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Allied Health Exam 2

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Question
Answer
Late 1800's to the Early 1900's set the stage for health insurance due to the   show
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Health Insurance began as   show
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show national health care plan.  
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show center stage.  
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AMA & AHA opposed   show
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AMA & AHA 1948   show
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show first broad-coverage health insurance in the U.S., originally designed to make cash payments to workers for wages lost because of job-related injuries and disease  
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private health insurance has prevented   show
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Group Hospital Plan and Birth of Blue Cross   show
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show coordinated them into a Blue Cross network  
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Blue Cross Network transformed insurance from a mechanism to reimburse for lost wages to one that   show
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Blue Cross was non profit and there were no   show
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show Blue Cross Association.  
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In 1946 Blue Cross was in   show
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Blue Cross was the birth of   show
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show Blue Cross structure.  
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show hospital plans, and was AHA endorsed for ONLY hospital care.  
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show 9% to 57%  
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In 1939, the California Medical Association started the first   show
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show physician fees.  
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show medical profession's own financial interests.  
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Blue Shield was AMA   show
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show merged, today they are a joint corporation, and are in almost every state.  
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During World War II, employees accepted employer-paid health insurance to   show
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Congress made employer-provided health coverage   show
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show union-management negotiations  
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show health insurance.  
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show provide coverage.  
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show primary source of payment of healthcare services in the U.S.  
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show Collection of premiums assumption of risk, responsibility for delivery of services, making of payments to providers  
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Health Care Expenditures are   show
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show cost of resources required to maintain a health care delivery system  
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show down.  
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Cost is related to the charge to the patients and insurance companies   show
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Expenditures occur in 4 major areas   show
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show source of money used to run a business  
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show price increase in economy, life expectancy increases (more medical care needed), technology and research increases (increased cost).  
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Four main areas that account for health care spending include   show
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show Demand is determined by the process of goods and services on the one hand and people's ability to pay on the other  
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show price of services.  
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Effects of financing and insurance include   show
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Negative effects of financing and insurance include   show
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Moral Hazard + provider-induced demand =   show
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show restricting the availability of expensive medical technology and care (i.e. insurance will only pay for some procedures)  
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Demand-side rationing   show
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show many payers, many forms of payment, many programs and many reimbursement options.  
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show patients (directly pay portion of the total cost of services) and the employers and government which are the primary financiers of health care.  
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show own care and pay for those who can't afford it.  
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show wages, medicare tax is also deducted from pay as a prepayment for when 65.  
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General taxes subsidize health care for   show
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show pay into catastrophic health for the uninsured.  
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show private insurance programs, public insurance programs, uncompensated or charity care.  
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show private (voluntary/personal) and public (government).  
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Private health insurance includes   show
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show medicare and medicaid, and state children's health insurance.  
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Financing is   show
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show have access to health care  
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show method of payment for health care services  
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show person for whom the policy is for  
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Insurer (3rd party payer)   show
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show individuals providing care or services  
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show plan that employee chooses; contains the conditions and services under which payment is made  
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show cost (usually by monthly fee) that is paid by the insured for coverage  
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show legally binding contract of the insurance plan  
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Enrollment period   show
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Deductible   show
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show at time of service; patient pays for a portion of the services up front  
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show clause that determines which insurance pays for services if insured has more than one  
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show patient pays provider directly from own savings – no insurance involved  
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show insured purchases insurance to cover certain benefits; pay provider at time service is provided  
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show insured pays fixed, predetermined amount for services rendered  
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Coding   show
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Billing   show
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show form sent to insurance company explaining charges incurred by the patient  
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Explanation of Benefits (EOB)   show
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Risk   show
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show protects against risk  
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show an individual protected by insurance  
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show an insurance agency that assumes the risk  
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Underwriting   show
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A insurance policy premium is based on   show
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Four principles of insurance risk include   show
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Restriction of usage   show
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show want to spread the risk  
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show health care costs.  
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show physicals, denial for preexisting conditions, some may accept those with preexisting conditions but not cover costs related to those conditions.  
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Due to risk management many people who are most in need of health insurance   show
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Cost Sharing   show
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Insurance requires some type of   show
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show risk.  
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Cost sharing reduces the misuse of   show
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show cost share lowers utilization without lowering quality  
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Three main type of cost sharing in private health insurance include   show
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show both parties pay premium.  
