BDSM Flashcards

1
Q

triple aim

A

improve: (1) patient experience, (2) population health, (3) value (quality/cost)

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2
Q

stakeholders

A
  • patients and communities
  • health care providers: individuals and institutions
  • insurers
  • employers
  • government
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3
Q

attributes of health care system

A
  • access, cost, quality, equity, and accountability
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4
Q

Bodenheimer’s distinction

A
  • integrated vs. dispersed healthcare

- driven by biomedicine, financial incentives, specialty bias, professionalism

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5
Q

levels of care

A
  • primary: entry
  • secondary: referral
  • tertiary: highly specialized
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6
Q

HMO (health maintenance organization)

A
  • care provided by member physicians
  • limited referrals
  • financed by fixed periodic payments determined in advance
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7
Q

staff model HMO

A
  • medical professionals are employees of HMO
  • only see patients signed up for HMO
  • capitation: set amount per patient
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8
Q

virtual integration HMO

A
  • insurance and provider functions are separate
  • HMO contracts with provider groups
  • focus on managing cost and price, not care
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9
Q

ACO

A
  • set of healthcare providers that collaborate (provider led)
  • shared accountability of cost and quality
  • full continuum of care
  • shared savings and better metrics
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10
Q

medical home

A
  • comprehensive primary care
  • patient-centered
  • preventative
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11
Q

ecological view of healthcare

A
  • understand numerator vs denominator confusion
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12
Q

why doesn’t function as a market good?

A
  • irrational behavior
  • imperfect information
  • market power asymmetry/lack of choice
  • externalities intrinsic to health and created by policy
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13
Q

insurance mechanisms

A
  • subsidy: no tax on money spent purchasing insurance
  • moral hazard: allows risk
  • tragedy of commons: overuse resource bc it is shared (not usually an issue)
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14
Q

why was reform needed?

A
  • employer-based system
  • pre-existing conditions
  • lower-income people
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15
Q

RomneyCare

A
  • everyone brings something to the table: government, employers, healthcare system, individuals
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16
Q

ACA key provisions

A
  • affordability (expand medicaid eligibility; sliding scale)
  • accessibility
  • individual requirements (mandate)
  • employer requirements
  • primary care (community health centers; more funding)
17
Q

comprehensive health reform

A
  • coverage and access
  • delivery system reform
  • prevention, wellness, public health
  • health in all policies
18
Q

MA vs ACA

A
  • incremental vs transformational
  • easier to enact reform
  • bipartisan support