Health Care

Question 1

What school was used as the model school for the Flexner Report 1910

Answer 1

John’s Hopkins Medical School

Question 2

What did the Flexner Report 1910 do?

Answer 2

Solidified an educational model that favored the lab over bedside, hospital over home and physician as researcher over practitioner

Question 3

A lot of med schools closed after the report, especially schools that educated….

Answer 3

female, black and working class students

Question 4

Who was the founder of the PA profession?

Answer 4

Eugene Stead MD

Question 5

Most medical care is delivered in …

Answer 5

small healthcare settings.

32% solo or 2 physicians
60% practice of 5 physicians or less

Question 6

What are social determinants of health?

Answer 6

NOTE THE THINGS IN () ARE JUST EXAMPLES.

• economic stability (employment, debt, income)
• education (language, levels of education, literacy)
• food (hunger, access to health)
• social & community (social integration, support system, discrimination)
• neighborhood & environment (housing, transportation, parks, safety)
• health & healthcare (coverage, quality of care, provider availability)

Question 7

Affordable Care Act did what?

Answer 7

Gave uninsured way to be insured.

• income based subsidies to uninsured
• employer mandate
• individual mandate
• medicated expansion

Question 8

Mechanisms for Affordable Care Act

Answer 8

Private: each state creates insurance exchange for individuals w/o coverage and small employers

Public: The medicaid expansion. Medicare, Medicaid, CHIP, VA

Question 9

Under the Affordable Care Act health insurers …

Answer 9

• couldn’t turn applicants down with a h/o illness or charge more
• cannot terminate coverage
• must renew coverage
• return at least 80% of premiums in form of health service benefits

Question 10

What is the most common type of health insurance provider

Answer 10

Employer based coverage

Question 11

What makes you qualified for Medicare if you are 65

Answer 11

Disabled or if you need hemodialysis and are eligible for social security

Question 12

Describe A, B, C & D parts of medicare

Answer 12

A: hospital services
B: Outpatient, physician services
C: HMOS that administer benefits “Medicare Advantage” (approved by medicare run by private)
D: Meds, rx drugs

Question 13

Who is eligible for Medicaid

Answer 13

Varies by state. Usually low income, children, parents of dependents, pregnant women, disabled

Question 14

Can someone have dual eligibility with Medicare and Medicaid?

Answer 14

Yes, if they are chronically ill and need long term care

Question 15

What does Medicaid cover?

Answer 15

most clinical services and Rx

Question 16

Define “Churn”

Answer 16

movement in and out of the program. Occurs bc of changes in income and employment.

Question 17

What population is most likely affected by churn?

Answer 17

hourly paid employees

Question 18

Who is the primary payer for long term services and support?

Answer 18

Medicaid

Question 19

How is Medicare financed?

Answer 19

federal income tax, payroll taxes, premiums paid my enrollees

Question 20

How is medicaid financed?

Answer 20

state and federal taxes. Every dollar the state spends the federal government matches it

Question 21

Does medicare or medicaid give low reimbursement rates for providers?

Answer 21

Medicaid

Question 22

What is S-CHIP?

Answer 22

The state childrens health insurance program developed in 1997

Question 23

Who does S-CHIP cover?

Answer 23

children in low income families who do not qualify for Medicaid

Question 24

How is private health insurance sponsored ?

Answer 24

Employer sponsored or private, nongroup (individual market

Question 25

Private employer sponsored insurance is financed…

Answer 25

jointly through employer and employee

Question 26

who uses private non group/individuals financed?`

Answer 26

self employed or retired

Question 27

How does the premium work for those in private non group insurance?

Answer 27

Premium correlates with risk.

Low risk people= low premium