HMP Exam 1ALREADY PASSED
Subsystems of US Health Care Delivery - =Managed care
Military medical care
Subsystems for special populations
Integrated systems
Long term care delivery
Public health system
Patient advocacy organizations
Managed care - =Dominant health care delivery system in the US and available to most
americans
Employers and government are the primary financiers
A managed care organization (MCO) functions like an insurance company
→ It promises to provide health care services contracted under the health plan to the enrollees of
the plan
Seeks to achieve efficiency by integrating the basic functions of health care delivery
Employs mechanisms to control (manage) utilization of medical services
,Determines the price at which the services are purchased and how much the providers get paid
Military medical care system - =Available mostly free of charge to:
→ Active duty military personnel of the US Army, Navy, Air Force, and Coast Guard
→ Certain uniformed nonmilitary services such as the Public Health Services and NOAA
The military medical care system:
→ Is well organized and highly integrated
→ Offers comprehensive services, both preventative and treatment oriented
TriCare - =Financed by the military and covers families, dependents, or retired military
VA health care system - =Part of the military medical care system
Is available to retired veterans
Focuses on hospital, mental health, and long-term care
Is one of the largest and older (1946) organized health systems in the world
Subsystems for special populations - =Special populations, or vulnerable populations:
→ Persons with health needs but inadequate resources to address them, including:
→ The poor and uninsured
→ Minority groups historically disadvantaged to access
→ Those of a certain immigration status
→ Geographically or economically disadvantaged communities
Typically receive care from the nation's "safety net"
, → Public health insurance programs
→ Safety net providers
→ Offer comprehensive medical and enabling services
Bureau of Primary Health Care (BPHC)
→ Provides federal support for community health centers
→ Programs for migrant farm workers, the homeless and public housing residents, and children
Integrated systems - =Networks of health care providers and organizations that provide
coordinated health care to a population
→ Responsible for the health outcomes and health status of the population
Objective: to have one health care organization deliver a range of services for a defined
population
Long term care - =Consists of medical and nonmedical care
→ Provided to individuals who are chronically ill or have a disability
Most LTC services are NOT covered by Medicare
Difficult to meet requirements to access LTC insurance
By 2030, 20-40 million Americans are projected to require LTC
Public health - =1. Monitor health status to identify and solve community health problems
2. Diagnose and investigate health problems and hazards
3. Inform, educate, and empower people about health problems and hazards
Subsystems of US Health Care Delivery - =Managed care
Military medical care
Subsystems for special populations
Integrated systems
Long term care delivery
Public health system
Patient advocacy organizations
Managed care - =Dominant health care delivery system in the US and available to most
americans
Employers and government are the primary financiers
A managed care organization (MCO) functions like an insurance company
→ It promises to provide health care services contracted under the health plan to the enrollees of
the plan
Seeks to achieve efficiency by integrating the basic functions of health care delivery
Employs mechanisms to control (manage) utilization of medical services
,Determines the price at which the services are purchased and how much the providers get paid
Military medical care system - =Available mostly free of charge to:
→ Active duty military personnel of the US Army, Navy, Air Force, and Coast Guard
→ Certain uniformed nonmilitary services such as the Public Health Services and NOAA
The military medical care system:
→ Is well organized and highly integrated
→ Offers comprehensive services, both preventative and treatment oriented
TriCare - =Financed by the military and covers families, dependents, or retired military
VA health care system - =Part of the military medical care system
Is available to retired veterans
Focuses on hospital, mental health, and long-term care
Is one of the largest and older (1946) organized health systems in the world
Subsystems for special populations - =Special populations, or vulnerable populations:
→ Persons with health needs but inadequate resources to address them, including:
→ The poor and uninsured
→ Minority groups historically disadvantaged to access
→ Those of a certain immigration status
→ Geographically or economically disadvantaged communities
Typically receive care from the nation's "safety net"
, → Public health insurance programs
→ Safety net providers
→ Offer comprehensive medical and enabling services
Bureau of Primary Health Care (BPHC)
→ Provides federal support for community health centers
→ Programs for migrant farm workers, the homeless and public housing residents, and children
Integrated systems - =Networks of health care providers and organizations that provide
coordinated health care to a population
→ Responsible for the health outcomes and health status of the population
Objective: to have one health care organization deliver a range of services for a defined
population
Long term care - =Consists of medical and nonmedical care
→ Provided to individuals who are chronically ill or have a disability
Most LTC services are NOT covered by Medicare
Difficult to meet requirements to access LTC insurance
By 2030, 20-40 million Americans are projected to require LTC
Public health - =1. Monitor health status to identify and solve community health problems
2. Diagnose and investigate health problems and hazards
3. Inform, educate, and empower people about health problems and hazards