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show payment before insurance pays  
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show out of pocket expenses patient contributes to care.  
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show percent of bill insurance pays after deductible.  
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Stop loss provision   show
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Lifetime cap may be part of insurance   show
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show insurance companies, managed care organizations, BlueCross BlueShield, government  
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Reimbursement   show
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Types of reimbursements include   show
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Fee-for-service   show
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show number of related services in one price, reduce provider induced demand because fees are inclusive of all bundle services.  
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show Under the omnibus budget reconciliation act of 1989, medicare developed the program to reimburse physicians according to "relative value" assigned to each service, based on time skill, intensity to provide service.  
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show used by PPOs  
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Capitation   show
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Retrospective reimbursement   show
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Prospective reimbursement   show
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Four main prospective reimbursement methods are   show
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Diagnosis Related Groups (DRGs)   show
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show Implemented August 2000, medicare's outpatient prospective payment system (OPPS) for services provided by hospital outpatient departments. Bundled rate, reimbursement rates are associated with each APC group.  
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Resource Utilization Group (RUG)   show
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show A fixed, pre-determined rate for each 60-day episode of care, regardless of services given. OASIS, outcomes and assessment information set used to rate a patient's functional status and clinical severity. Assessment measures translate into points.  
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Patient Protection and Affordable Care Act (ACA) 2010   show
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Two functions of financing are   show
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Sources of financing health care are   show
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When ACA is fully implemented in 2014, burden of HC spending will shift to   show
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show private insurance, which is mostly employer based.  
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Private or voluntary/personal insurance types include   show
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High deductible health plans can also be group or   show
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Managed Care organization can also be individual as well as   show
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show medicare and medicaid, state children's health insurance.  
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show mandatory.  
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Private insurance is available in single or   show
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show employer based.  
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There are many different types of private insurance providers such as   show
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show the insurance company.  
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Those covered by individual private health insurance can pick options of coverage based on   show
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Those with individual private health insurance may include   show
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show individually determined.  
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show coverage picked.  
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Within individual private health insurance high risk people are often unable to receive   show
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show employer, union, or professional organization.  
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Group insurance anticipates large numbers of   show
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show equally among the insured.  
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show comprehensive coverage.  
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Self Insurance is where the employer   show
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Self-insurance occurs when large employer's work forces are   show
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show medical experience.  
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show pay all claims incurred by employees.  
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Within self-insurance high losses are covered through reinsurance which is   show
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Consumer Driven Health Plans (CDHP) feature high   show
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Consumer Driven Health Plans gives consumers greater control and responsibility   show
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show Pay less for health care but still covered for catastrophic illness.  
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HDHPs feature low   show
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Within HDHPs preventative care is typically not   show
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Within HDHPs yearly cap is based on   show
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show HSA or health savings account and HRA health reimbursement arrangement.  
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show health savings account, mainly the employee contributes to saving account on a tax-deductible bases, money in account is used to pay for health services until the high deductible is reached.  
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In a HDHP/HSA there is a cap on out of pocket   show
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Within a HDHP/HSA there is a tax advantage because the account is   show
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show exempt payments made for qualified medical expenses.  
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Within a HDHP/HRA employees pay medical expenses, premiums, and LTC insurance and then the employee is   show
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A HDHP/FSA is a flexible spending account it is similar to an HSA but   show
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Managed Care Organization is a type of   show
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The three critical factors in differentiating between the types of MCOs are   show
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The most critical factor in differentiating between the types of MCOs is the   show
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show health maintenance organization HMO, preferred provider organization PPO, exclusive provider organization EPO, and point of service organization POS.  
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show low premiums but less options, are copay driven rather than deductible, part of your premium goes to medical group whether you use or not, capitation is the primary method of reimbursement, increase in fee for service.  
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Health Maintenance Organizations are restrictive meaning   show
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HMO's are referral based meaning they are   show
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show preventive and screening services, "health maintenance" within the organization.  
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HMO models include   show
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HMO staff model features fixed salaried MD on staff in a   show
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show sometimes hospitals, that service only those enrolled in HMO.  
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show deliver care.  
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show MDs.  
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show utilization.  
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In an HMO staff model you need a large number of enrollees to   show
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Enrollees in an HMO staff model are limited on the MDs   show
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HMO Group model contracts with a multi-specialty   show
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show group practice.  
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show one or more hospitals for specialty services.  
