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public health
WCE 2 Olotu
| Term | Definition |
|---|---|
| Acquisition | One organization purchases another |
| Merger | UNIFICATION of two or more organization into a single entity through mutual agreement |
| Alliances | Agreement between TWO ORGANIZATIONS to share existing resources without joint ownership of assets |
| Network | ALLIANCES WITH NUMEROUS PROVIDES EX: IPA |
| Joint venture | CREATION OF A NEW ORGANIZATION in which two or more institutions share resources to pursue a common purpose EX: MCO formed by the coming together of an acute care hospital, multi-specialty physician group, skilled nursing facility |
| Horizontal integration | EXTEND the provision of a SIMILAR core product or service EX: Pharmacy chain ( Walgreens acquisition of RiteaAid stores, CVS acquisition of Target pharmacy |
| Vertical integration | Increase the COMPREHENSIVENESS OR DIVERSIFICATION of care EX: Kaiser composed primarily of hospital system, physician group, managed care org. |
| Three main components of highly integrated health care system | Hospital, physician, payer or health plan |
| Integrated delivery system | Kaiser, Mayo Clinic , Henry ford health system |
| Accountable Care Organization (ACO) | - Integrated group of PROVIDERS who are willing and able to take responsibility for improving the overall health status - Launched in January 2012 - Reduced the huge costs associated with Medicare |
| Select all that apply : what is to be accepted ACO must serve | - 5000 Medicare - 5 year - Purely voluntary |
| One sided track of ACO | NO financial risk or bonus only model |
| Two sided track of ACO | Presence of finial risk or bonus and risk model |
| What are the 3 cornerstones of health care delivery | cost, access, quality |
| Marco-perspective view | *National Health Expenditures * - GDP that a country spends on delivery of health care services - standpoint of the for the whole population |
| Micro perspective view | Cost incurred by employers Incurred by individuals when they receive health care cost - individual caregiver and health care organizations |
| Health care administrative cost | the management of the financing, insurance, delivery, and payment function |
| Fraud and abuse | when a higher priced service is billed when a lower priced service was actually delivered = upcoding |
| What is an example of regulatory based strategies | Supply side control price control |
| Supply side control | restriction on capital expenditures |
| Price control | prices in order to control cost (medicare) |
| Competition based strategies | cost sharing antitrust regulation payer driven price competition utilization controls through managed care |
| Availability | whether access to primary care service is provided 24 hours a day, 7 days a week |
| Accessibility | PROVIDER LOCATION SET UP and patients preferences (convenience, design, payment option) |
| Affordability | premiums too high and affordable |
| Accommodation | appointment related processes |
| Acceptability | attitudes about their providers. Patient and providers are acceptable of each other regardless of race, religion or ethnic origin |
| which of the following are micro perspective | the clinical aspect of care delivery the interpersonal aspects of care delivery quality of life |
| **Processes that improve quality | clinical practice guidelines cost efficiency Risk management |
| **Overutilization | when the cost or risk of a treatment outweighs its benefit, but additional care is still delivered regardless |
| **Underutilization | when the benefit of an intervention outweighs its cost or risk, yet is not used |
Created by:
angelicap