Ch. 2 – Health Care Economics Study Guide Flashcards
Medicare
federally funded health care program for older Americans
Tricare
a system of that provides medical coverage for active and retired service
Medicaid
:a government program that offers health insurance to many low-income and disabled people
SCHIP
State’s Children’s Health Insurance Program
Managed care
puts health care providers in the position of managing a patient’s use of health care; Types of Plans: Health Maintenance Organization (HMO) plan, Preferred Provider Organization (PPO) plan, Point of Service (POS) plan
Regulatory compliance
Rules and/or guidelines that have to be followed by healthcare organizations and providers.
Quality assurance
Assessing, monitoring and correcting patient care to enhance the quality of Health Maintenance Services which pursues perfecting patient care.
Which of the terms in # 3 describes the management of time, staff, equipment, technology, and facilities in providing health care?
Resource Utilization
Which type of health insurance coverage is obtained through an employer or purchased as an individual policy?
Individual coverage
Which type of healthcare facility receives federal, state, and local tax exemptions in exchange for providing a community benefit, such as care for Medicaid and other low-income patients?
Non profit hospitals
Measures designed to lower health care costs are known as
Managed care
Health Maintenance Organization
this plan provides coverage only if the care is delivered by a member of its hospital, physician, or pharmacy panel
Point of Service Plan
this is a physician-coordinated plan that combines characteristics of both HMO and PPO plans
Preferred Provider Organization
this plan allows patients to receive care from a non-plan provider, but requires them to pay a higher out-of-pocket price if they do so
Restricted Network plan
Restricted provider network means a limited network of health providers