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show control over utilization.  
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In an HMO group model the HMO pays group practice to   show
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Independent practices can also treat   show
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show one that is administratively tied to the HMO-service exclusive to HMO members.  
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HMO network model contracts with   show
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HMO network model is suited for operations in large metropolitan areas and across widespread geographic regions where   show
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In an HMO network model the patient chooses   show
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show capitation.  
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show all MD services.  
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In an HMO network model doctors can make referrals to specialists but   show
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show no central overseeing agency.  
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show HMO and providers.  
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show bearing entity.  
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The IPA is paid a capitation fee by the   show
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show directly with MDs  
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An IPA establishes contracts with both independent solo pracitioners and   show
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show MD groups.  
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In an IPA HMOs may create and invite area   show
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An IPA is hospital based and structured so that only certain   show
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IPA assumes the responsibility for   show
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In an IPA MDs are responsible for providing services but logistics of arranging MD services are shifted to the   show
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Preferred Provider Organization or PPO is the   show
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In a PPO enrollees have more control over care decisions and are rewarded with   show
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show referral based, patients manage and negotiate contracts with preferred providers in and out of network, more treatment options and no PCP.  
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A PPO is more flexible but the premium is   show
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In a PPO group practice is paid by   show
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show plan that is paid annually.  
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In a PPO patients can use out of   show
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show network, you can see specialist without referral or prior approval, leads to little control over utilization.  
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show reduced fees.  
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show service at an agreed upon reduced rate.  
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show patient population.  
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show HMO and PPO.  
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show of network benefits, choose at time of medical service who to seek care from, allows the enrollees to seek out of network care at a higher out of pocket cost.  
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In a POS providers paid by   show
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In a POS gatekeepers may be used to   show
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In a POS it is referral based, pick your primary care practitioner and specialty care with referrals for   show
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show driven model.  
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COBRA   show
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COBRA is aimed to reduce gaps in   show
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show 18 months.  
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show 36 months.  
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In COBRA you must pay entire premium but it is still   show
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show any form of insurance NOT subsidized by the government, includes individual and employer-based.  
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show employer driven.  
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show vary.  
🗑
show financed.  
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Accounts for 45.4 percent of total US health care expenditures   show
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Piecemeal was the addition of new programs and   show
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In 2010 31 percent are covered by   show
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Public financing supports categorical programs, not public in the sense that   show
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Categorical programs are each designed to benefit a   show
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Medicare and medicaid are categorical programs and were created under the   show
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show widely available source of payment for health care.  
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Before 1965 private health insurance was available primarily to   show
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show government overseeing health care.  
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Americans wanted reform initiative for the underprivileged whose   show
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show opposed because it was a threat to the MD patient relationship, there was public debates that supported this bill resulted in compromise reform.  
🗑
1960 Medical Assistance Act also known as the Kerr-Mills Act   show
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show implement, it was deemed ineffective.  
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show top priority.  
🗑
AMA urged congress to expand   show
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show Medicare Part A which included hospital and nursing home, medicare part B MD premium based and medicaid which made poor eligible.  
🗑
show title 18 of the social security act.  
🗑
show title 19 of the social seurity act.  
🗑
show select populations.  
🗑
Medicare and medicaid are financed by the government but delivered by   show
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Medicare and medicaid put a huge burden on   show
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show people 65 years or older, disabled of any age who are entitled to benefits for at least 24 months, people of any age with end-stage renal disease, and Lou Gehrig's disease.  
🗑
show Agency under the US department of health and human services that administers the program. Enrollees expected to grow.  
🗑
show everything.  
🗑
Medigap policies cover   show
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show Hospital insurance HI  
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Medicare Part B   show
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show Medicare advantage  
🗑
Medicare Part D   show
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show social security tax and covers inpatient services, short term convalescence and rehab in a skilled nursing facility, home health, hospice, managed care, and administrative costs.  
🗑
show primary care MD  
🗑
show doctor, hospital, other providers and facilities but must be medicare approved.  
🗑
Medicare covers most   show
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Those with medicare may also have other coverage through   show
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Those with medicare pay   show
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show benefit period.  
🗑
show hospitalized.  
🗑
Benefit period ends when the beneficiary   show
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show benefit periods.  
🗑
Medicare acute care hospital benefits include   show
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Medicare acute hospital benefits include all expenses paid for first 60 days after   show
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Medicare acute hospital care requires a copayment from   show
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show 90 days.  
