IHOP Exam 1 UPDATED ACTUAL Questions and CORRECT Answers
Financing: Obtaining Health Insurance or payment for
health services
Insurance: protection against high costs when expensive
care is needed, specifies how and where services are
What is Quad Function Model? received
Delivery: provision of services by healthcare providers
Payment: reimbursement of costs incurred when
providers delivered services
Single Payer, national health service model
Gov't Role:
What is the Beveridge Model? 1) sole payer (taxes) care is free at point of service
2) Primary Provider (owns most hospitals and employs
most providers)
Access care to all residents + Potential for lower costs
What are Strengths of Beveridge Model? - One administrative system for reimbursement
- market power to negotiate lower prices
- ability to determine coverage by a centralized agency
Over utilization of services
What are weaknesses of Beveridge Model? Long Wait list
Funding issues
Social Insurance Model
Financed by employers and employees through payroll
What is Bismarck Model? deduction
Rely on insurance (Sickness Funds)
Providers are mostly Private
What are Strengths of Bismarck Model?
, Access of care to all employed workers
Potential for lower cost
Govt control over many aspects including prices
What are weaknesses of Bismarck Model? How are unemployed covered?
Hybrid of Beveridge and Bismarck
What is the National Health Insurance Model? - Single Payer (Beveridge)
- Mostly Private (Bismarck)
Access to all residents
Potential for lower costs
What are Strengths of National Health Insurance Model?
Govt control over many aspects including prices
Non-profit insurance system
What are weaknesses of National Health Insurance Mod- Over utilization
el? Waitlist
No insurance model
What is the Out of Pocket Model? People pay at point of service out own pockets
People that cannot pay go without care
Environment
Lifestyle
What are Blum's Model of Determinants of Health?
Heredity
Medical Care
Better Health
Better Care
What is Quintuple Aim? Lower Cost
Team Wellness
Better Inclusion
Demand: number of providers to meet patient care de-
mands
Supply: Current skills, qualifications, impact of retirement
, Gap Analysis: Projected demand of healthcare profs to
current supply to identify and surpluses or shortages
What are 4 Pillars of Workforce Planning?
Action Planning: Develop strategies to address workforce
gaps and ensure adequate staflng levels
No central agency
Access to services depends largely on insurance coverage
Insurers act as middleman between payers and providers
Multiple payers (employers, government, individuals)
Power struggle between different players
What are Key Features of US Healthcare System?
Healthcare is delivered under imperfect market condi-
tions
Litigation risks
High technology
Lopsided continuum of services
Quest for quality
Belief in scientific advancement and the application of
scientific methods to medicine
What are Anthro-Cultural Beliefs and Values in the US? Champion of capitalism
Entrepreneurial spirit and self-determination
Financing: Obtaining Health Insurance or payment for
health services
Insurance: protection against high costs when expensive
care is needed, specifies how and where services are
What is Quad Function Model? received
Delivery: provision of services by healthcare providers
Payment: reimbursement of costs incurred when
providers delivered services
Single Payer, national health service model
Gov't Role:
What is the Beveridge Model? 1) sole payer (taxes) care is free at point of service
2) Primary Provider (owns most hospitals and employs
most providers)
Access care to all residents + Potential for lower costs
What are Strengths of Beveridge Model? - One administrative system for reimbursement
- market power to negotiate lower prices
- ability to determine coverage by a centralized agency
Over utilization of services
What are weaknesses of Beveridge Model? Long Wait list
Funding issues
Social Insurance Model
Financed by employers and employees through payroll
What is Bismarck Model? deduction
Rely on insurance (Sickness Funds)
Providers are mostly Private
What are Strengths of Bismarck Model?
, Access of care to all employed workers
Potential for lower cost
Govt control over many aspects including prices
What are weaknesses of Bismarck Model? How are unemployed covered?
Hybrid of Beveridge and Bismarck
What is the National Health Insurance Model? - Single Payer (Beveridge)
- Mostly Private (Bismarck)
Access to all residents
Potential for lower costs
What are Strengths of National Health Insurance Model?
Govt control over many aspects including prices
Non-profit insurance system
What are weaknesses of National Health Insurance Mod- Over utilization
el? Waitlist
No insurance model
What is the Out of Pocket Model? People pay at point of service out own pockets
People that cannot pay go without care
Environment
Lifestyle
What are Blum's Model of Determinants of Health?
Heredity
Medical Care
Better Health
Better Care
What is Quintuple Aim? Lower Cost
Team Wellness
Better Inclusion
Demand: number of providers to meet patient care de-
mands
Supply: Current skills, qualifications, impact of retirement
, Gap Analysis: Projected demand of healthcare profs to
current supply to identify and surpluses or shortages
What are 4 Pillars of Workforce Planning?
Action Planning: Develop strategies to address workforce
gaps and ensure adequate staflng levels
No central agency
Access to services depends largely on insurance coverage
Insurers act as middleman between payers and providers
Multiple payers (employers, government, individuals)
Power struggle between different players
What are Key Features of US Healthcare System?
Healthcare is delivered under imperfect market condi-
tions
Litigation risks
High technology
Lopsided continuum of services
Quest for quality
Belief in scientific advancement and the application of
scientific methods to medicine
What are Anthro-Cultural Beliefs and Values in the US? Champion of capitalism
Entrepreneurial spirit and self-determination
