COST, ACCESS, & HEALTH POLICY Flashcards Preview

Health Care Systems > COST, ACCESS, & HEALTH POLICY > Flashcards

Flashcards in COST, ACCESS, & HEALTH POLICY Deck (20)
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1

What is cost?

price
What is charged or what is paid

2

Payment

what is actually paid

3

Which should you pay more attention to as a practicing PT?
(price or payment)

payment

4

Which should you pay more attention to as a health care consumer?
(price or payment)

price

5

1965-1970

Passage of Medicare/Medicaid = huge increase in utilization as elderly now have coverage through Medicare

6

1985-1990

Medicare implementation of DRGs causing massive reduction in inpatient acute LOS

7

1995-2000

Implementation of Balanced Budget Act PLUS effect of HMOs in reducing utilization

8

2000-2005

Implosion of HMOs and subsequent reversal of cost control measures

9

2005-2010

Rise of CDHPs and HDHPs, putting more cost responsibility on patients

10

2010-2015

Passage of ACA with Medicare payment reductions implemented to pay for Medicaid expansion

11

Why control health care spending?

Increased NHE consumes more of the U.S. economic output
Insurance creates moral hazard
Increased cost to American business
Reduced access to insurance
Is too expensive – people cannot afford to receive care
No one wants to pay higher taxes

12

U.S. health care system is neither a

Highly regulated market
Highly competitive market

13

Life expectancy 1900

47

14

Life expectancy 2010

81

15

Certificate of Need (CON)

Meant to control capital spending = new hospitals, new buildings, new equipment
Must essentially ask for permission to add any of the above
Has largely failed to reduce NHE

16

Quality Improvement Organizations (QIOs)
are made up of who?

made up of health care professionals, paid by CMS, to review care provided to Medicare patients

17

What was the primary reason for the ACA?

rising uninsured population in America

18

What is access to health care services tied to?

ability to pay for those services
Insurance coverage
Personal wealth sufficient to pay for health care

19

Access Dimensions

availability
accessibility
accommodation
affordability
acceptability

20

Telehealth

Potential for video streaming technology to provide more availability access for those in rural areas