Health Care Delivery

Question 0

PPO’s

Answer 0

Preferred provider organization. Hospital, clinic, etc. patient can choose between offered services and will receive discounts. This route is often more expensive though.

Question 1

HMO’s

Answer 1

Prepaid basis, contracts with select providers and can receive reduced fees. The goal is to keep patients well, and by doing so, the more money is in the “pot”

Question 2

Medicare

Answer 2

Offered to someone who is 65+, people with permanent disabilities; two parts. A and B. part b is optional and only offers partial coverage.

Question 3

Diagnostic related groups (DRG’s)

Answer 3

Implemented by Medicare; looked at different diseases to find standard or average for realistic cost, decided on set cost for a specific disease or injury

Question 4

Medicaid

Answer 4

Federal assistance paid out of general taxes.

Question 5

Private health insurance

Answer 5

Individuals seek these out themselves, not government related, includes non profit and profit organizations.

Question 6

Prospective payment system (PPS)

Answer 6

Payment mechanism for reimbursing hospitals for impatient health care services in. Which a predetermined rate is set for treatment of a specific illness

Question 7

Restorative care

Answer 7

Help individuals regain maximal functional status and enhance quality of life through promotion of independence and self care.

Question 8

Extended care facilities

Answer 8

Intermediate medical, nursing, or custodial care for patients recovering from acute illness or those with chronic illnesses or disabilities. Some include long term facilities.

Question 9

Home care

Answer 9

Provides health care to individuals and their families in their homes

Question 10

Respite care

Answer 10

Short term relief or “time off” for people providing home care to an ill, disabled or frail older adult. Offered in home, a day care setting or a health care institution that provides overnight care.

Question 11

Adult day care centers

Answer 11

Services are offered during the day to allow family members to maintain their lifestyles and employment and still provide home care for relatives.

Question 12

Hospice

Answer 12

System of family-centered care that allows patients to live and remain at home with comfort, independence, and dignity while easing the pains of terminal illness. Focus of hospice is palliative care