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HOSA BOWL > Health Care Systems > Flashcards

Health Care Systems Flashcards

1
Q

What are the four types of hospitals and their definitions?

A

General: IF treats wide range of conditions and age groups

Specialty: IF treats certain conditions and age groups

Government: IF managed and funded by state/federal government

University/College: IF managed by uni/college and focuses on research/study

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2
Q

What are the three types of long-term care facilities and their purposes?

A

Residential (Nursing/Geriatric): care for individuals unable to care for themselves

Extended (Skilled): temporarily care for individuals until they can care for themselves

Independent Living (Assisted Living): “apartment” style facility for individuals who can care for themselves

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3
Q

What kind of facility would be identified as a medical office?

A

A private-based facility owned by either a physician or an organization

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4
Q

What is concierge (retainer) medicine?

A

primary care physicians give personalized care for annual/monthly fees

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5
Q

What are the types of clinics and their main functions?

A

Specialty: dx and tx specific diseases

Substance Abuse: provide rehab for substance abuse

Surgical: provide “same-day” surgeries

Outpatient: dx and tx patients w/o admission

Urgent (Walk-in): tx acute illnesses and injuries

Rehabilitation: provide physical, speech, and occupational therapy

Health Department: provide special services

Industrial (Occupational): provide care for employees

Medical Center: provide care and allow research/student education

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6
Q

What do genetic counseling centers do?

A

To provide prenatal screening, evaluate for congenital and heritable disorders, and provide psychological counseling

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7
Q

What are hospice care agencies?

A

Agencies that provide palliative care for patients at home/medical facility

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8
Q

What are home health care agencies?

A

Agencies that provide care for patients unable to care for themselves AT THEIR HOME

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9
Q

What are Health Maintenance Organizations?

A

a system/plan that allows patients to pay fixed premiums for preventative healthcare

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10
Q

What are mental health facilities?

A

Facilities that specialize is dx and treating/managing mental disorders

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11
Q

What’s the World Health Organization (WHO)?

A

an international organization managed by the United Nations to research and address health issues

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12
Q

What’s the USDHHS and what do they do?

A
  • The U.S. Department of Health and Human Services
  • they maintain the health of the US
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13
Q

What are the federal health agencies of the US and their purpose?

A

AHRQ: support health research and quality maintenance

Veteran’s Administration: provide care for US veterans

USDHHS: protect the health of the US

FDA: regulates food, drugs, and medical products

OSHA: protects workplace health

Office of the National Coordinator for Health Information Technology (ONC): establish secure and private system to share patient info

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13
Q

Give two divisions of the USDHHS and their purposes.

A

Center for Disease Control and Prevention (CDC): addresses epidemiology of diseases in the US

National Institutes of Health (NIH): researches disease

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14
Q

What are voluntary (non-profit) health agencies?

A

Agencies that may research/support health and are funded by grants, donations, or membership fees

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15
Q

What is the Joint Comission?

A

The largest U.S. non-profit health agency that ensures quality patient care

16
Q

What is a premium in health insurance?

A

A fixed annual/monthly fee an individual must pay to be covered by an insurance

17
Q

What is co-insurance?

A

patient must pay a percent amount of the expense

18
Q

What is a co-payment?

A

patient must pay a fixed amount of the expense

19
Q

What is an assignment of benefits?

A

An agreement that allows provider to collect fee from patient’s insurance

20
Q

What is a preferred provider organization (PPO)

A

an employer-sponsored health insurance plan only applicable to contracted providers

21
Q

What groups are eligible for Medicare?

A
  • Aging population (65+ yrs)
  • Individuals with disabilities AND who have received Social Security benefits for >2yrs
  • Ppl with end-stage renal disease
22
Q

Give the three main types of Medicaid and the services they cover

A

Type A: hospital services

Type B: medical services (WITH premium and deductible)

Type D: pharmaceutical services

23
Q

What is a medigap policy?

A

A health insurance plan where the patient must pay a premium but can choose amount of coverage

24
Q

Generally, which groups are eligible for Medicaid?

A
  • low-income individuals
  • individuals with disabilities
25
Q

What is the Children’s Health Insurance Program (CHIP)?

A

a health insurance plan for children in the medical gap

26
Q

Who manages Medicare? Medicaid?

A

Medicare is a federal program, Medicaid is a federal-state program

27
Q

What is worker’s compensation?

A

A health insurance plan meant to reimburse workers injured on-the-job

28
Q

Who manages worker’s compensation? Who pays for it?

A
  • State manages this health insurance plan
  • Both state and employers will pay
29
Q

What is managed care in health insurance?

A

Prioritizing preventative/diagnostic care AND ensuring each expense has a purpose

30
Q

What is fee-for-service compensation in health insurance?

A

expenses are based on set prices for the services

31
Q

What is value-based compensation in health insurance?

A

expenses are based on patient satisfaction, quality of care, and outcome

31
Q

What is value-based compensation in health insurance?

A

expenses are based on patient satisfaction, quality of care, and outcome

32
Q

What are the four components of HIPAA?

A

1) Tax incentives for medical savings accounts

2) Patient info security and fraud protection

3) Increased access to employer-sponsored insurance

4) Improved standards for group health plans

33
Q

What are three main points from the Patient Protection and Affordable Care Act?

A

1) minimum health insurance plan required

2) extends insurance coverage in certain cases

3) increased access to Medicaid and CHIP

34
Q

What is TRICARE?

A

a health insurance plan meant to cover military members and their families

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