Chapter 12 Flashcards
Higher the quality and the broader the access?
Higher the cost
What are the three cornerstones for healthcare delivery?
Cost, access, and quality
Cost include?
Reimbursement for services, cost of equipment and supplies, and operational overhead
Cost spiraled after the Medicare and Medicaid legislation allowed?
For expansion of services and broader criteria for participation in eligibility
Predictions and health care of GDP in 2010?
25% by 2025,
37% by 2050
40% by 2082
Why is the rise of insurance premiums?
Comprehensive policies and lead them selves from moral hazard
Who is the burden for providing public funding insurance?
For the poor and the indigent
what are some reasons for containment?
Raising cost consumes more of the national economic output, premiums rose by 119%, makes it difficult for employees to offer insurance, takes a toll on average and low income families
Third-party payments?
Provokes more provider induced demand for service
In perfect market?
Not being checked for waist and overuse
Growth technology?
Too much investment on R&B results in higher cost of technology and its operations
Increase in the elderly?
The age aging broom (47 to 81yr) more people with more chronic conditions, artificially keeping people alive
Medical model of healthcare delivery?
Medical intervention vs preventative care
Multiplayer system?
Administrative cost
Defensive medicine?
Fear of legal liabilities lead to unnecessary procedures
Fraud and abuse?
Fraud, upcoding, lies about true cost
Practice variations?
No uniform system for diagnosis and treatment
Why are attempts for containment for excavating cost difficult?
Very difficult due to so many practice variations and regulation
Help planning?
No efficient due to combine and federal and private handling
Health planning Council?
Had no teeth to regulate
Certified of need status?
Based on community needs
Peer review?
To determine good and bad practices and urged changes
Competitive approaches? A-D
A. Demand – side: call sharing with co-pays and deductibles
B. Supply – side: antitrust laws prohibiting illegal practices
C. Payer-driven price competition: difficult because most users don’t understand the healthcare market
D. Utilization Controls: managed care has greater control of use and misuse
The ACA and cost containment?
Has Medicare payment cuts to providers/competition among exchanges could result in some reduction in cost
Access to care?
Healthcare services were needed
Barriers that still exist in USA?
Race, income, and occupation
Quality of care is difficult?
To define measure quality
The dimensions of quality are?
A) The micro view – the clinical and interpersonal aspects of care delivery, and quality-of-life.
B) The macro view – quality assessments and assurance