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Acute care hopsital benefits includes a higher copay after   show
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show 90 days.  
🗑
show 190 days lifetime.  
🗑
Medicare acute care hospital benefits include private funds, medigap insurance and medicaid kicks in after   show
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Medicare certified SNF benefits eligibility begins after   show
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Medicare certified SNF benefits have a 100 days   show
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show hospital and related to hospitilization.  
🗑
show 20 days, then a copay from days 21-100.  
🗑
show require intermittent or part-time skilled nursing care or rehabilitation care.  
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show 100 home visits after hospitalization.  
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show 80 percent.  
🗑
In order for those under medicare to receive the hospice benefit the patient must be   show
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Medicare hospice only need a token copayment required   show
🗑
show physician insurance/supplementary medical insurance SMI  
🗑
Medicare is financed partially by   show
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You are automatically enrolled in   show
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Medicare is voluntary enrollees pay monthly   show
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Medicare covers   show
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show Medicare Advantage which was formerly the medicare + choice 1998.  
🗑
Medicare Advantage 1998 was part of the   show
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Medicare advantage does not specifically include additional   show
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show Part A, B, and D  
🗑
Medicare Part C eliminates the need for   show
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In order to enroll in Medicare part C you must be   show
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show private MCO, which must follow Medicare rules.  
🗑
show captivated fee structure from Medicare, premiums that are set by MCO, may have copays deductibles and a gatekeeper depending on the plan, HMO, PPO, fee for service, etc.  
🗑
show accept the plan coverage and fee terms.  
🗑
Medicare Part C provids all of Part A and B coverage, some offer   show
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show Prescription Drug Coverage 2006  
🗑
show Medicare Prescription Drug, Improvement and Modernization Act (MMA) of 2003  
🗑
show Part A and B, but you must apply.  
🗑
show Stand alone prescription drug plans (PDPs) – for those in Part A & B and Medicare Advantage Prescription drug plans (MA-PD) – part C beneficiaries  
🗑
Medicare Part D is   show
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show comprehensive coverage, no vision, eyeglasses, dental, hearing aids, or routine exams.  
🗑
show pap smears, glaucoma screenings, cholesterol and prostate screenings, and pneumonia vaccines.  
🗑
Medicaid is title 19 of the   show
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Medicaid is state financed health care for   show
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show state and federal govt.  
🗑
show federal funds according to the states per capita income, more income equals less funding, federal matching funds are dependent on services.  
🗑
show Each state establishes its own eligibility criteria according to income and assets, covered services and payments to providers vary considerably from state to state.  
🗑
Medicaid Disabilities everyone is   show
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show disabled with income above regular medicaid limits.  
🗑
show is 15,000.  
🗑
Medicaid covers   show
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show ACO  
🗑
Affordable Care Act of 2010   show
🗑
show Created in 1997 under title 21 of the social security act to reduce the number of uninsured children in low income families.  
🗑
show approved by congress and signed by President Obama  
🗑
show not covered under private insurance.  
🗑
CHIP is a low cost insurance for children in families who earn too much to qualify for   show
🗑
show medicaid coverage.  
🗑
States can use existing Medicaid, create a separate CHIP program, or use a   show
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CHIP covers   show
🗑
show Consolidated Omnibus Budget Reconciliation Act of 1985  
🗑
COBRA reduces gaps in coverage for   show
🗑
In COBRA employer must extend benefits to   show
🗑
show spouse or dependent up to 36 months.  
🗑
show cheaper than purchasing own insurance.  
🗑
show meet eligibility criteria to become beneficiries.  
🗑
Public insurance includes   show
🗑
Iron triangle   show
🗑
Past attempts at universal health care access have failed because increasing access means more   show
🗑
show national.  
🗑
show compares medical inflation to general inflation, measured by annual changes in the consumer price index, also compares changes in the national health spending to changes in the gross domestic product.  
🗑
show providers and individuals.  
🗑
show employers who purchase insurance, providers who deliver services, consumers of health care.  
🗑
show the ACA.  
🗑
The united states has a very high amount of health care expenditures as a percentage of   show
🗑
Highest amount of health care expenditures is spent on   show
🗑
Rising health care expenditures have been attributed to   show
🗑
Third party payment leads to   show
🗑
show demand.  
