HCE all

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  1. Anesthesiologist assistant
    Athletic trainer
    Personal trainer
    Lactation consultant
    Orthotist and prosthetist
    Respiratory therapist
    Surgical tech
    Allied Health
  2. Chiropractic
    Massage therapy
    Alternative Medicine
  3. Audiologist
    Speech-language pathologist
  4. Counselor
    Genetic counselor
    Rehab counselor
  5. Dietitian
  6. Dentist
    Dental hygienist
  7. Art therapy
    Music therapy
    Dance therapy
    Art therapy
  8. Medical coder
    Medical librarian
    Medical transcriptionist
    Health Information
  9. Phlebotomist
    Pathologists’ assistant
    Blood bank tech
    Laboratory Science
  10. Sonographer
    MRI tech
    Radiologist assistant
  11. Registered nurse
    Nurse anesthetists
    Nurse midwives
    Nurse practitioners
  12. Pharmacist
    Pharmacy tech
  13. Medical doctor
    Doctor of osteopathy
    Physician assistant
  14. Podiatrist
  15. Psychology
  16. Occupational therapist
    Physical therapist
  17. Veterinarian
    Veterinarian tech
    Veterinary Medicine
  18. Optometrist
    Teacher of the visually impaired
    Vision rehabilitation therapist
  19. Emergency
  20. Acute
  21. Sub- acute
    Skilled Nursing Facility
  22. Out- patient
    go in for procedure and out same day
  23. Home Care
    In home
  24. Who started the idea of national insurance?
    Roosevelt in 1912
  25. What happened in 1965?
    Johnson created Medicare and Medicaid
  26. What happened in 2003
    Bush created Medicare Modernization Act which added Parts C and D
  27. What happened in 2009
    Obama started the ACA
  28. Medicare eligibility
    • Age 65
    • paid SS for at least 10 yrs
    • Permanently disabled
    • Financed through taxes
  29. Part A
    • Hospital
    • Automatically qualify
    • Free if pay 10 yrs SS
    • If not, purchase with premium
    • Pay deductible each time visit
  30. Part B
    • Medical Costs
    • (Doctors Visits, Preventive screenings)
    • Automatically Enrolled
    • Pay monthly premium
  31. Part C
    • Medicare Advantage
    • Optional
    • Combines part A and B
    • Usually contains extra benefits and Part D
    • Not Free
    • Have networks
  32. Part D
    • Prescription
    • Not Automatically enrolled
    • Only through private plans
    • Pay premiums
    • if not purchased right away- premium penalty
  33. Medicaid
    • fed gov pays 50-70% of cost
    • low income, elderly, disabled, bind, children under 6, pregnant with fam below 133% pov level
  34. Hoe did health insurance come about?
    In WWII companies lured workers by coupling insurance with their job
  35. What is Professionalism
    • Behavior that will lead to;
    • adherence to ethical practice
    • effective interactions with patients
    • effective interactions with staff
    • reliability, and commitment to improvement
  36. Traditional Medicare
    • Fee for service
    • Can see any doctor that accepts Medicare
  37. Medicare Advantage
    • lower copay and deductible
    • extra benefits
    • have to see physicians in network
  38. Who are the stockholders?
    • Gov
    • Priv insurance
    • Tax payers
    • Health care provider
    • Patients
  39. Why gov gave 14% more money to Medicare Advantage than directly to health care providers?
    If procedure $20, gov have to pay $25. $20 for the procedure and $5 to the private insurance company
  40. Modes of paying for health care
    • out of pocket
    • individual private insurance
    • employment-based group private
    • gov financing
  41. Why out of pocket bad?
    • need vs luxury
    • hard to plan for
    • only rely on HCP recommendations
  42. Experience Rating
    Higher risk of problem, higher premium
  43. Community Rating
    Everyone pays the same premiums whether young or old
  44. Types of Private insurance
    • Traditional Fee for Service
    • Health Maintenance Organization (HMO)
    • Preferred Provider Organization (PPO)
  45. Traditional fee for service
    • most expensive
    • most flexibility when choosing HCPs
  46. Health Maintenance Organization (HMO)
    • lower copay
    • cover costs of more preventative services
    • few choices of HCPs
    • need PCP
    • HCP makes choices on surgeries not insurer
  47. Preferred Provider Organization (PPO)
    • lower copay (like HMO)
    • Pay more but get more options
    • more choices of HCPs than HMO
    • Can go out of network but have to pay more
    • dont need PCP
  48. Deductible
    Money you pay up to an amount and then insurance pays with you ($3000)
  49. What are copays for?
    Insurance company made to deter you from going somewhere so the doctors also make less money
  50. Co-insurance
    If insurance pay 80% you have to pay the other 20%
  51. Benefit max
    If you cost too much, stop paying
  52. Premium
    Amount you pay each month (part by employer and part by employee
  53. Why do some have inadequate access to health insurance?
    • Financial restrictions
    • Non financial barriers
  54. Financial restrictions
    • dont have insurance
    • underinsured
  55. Why has private health insurance coverage decreased over the past decades?
    • cost of insurance has sky rocketed and employers cant afford
    • our workforce has changed
  56. Consolidation Omnibus Budget Reconciliation Act of 1985 (COBRA)
    can continue coverage with post employment for 18 months if pay full premium
  57. Who benefits from the link between employment and insurance?
    • insurance company- employers forced to buy insurance whether their employees use it or not
    • Employee- get insurance w/o paying full price
    • Gov- less people to pay for on gov insurance, keep you working bc get benefits from job
  58. Who is mostly uninsured?
    • Hispanics or income <$25,000/yr
    • bc low income have smaller jobs that dont have good insurance or work under the table
  59. Why is access not guarenteed to those with Medicaid?
    • HCPs receive less for care than those with private insurance
    • many have stopped accepting medicaid
  60. Why is there a lack of prompt access?
    • shortage of PCPs
    • fewer accepting Medicaid
    • increase in wait time bc of universal insurance
  61. Why is race a barrier to health care?
    • cultural differences (beliefs and religion)
    • Ineffective communication (language)
    • Racism
    • minorities recieve less care even if pay the same amount
    • neighborhoods with high minoritys have fewer physicians
Card Set:
HCE all
2013-10-01 21:01:57
HCE all

HCE all
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