Lecture 8 Flashcards
is DUR done more in retail or hospital?
retail. but it’s done in both
explain what OBC is
outcomes based contracting
contract between manufacturer and the formulary manager
company that makes the product tells the formulary manager to pay them only if the outcomes promised by the product are actually achieved
OBC is popular for what kind of drugs?
expensive drugs such as speciality, gene therapy, biologics
FFS gives incentive for physicans to do what??
provide more treatments, bc payment depends on QUANTITY of care
Does FFS exist in the united states today?
yes, but not nearly as popular as in the past
UNBUNDLING – paying for everything separately
creates GREED
Today, there is bundling and negotiation of services for ONE payment.
this is a type of _____ payment
PROSPECTIVE
What is meant by “administrative burden”
Paperwork, esp associated with PA’s and other utilization managements
what is a BENEFIT of the “administrative burden”
ensures quality
what law mandated EMR/EHR and why is it a good thing
obamacare
delay of care is no longer an issue
EMR is good for the _____ of care
coordination
EMR is _______ level technology
provider
______ is patient level technology
“smart cards”
why do we not have smart cards in the US
all medical records are contained in the chip of a card.
private information may get compromised – bog concern
true or false:
other countries have a better welfare system
true
what is welfare?
supposed to compliment the healthcare system.
gives benefits to special populations like military, kids, pregnant women, seniors, etc
true or false:
the social determinants of health are better in other countries
true
what is the safety net system?
system that takes care of people who dont have insurance, etc
true or false:
our safety net system is adequate and the safety net population is staying relatively the same in numbers
FALSE
our safety net system is inadequate and our population for the safety net system keeps growing because our life expectancy is going up —– lot more elderly
is defensive medicine preventative medicine?
NO
defensive medicine is excessive diagnostic testing to reduce the risk of the malpractice of medicine
physican is pushed to do this out of FEAR (not greed like FFS)
give an example of administrative inefficiency
we have some older dr’s who have not updated theur skills to today, or who dont want to try new things
true or false:
patient demands are part of why we spend so much on healthcare and use the most resources
TRUE
this is due to DTC (direct to consumer) commercial for Rx.
When they ask, dr usually obliges even if its not proper for the diagnosis
explain how technological advancements are a factor of the rising health care costs
we have imaging technology which can improve the quality of care, but a lot of times it’s done without really needing it — very expensive
true or false:
the failure to provide routine preventative measures is part of the rise of healthcare costs
true
iatrogenic
illness caused by the SYSTEM ITSELF
ex: wrong side surgery
iatrogenic illnesses kill ______ people every year
98,000
what is a nosocomial infection
healthcare associated infection