🗑
show competitive markets.  
🗑
show true cost of production.  
🗑
Growth and intensive use of technology have a direct impact on   show
🗑
show expensive to develop, once developed creates new demand for use, technology also raise the expectations of consumers about what medical science can do to diagnose, treat disease and prolong life.  
🗑
show 3.5 times the rate of other age groups.  
🗑
With increased life expectancy and the aging of the baby-boomer generation there are   show
🗑
Elderly drive up health care costs because chronic conditions   show
🗑
show medical intervention while, de emphasizing medical prevention.  
🗑
High cost is due to the medical model of health care delivery because health promotion and disease prevention   show
🗑
Administrative costs are costs associated with   show
🗑
show 24-25% of all health expenditures.  
🗑
show the US has many legal risks for providers, this leads to tests and service that are not medically justified, but are performed by physicians to protect against malpractice lawsuits.  
🗑
show health care costs.  
🗑
High cost in the health care system is also due to wast and abuse which involves   show
🗑
show billing claims or cost reports are intentionally falsified.  
🗑
Fraud is a major problem in   show
🗑
Practice variations are referred to as   show
🗑
show differences in practice patterns and have been associated with geographic areas of the country.  
🗑
show US delivery system.  
🗑
Practice variations increase health care costs without better   show
🗑
show not been successful.  
🗑
Implementing a system wide cost control initiative has   show
🗑
show where providers make up for lost revenues by increasing utilization or charge higher prices in other areas free of control.  
🗑
The strengths of the US health care system also contribute to   show
🗑
show the most expensive means of providing health care in the world.  
🗑
show hospitals with PPS and physicians services with resource based relative value scales.  
🗑
show health planning, price controls, peer review, and competitive approaches.  
🗑
show align and distribute health care resources that would achieve health outcomes for all, supply side rationing.  
🗑
Health planning does not fit well in the US due to   show
🗑
show price for inpatient hospital care.  
🗑
Price controls included the conversion of hospital Medicare reimbursement from a retrospective to a   show
🗑
Peer review is the process of medical review of   show
🗑
show reasonable, necessary, of quality and provided in an appropriate setting, can deny payment if care does not meet with their standards.  
🗑
PROs are also referred to as   show
🗑
Competition is   show
🗑
show providers of health care services try to attract patients who have the ability to choose from several different providers.  
🗑
Demand side incentives are   show
🗑
show antitrust laws in the United States, which prohibit business practices that stifle competition among providers such as price fixing, price discrimination and mergers.  
🗑
show cost efficient.  
🗑
Quality is defined as   show
🗑
The institute of Medicine in their evaluation of quality leave out the roles of   show
🗑
The institute of medicines definition of quality has implications that   show
🗑
According to the institute of medicines implication of quality professional consensus is used to develop   show
🗑
Quality indicators can be both   show
🗑
Micro perspectives of quality focus on   show
🗑
show quality from the population's standpoint such as cost and access, reflect the performance of the entire health care delivery system.  
🗑
US spends more of its national income on   show
🗑
US has tremendous advances in   show
🗑
US trails far behind in   show
🗑
Donabedian in 1980 proposed three domains in which health care quality should be examined which are   show
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Structure includes   show
🗑
show The relatively stable characteristics of the providers of care, of the tools and resources they have at their disposal, and of the physical and organizational setting in which they work  
🗑
Deficiencies in structure lead to   show
🗑
show delivery of health care, the specific way in which care is provided.  
🗑
show correct diagnostic test, correct prescriptions, accurate drug administration, communication, and compassion.  
🗑
CPGS are   show
🗑
CPGS are also called   show
🗑
show clinical problem based on evidence, in order to guide physicians clinical decisions.  
🗑
CPGS intentions are to   show
🗑
Cost efficiency is referred to as   show
🗑
Cost is efficient when benefits received are   show
🗑
show benefits received are greater than the cost incurred.  
🗑
show outcome based and patient centered case management tools that are interdisciplinary and facilitate coordination of care among multiple clinical departments and caregivers.  
🗑
Critical pathways provide a timeline that identifies planned medical interventions along with   show
🗑
Critical pathways improve quality by   show
🗑
show prevent adverse events related to clinical care and facilities operations, focusing on avoiding medical malpractice.  
🗑
show the effects or final results obtained from utilizing the structure and processes of health care delivery.  
