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Cricks Health Care O
Overview of Health Care System Basics
| Question | Answer |
|---|---|
| Who are providers? | hospitals, doctors, pharmacies, nurses |
| Who are patients? | anyone who interacts with providers for money |
| Who are insurers? | Agencies who pay on behalf of patients- who are their clients |
| Who is a payor? | Anyone who is paying for service, private, insurance agencies, US government, employers |
| What is a premium? | Fee paid to insurers to provide insurance |
| What is the purpose of a co-pay? | To prevent people from over-using insurance |
| What is a Health Maintenance Organization? | An insurance company who employs its own doctors and other providers (even hospitals) that its insured members must do business with. This restricts access to more expensive medical procedures |
| What is a Preferred Provider Organization? | An insurance company who does not employ its doctors, so they can be more flexible in offering care. Insurance company has less input on what care patient receives |
| What is the “moral hazard” in insurance? | If healthcare costs are too shared, then people will seek medical treatment that may not be needed because it is cheap- no added cost to them |
Created by:
russcrick
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