HCD 303: Final Study Guide with correct answers

HCD 303: Final Study Guide with correct answers System - Correct Answer 1. a set of connected things or parts forming a complex whole. 2. a set of principles or procedures according to which something is done; an organized scheme or method. Quality - Correct Answer the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge Access - Correct Answer concerned with helping people to command appropriate health care resources in order to preserve or improve their health Cost - Correct Answer the actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications Universal Coverage - Correct Answer a health care system that provides health care and financial protection to all residents of a particular country or region Social Solidarity - Correct Answer 1. the idea that the government has the responsibility that people have ACCESS to healthcare services 2. this does not mean the government will PROVIDE healthcare Subsidiarity - Correct Answer an organizing principle that matters ought to be handled by the smallest, lowest or least centralized competent of government General reciprocity - Correct Answer the principle belief of giving without any expectation of an immediate return Centralized - Correct Answer organized and run at the federal level Decentralized - Correct Answer organized and run at the state/regional level Public Health Services/Insurance - Correct Answer government owned, could be state or federal Private Health Services/Insurance - Correct Answer not owned by government Copayment - Correct Answer The set dollar amount that you must pay at the point of service Coinsurance - Correct Answer The set percentage of the bill that must be paid at the point of service Deductible - Correct Answer how much you have to pay out of pocket before your insurance pays anything Sickness funds - Correct Answer German insurance programs offered by nonprofit groups to serve a given occupation, geographic location, or employer. Otherwise known as social insurance. - people pay premiums based on their income that goes to one of several insurance companies - Private & Decentralized Safety nets - Correct Answer Programs put in place to protect vulnerable populations from cost-sharing Cost-sharing - Correct Answer occurs when patients pay for a portion of health care costs not covered by health insurance. It's a financial incentive; to direct you to the appropriate level of care Subsidy - Correct Answer Government assistance - a sum of money granted by the government or a public body to assist an industry or business so that the price of a commodity or service may remain low or competitive Health financing - Correct Answer the function of a health system concerned with the MOBILIZATION, ACCUMULATION, and ACCOMMODATION of money to cover the health needs of the people, individually and collectively, in the health system Health spending as a % of the GDP - Correct Answer how much a countries spends on health care based on gross domestic product Fee-for-Service - Correct Answer how much a countries spends on health care based on gross domestic product - provides the least financial risk for providers and the most financial risk for payers Per Diem - Correct Answer a type of prospective payment model in which the cost of healthcare is established prior to treatment and paid to the hospital or provider based on the number of days treatment was given - payment model reimburses organizations and/or providers based upon the number of days treatment was given Pay-for-performance - Correct Answer a payment model that reimburses healthcare organizations and physicians who achieve, improve, or exceed their performance on specified quality and cost measures, as well as other benchmarks - payment model was dubbed pay-for-process by physicians and played a significant role in what would ultimately become the opioid epidemic Salary - Correct Answer physicians are paid a predetermined salary based upon their level of expertise and experience - payment model utilized to reimburse specialists in Singapore Bundled payments - Correct Answer (DRG, EDGR, Reference Pricing) DRG - Correct Answer - Diagnosis-related Groups - created by Medicare in 1983 as an attempt to contain health care costs. - A hospital receives a set amount of money for a patient with a certain diagnosis.