🗑
Outcomes are viewed as the measure of   show
🗑
show improvement in health stats.  
🗑
show infection rates, rate of re hospitalizations and patient satisfaction.  
🗑
show quality of care.  
🗑
show legislation that mandated the collection of national data on legal actions against health care providers, this information allows people to know actions brought against physicians in other states.  
🗑
Research can influence health policy through   show
🗑
documentation includes   show
🗑
show program evaluations and outcomes research, look for what does and does not work  
🗑
show course of action that has a desirable consequence.  
🗑
show ability to obtain needed, affordable, convenient, acceptable, and effective personal health services in a timely manner.  
🗑
show health status, environment, lifestyle, and heredity factors.  
🗑
The National Health Interview survey or NIHS and the Medical Expenditure Panel Survey or MEPS are both leading data sources used to   show
🗑
show surveys that have data on health care use and expenditures.  
🗑
Federal and state govt. also collect   show
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show lower overall health care usage and access.  
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Racial/ethnic minorities are less likely than their white counterparts to have a specific source of   show
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show primary care provider  
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Nonwhite medicare beneficiaries have fewer   show
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Access to care also relies on having available   show
🗑
show providers and that their geographic distribution is desirable.  
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show rural health clinics to expand access.  
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The National Health Service corp has student assistance programs to   show
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The National Health Service corp establishes community health centers in   show
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Two main concerns about the medicare policy are   show
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show face access problems,  
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show access problems.  
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Access policies should encourage   show
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In rural communities making medical care available to residents is difficult because   show
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show a limited time.  
🗑
show create incentives for permanent practices in rural areas  
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Low income mothers and their children have problems accessing the health care system because   show
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SCHIP   show
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show obtaining health care.  
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AIDS patients have difficulty getting insurance because   show
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show universal access.  
🗑
show increasing costs, lack of access, and concerns about quality.  
🗑
Health care costs in the US are the   show
🗑
show health status, demographics and ability to pay.  
🗑
Quality is assessed through   show
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Cost containment efforts are n place to   show
🗑
The US does not have a centrally controlled system of health care delivery however   show
🗑
The three roles of the government in health care delivery are   show
🗑
The role of the govt. as a payer of health care includes   show
🗑
The role of the govt. as a provider of health care includes   show
🗑
show involvement in the political process to make laws, as well as controlling licensure.  
🗑
Public policies are   show
🗑
The Legislative branch is known as the congressional branch and they   show
🗑
The executive branch is known as the presidential branch and they   show
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The judicial branch of government is known as the supreme court and they   show
🗑
show actions, behaviors, and/or decisions of others.  
🗑
show public policies that pertain to or influence the pursuit of health.  
🗑
Health policies are also principles that   show
🗑
Health policies are often the result of   show
🗑
show health care at all levels including policies affecting the production, provision, and financing of health care services.  
🗑
Health policies can affect   show
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Health policies are used to   show
🗑
Regulative health policies ensure   show
🗑
Allocative health policies relate to resources for health care such as   show
🗑
show behavior of particular groups.  
🗑
show medical education.  
🗑
States license health professionals as well as oversee the   show
🗑
States control the administer workers   show
🗑
States also govern consumer   show
🗑
Some states regulate control over   show
🗑
Allocation involves the direct provision of   show
🗑
show distributive and redistributive.  
🗑
Distributive allocation policies   show
🗑
show take money or power from one group and gives it to another such as in medicare or medicaid.  
🗑
show subsidiary to the private sector.  
🗑
The US health care policy features a decentralized role for the   show
🗑
show pluralistic meaning it has special interest.  
🗑
The US health care policy has an impact of   show
🗑
show development and evolution of health policy.  
🗑
Health care is not seen as a right of citizenship or a   show
🗑
show government intervention.  
🗑
show informed decisions.  
🗑
show privilege.  
🗑
Role of the government in health care has grown incrementally in response to   show
🗑
Government is left to fill the gap for the   show
🗑
Health policy concerns regarding medical technology include   show
🗑
show cost of development and access to it.  
🗑
show cost efficient and accessible.  
🗑
The government regulates drugs and   show
🗑
show uniform, smooth running system.  
🗑
show complex and fragmented system of health care financing.  
🗑
show contributions that they and their employers pay.  
🗑
show tax revenues such as medicare part a and b, and medigaps.  
