Lecture 8

Question 1

is DUR done more in retail or hospital?

Answer 1

retail. but it’s done in both

Question 2

explain what OBC is

Answer 2

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

Question 3

OBC is popular for what kind of drugs?

Answer 3

expensive drugs such as speciality, gene therapy, biologics

Question 4

FFS gives incentive for physicans to do what??

Answer 4

provide more treatments, bc payment depends on QUANTITY of care

Question 5

Does FFS exist in the united states today?

Answer 5

yes, but not nearly as popular as in the past

UNBUNDLING – paying for everything separately

creates GREED

Question 6

Today, there is bundling and negotiation of services for ONE payment.

this is a type of _____ payment

Answer 6

PROSPECTIVE

Question 7

What is meant by “administrative burden”

Answer 7

Paperwork, esp associated with PA’s and other utilization managements

Question 8

what is a BENEFIT of the “administrative burden”

Answer 8

ensures quality

Question 9

what law mandated EMR/EHR and why is it a good thing

Answer 9

obamacare

delay of care is no longer an issue

Question 10

EMR is good for the _____ of care

Answer 10

coordination

Question 11

EMR is _______ level technology

Answer 11

provider

Question 12

______ is patient level technology

Answer 12

“smart cards”

Question 13

why do we not have smart cards in the US

Answer 13

all medical records are contained in the chip of a card.
private information may get compromised – bog concern

Question 14

true or false:

other countries have a better welfare system

Answer 14

true

Question 15

what is welfare?

Answer 15

supposed to compliment the healthcare system.
gives benefits to special populations like military, kids, pregnant women, seniors, etc

Question 16

true or false:

the social determinants of health are better in other countries

Answer 16

true

Question 17

what is the safety net system?

Answer 17

system that takes care of people who dont have insurance, etc

Question 18

true or false:

our safety net system is adequate and the safety net population is staying relatively the same in numbers

Answer 18

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

Question 19

is defensive medicine preventative medicine?

Answer 19

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)

Question 20

give an example of administrative inefficiency

Answer 20

we have some older dr’s who have not updated theur skills to today, or who dont want to try new things

Question 21

true or false:

patient demands are part of why we spend so much on healthcare and use the most resources

Answer 21

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

Question 22

explain how technological advancements are a factor of the rising health care costs

Answer 22

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

Question 23

true or false:

the failure to provide routine preventative measures is part of the rise of healthcare costs

Answer 23

true

Question 24

iatrogenic

Answer 24

illness caused by the SYSTEM ITSELF

ex: wrong side surgery

Question 25

iatrogenic illnesses kill ______ people every year

Answer 25

98,000

Question 26

what is a nosocomial infection

Answer 26

healthcare associated infection