Unit 2 Lesson 4: Analyzing a Complex System Flashcards
What is Health Maintenance Organization (HMO)
A type of insurance plan that only pays if you use doctors or facilities that have contracts with the plan.
What is Preferred Provider Organization (PPO)
With a PPO plan, you will pay less for health providers that are in the plan’s network. You can also use out-of-network providers and pay a higher percentage of the bill.
What is Exclusive Provider Organization (EPO)
This type of plan will only pay for doctors, specialists, and hospitals that are in the network.
What is Point of Service (POS)
Similar to a PPO, a POS plan will have you pay less for providers that are in the network. In a POS plan, your primary care provider must give you a referral to see any specialists.
What is catastrophic health insurance
These plans have very high deductibles that the person has to pay before the plan will pay anything. The upside is that the monthly premiums will be lower.
When do catastrophic health insurance protect you
These plans can protect someone in the event of a catastrophic illness or injury but doesn’t help much with day-to-day health problems.
What is Accountable Care Organization (ACO)
An Accountable Care Organization (ACO) is a group of practitioners and facilities that have banded together to provide quality care efficiently and appropriately, and they are paid based on outcome rather than quantity of treatments.
What is Primary Care Medical Home (PCMH)
A Primary Care Medical Home (PCMH) model is a patient-centered, team-based approach to the health of the whole person and focuses on primary care providers performing about 75 percent of the care.
What do PCMH teams
These PCMH teams can include advanced practice nurses, physicians, physician assistants, and others who work to prevent and quickly treat problems in the most efficient way. Relationships between patient and provider are seen as a key to PCMH success.
Have to costs of medical care rising or lowering
The costs of medical care have been rising faster than other parts of the economy in the United States, although the speed of cost increases seems to be slowing down.
Describe how US healthcare is expensive
. Healthcare accounts for a large share of the economy. It is a big expense for the government, businesses, and individuals. The United States spends more on healthcare for each person than any other country in the world—more than double the average for developed countries.
There are three factors that have been identified as contributors to the rising cost of healthcare; what are they
new technologies and prescription drugs; the rise of chronic diseases like obesity; and high administrative costs in healthcare.
What are the bad things healthcare in US have done
Healthcare is part of what has contributed to a higher national debt, state government budget problems, and financial problems for individuals. The high cost of healthcare can make it hard for lower income people to get adequate medical care. High cost can also cause bankruptcies for individuals who end up having a major health crisis in the family.
What are some of the benfits of the healthcare
On the other hand, the health sector of the economy is also a driver of the economy. Demand for healthcare creates jobs, and jobs that pay living wages. Plus, new technologies and pharmaceutical products can add money to the economy. So healthcare has a complex relationship with the economy.