🗑
The poor are covered through medicaid via   show
🗑
Special populations such as veterans, native americans, and the armed forces have coverage provided directly by the   show
🗑
Process of legislation regarding policy development and enactment is   show
🗑
show subcommittees.  
🗑
show pass through both to be a law.  
🗑
Medicare and medicaid revisions are not   show
🗑
States are left to interpret and enact medicare and medicaid revisions   show
🗑
Current health care reform was divided on what   show
🗑
show health care policy  
🗑
States develop and implement health care policies involving financial support for the poor and disabled   show
🗑
States develop and implement health care policies involving Quality assurance, practitioner and facility oversight   show
🗑
States develop and implement health care policies involving regulation of health care   show
🗑
States develop and implement health care policies involving health personnel training and authorization of local   show
🗑
States have broad, legal authority to   show
🗑
The state can license and regulate health care   show
🗑
show health insurance.  
🗑
The state can set and enforce environmental   show
🗑
The state can enact controls on health care   show
🗑
show services.  
🗑
show health policy decisions.  
🗑
show enact policy at the federal level .  
🗑
The fact that states vary in implementation of service leads to inadequacies in   show
🗑
show original policy.  
🗑
show differently.  
🗑
show groups needs.  
🗑
Groups involved in health care policies include   show
🗑
show most effective demanders of policies.  
🗑
show resisting any major change.  
🗑
Interest groups combine and concentrate the resources of their members to   show
🗑
Examples of health care interest groups include the   show
🗑
Employers concerns are about health care insurance   show
🗑
show the cost.  
🗑
Health policies affect labor practices and how   show
🗑
The interest of consumers are not   show
🗑
Consumers do not have sufficient financial means to   show
🗑
Consumer groups advocate and represent   show
🗑
show alliances among themselves and with members of the legislative body to protect and enhance the interests of those receiving benefits from government programs.  
🗑
show benefits.  
🗑
show identification of a problem where markets fail, or do not function well.  
🗑
Government regulates and allocates resources of health care through   show
🗑
show legislative branch of the US govt.  
🗑
show idea becomes a law, and how the law is implemented.  
🗑
The legislative process of health care law making is known as the   show
🗑
Policy cycle   show
🗑
show issue raising/ awareness of a problem, policy design/drafting the bill, building of public support, legislative decision making, building of policy support within the house and senate, and policy implementation.  
🗑
show congress and interest groups.  
🗑
show propose or sponsor a new law.  
🗑
An idea is drafted as a bill, the legislators may ask other legislators to become   show
🗑
show number, title, and are listed.  
🗑
show committee by the authorizing body.  
🗑
show combine it with other bills, refer to another committee for review, or hold hearings to get testimony and possible amendments.  
🗑
show full committee.  
🗑
The full committee reviews the deliberations and recommendations of the subcommittee and may   show
🗑
show die in the committee, which many do.  
🗑
The legislative process is repeated until the   show
🗑
A full committee reporting involves a passed bill and the full committee   show
🗑
show report about the bill is written and published, includes purpose of the bill and its impact on existing laws, budgetary considerations, and any new tax increases required by the bill.  
🗑
show public hearings, opinions of the committee for and against the proposed bill  
🗑
Full house or senate review involves the bill being added to the   show
🗑
show the other chamber, both legislative chambers follow the same procedure however, if amendments are added in one chamber it goes back to the other for approval. Back and forth movement occurs until the bill is approved by both.  
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The legislative chambers may forward the bill to a   show
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show members of similar committees in both house and senate, and are charged to reconcile differences between the senate and house versions of the bill. If no agreement the bill dies, if a agreement on a compromised version they prepare a report detailing.  
🗑
show the bill will be sent back to them for further work.  
🗑
show forwarded to the president for a signature.  
🗑
show approving and signing the bill, which becomes the law, vetoing the bill which sends it back to the house or if he does not sign it after 21 days it becomes law if not vetoed.  
🗑
If less than 21 days left in congressional session and the president does not take action congress can   show
🗑
Once legislation is signed into a law, it is forwarded to the   show
🗑
show implemented.  
🗑
show rewrites regulations.  
🗑
show enabling legislation.  
🗑
show shape the final outcome.  
🗑
show serve the public's interests.  
🗑
National health care is supported, but the idea of federal government running the system is   show
🗑
The challenge is finding a balance between government provisions and control and   show
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