public health economics Flashcards
medicare general
federally funded
patient is collecting social security over 54
disabled on disability for two or more years
has end stage kidney failure
has ALS
patient pays 20% of bills and copays
medicare part a
emergency room
hospital
inpatient
skilled nursing facilities PT OT SLP wound care
home care
hospice
medicare part b
doctor visit
durable medical equipment
outpatient
mental health
preventative
x rays and lab
some home health
ambulance
medicare part c
Medicare advantage plan
combo of part a and b and includes vision and dental and hearing
provided by private insurance
medicare part d
prescription drug plan
private companies have contract with the government to cover different types of drugs
medicaid general
federal and state funded
low income
children
federally assisted income
disabled
patient copays are lower and more affordable
medicaid coverage
inpatient and outpatient
radiological services
home health
vaccines
family planning and pregnancy
managed care
control costs by influencing the way patients can receive care
HMOs
lower monthly payments and copays
only pay for those in network
choose a primary care doctor from a list and they refer you out to any specialists
not all doctors accept these plans
PPO
preferred - you choose your own care
can choose to see someone in or out of network but if they’re out of network its a higher cost
veteran care
TRICARE department of defense or unfiromed
Veterans Administration active or retired duty
other healthcare financing options
Indian health services –> tribal health care for native Americans and alaska natives
third party payers –> from an agency to providers
medical savings plan –> comes out of your paycheck, you pay yourself
individual payment
insurance
WIC program
US healthcare system structure: private or personal care
funded through insurance companies, employers, managed care, and individuals paying for care
primary care system
US healthcare system structure: public health
financed through public support
demographic trends affecting healthcare
population growth
aging baby boomers
change in largest minority group
the US household composition is changing
declining mortality
social and economic trends affecting healthcare
changing lifestyles
growing appreciation of the quality of life
family and living patterns changing
changing house house incomes
revised definition of quality healthcare
any economic downturn experienced by the country
affordable care act
healthcare trends affecting healthcare
not enough primary care providers
advanced practice nursing specialties
move to contain costs to over to community based care
nursing shortage
need to increase the number of minority nurses to help decreased health disparities
technological trends affecting healthcare
positive and negative aspects of technology
digital divide
electronic medical records
