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Flashcards in Spogen! Deck (20)
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1

How do we rank internationally in health care delivery?

US ranks #37

2

Which is not a parameter used in ranking?
Access to health system
cost of accessing care
accessing cutting-edge tech
comparison of disease-specific treatment patterns & outcomes?

c. access to cutting-edge tech

3

T/F New models of health care have driven down the cost of health care.

False.

4

How is health care accessed?

individuals decide how sick they are & choose where to go (hospital, primary care etc)

5

How is health assessed?

individuals decide when & who will assess their health

6

How many Americans are uninsured?

20 million

7

How is the health care delivery system in the US?

consumer driven, but becoming insurance driven

8

Uninsured deal w/ health care how?

covered by a "safety net" of providers
like ER

9

Insurance plans were originally developed when?

Great Depression as a way to increase employee's compensation

10

T/F Insurance plans have payment rates that are based on Medicare rates.

T

11

T/F Medicare is based on payment via SGR formula.

False! Congress just changed it.

12

How is Medicare & Medicaid run?

Medicare--national program but farmed out to insurance companies in different regions
Has part A & B (outpatient has donut hole)
Medicaid-administered by the states & both states & feds finance the program.

13

What is SHIP?

state children's insurance plan
covers children health issues that helps families that make less than 200% of FPL but don't qualify for Medicaid

14

T/F Malpractice insurance has restricted many practices scope of practice.

T

15

T/F Hospitals require that you have malpractice insurance.

T

16

CMS funds what?

both medicare & medicaid
and inpatient training of doctors

17

Time for resident training is based on what?

3rd party (ACGME) dictates the amount & specifics of training programs

18

Who determines the types & #s of residency training slots?

hospitals

19

Funding for residencies?

congress approves funding
funding goes thru CMS & goes to hospitals
direct CMS funding goes to residency salaries
indirect CMS funding for what it takes to educate resident
still only partial funding

20

How does a PCP relate to health care costs?

1. knowing you have a PCP reduces costs by 30%
2. having PCP involved in hospital care reduces costs by 67%
3. ratio of PCP: pt is 1:4 in US; in other develop countries: 4:1