Access to Care / Health Reform

Question 1

Health reform

Answer 1

• Health reform: a general rubric used for discussing major health policy creation or changes—for the most part, governmental policy that affects health care delivery in a given place

Question 2

Medicaid

Answer 2

• Medicaid: health care for the needy; a federally and state-funded program

Question 3

Medicare

Answer 3

• Medicare: health care for the aged; a federally administered system of health insurance available to persons aged 65 and over

Question 4

individual mandate

Answer 4

• individual mandate: An individual mandate is a requirement by a government that certain individual citizens purchase a good or service

Question 5

employer mandate

Answer 5

• employer mandate: employers with 50 or more employees to provide health coverage to those employees and sets a minimum baseline of coverage and employer contributions. Employers who do not comply will face annual penalties based on the number of employees in the firm

Question 6

affordable care act

Answer 6

• affordable care act: is the landmark health reform legislation passed by the 111th Congress and signed into law by President Barack Obama in March 2010. The legislation includes a long list of health-related provisions that began taking effect in 2010 and will “continue to be rolled out over the next four years.” Key provisions are intended to extend coverage to millions of uninsured Americans, to implement measures that will lower health care costs and improve system efficiency, and to eliminate industry practices that include rescission and denial of coverage due to pre-existing conditions.

Question 7

accountable care organizations (ACO)

Answer 7

• accountable care organizations (ACO): groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients.

Question 8

patient centered medical home

Answer 8

• patient centered medical home: a model of care that emphasizes care coordination and communication to transform primary care into “what patients want it to be.”

Question 9

IHI triple AIM:

Answer 9

• IHI triple AIM: – the simultaneous pursuit of better care for individuals, better health for populations, and lower per capita costs – has become increasingly central to discussions of health care improvement.

Question 10

benefits package

Answer 10

• benefits package: A term informally used to refer to the employer’s benefits plan or to the benefits plan options from which the employee can choose. “Benefits package” highlights the fact a health benefits plan is a compilation of specific benefits

Question 11

cost-sharing

Answer 11

• cost-sharing: Any contribution consumers make towards the cost of their healthcare as defined in their health insurance policy.

Question 12

single-payer health care

Answer 12

• single-payer health care: refers to one entity acting as administrator, or “payer.” In the case of health care, a single-payer system would be setup such that one entity—a government run organization—would collect all health care fees, and pay out all health care costs.

Question 13

employer-based health care

Answer 13

• employer-based health care: coverage offered through one’s own employment or a relative’s. It may be offered by an employer or by a union.