a contract with employers so they can offer group health insurance to their employees.
Integrative medicine
Combination of
complementary and alternative medicine (CAM) with a traditional medicine approach
Green House Project
A unique type of nursing home that focuses on
being a home to the residents instead of an
institution where they receive care
Accountable care organizations (ACOs)
Are groups of providers and hospitals that provide coordinated care to Medicare patients. Goal is to ensure that patients receive timely care while avoiding duplication of services and preventing medical errors.
Pay-for-performance (P4P)
Value-based
purchasing (VBP) describes healthcare payment systems that reward healthcare providers, including hospitals, physicians, and other providers, for their efficiency, which is defined as providing higher-quality care for less cost.
PCMH main goal
To have a centralized setting that
facilitates cooperation between the patient and their primary care provider
-Patient care is facilitated by health information
technology (HIT), health information exchanges
(HIEs), and other means to ensure that patients get the indicated care when and where they need it in a culturally respectful way
US population change
The white population decreases, while the rest increase, while the American Indian/ Alaskan Native population remained static
Universal HC has (system type)
Single-payer system, which means the government pays for HC services
3 models for structuring a universal HC system
-National health insurance
-National health system
-Socialized insurance system
National Health Insurance
As in Canada, is
funded by the government through general taxes although the delivery of care is by private providers.
National Health System
As in Great Britain,
taxes support the system, but the government also manages the infrastructure for healthcare delivery
Socialized health insurance system
As in Germany, the government mandates financial contributions by both the employer and employee with private providers delivering health care
Japan’s HC system is regulated by
the government with the statutory goal of providing quality care
Japan citizens have to be covered by any of the following components of the social security system?
-social insurance
-social welfare
-public assistance
-public health
2015 Health Care Reform Act
Local governments
are responsible for oversight of community
healthcare plans and collecting premiums
Japan people older than __ are automatically enrolled in LTCI
40 , triple hc costs in next 20y
