Public Health Exam 3 Questions and Answers 100% Correct.

Public Health Exam 3 Questions and Answers 100% Correct. Inpatient Facilities - Answer - A healthcare facility in the US in which an individual may remain more than 24 hours. Examples include: Hospitals and Nursing Homes Outpatient Facilities - Answer - A healthcare facility in the US in which patients can remain for less than 24 hours. These facilities include the offices of clinicians, general and specialty clinics, emergency departments, and a range of new types of communitybased diagnostic and treatment facilities. Academic Health Center - Answer - The actual chances or probability of developing the disease expressed as a probability such as .01 or a percentage as 1%. Provider - Answer - Term Used to include a wide range of health professionals that provide health services Healthcare System - Answer - A healthcare system plus the financial system that pas for the delivery of health care Health Systems - Answer - the healthcare system plus the public health system Joint Commission - Answer - hospitals are licensed by the state and usually accredited by a national organization, such as the JCAHO Medically Underserved Area (MUA) - Answer - to receive a 330 grant a clinic must meet this requirement of being located in a federally-designated medically-underserved area. Medically Underserved Population (MUP) - Answer - to receive a 330 grant a clinic must meet this requirement- serve a federally- designated medically-underserved population Community Health Center - Answer - Were established in 1965 as part of the Johnson administration's War on Poverty. The centers were designed based on a community empowerments philosophy that encouraged the flow of funds directly to nonprofit, community-level organizations, often bypassing state governments. The Health Centers Consolidation Act of 1996 combined community health centers with healthcare services for migrants, the homeless population, and residents of public housing to create the consolidated health centers program under Section 330 of the Public Health Service. Medical Malpractice - Answer - a body of state civil law designed to hold practitioners accountable to patients for the quality of health care. Different Insurance Definitions (Just List) - Answer - Cap, copayment, deductible, eligible, premium, medical loss ratio, portability, medicare, Medicaid, Community Rating, PPO, POS, HMO, Fee for service, cepitation, experience rating, SCHIP, Universal coverage, Affordable Care Act Cap - Answer - a limit on the total amount that the insurance will pay for a service per year, per benefit period of per lifetime Copayment - Answer - an amount that the insured is responsible for paying even when the service is covered by the insurance deductible - Answer - the amount that an individual or family is responsible for paying before being eligible for the insurance coverage Eligible - Answer - An individual may need to meet certain criteria to be eligible for enrollment in a health insurance plan Premium - Answer - The price paid by the purchaser for insurance policy on a monthly or yearly basis Medical Loss Ratio - Answer - the ratio of benefit payments paid to premiums collected indicating the proportion of the premiums spent on medical services. Lower medical loss ratios imply that a larger amount of the premium cost for these types of group insurance, but often is when applying for an individual policy. Portability - Answer - The ability to continue employer-based health insurance after leaving a job-usually by paying the fll cost of the insurance. A federal law, known as COBRA , generally ensures employees 18 months of portability. Medicare - Answer - a federal health insurance system that covers most individuals 65 and older as well as teh disabled and those with end-stage rental disease Medicaid - Answer - a federal-state program which covers groups defined as categorically needed as well as groups that may be covered at the discretion of the state including those defined as medically needy such as those in need of nursing home care. Community rating - Answer - insurance rates set the same for all eligible individuals and families based on the previous expenses in a defined community Experience rating - Answer - health insurance rates set on the basis of a groups past history of healthcare expenses (medical underwriting) Capitation - Answer - a system of reimbursement for health care based upon a flat payment per time period for each person for whom a provider of care assumes responsibility for providing healthcare services regardless of the services actually provided Fee for service - Answer - a system of reimbursement for health services provided based on charges for health services actually provided to patients Health Maintenance Organization - Answer - also referred to as HMO. Introduced in 1973 by the federal government as an alternative approach to employment-based insurance. HMOs charged patients a monthly fee designed to cover a comprehensive package of services. Clinicians or their organizations were paid based upon the number of individuals that enrolled in their practice. The compensation was based upon capitation, or a fixed number of dollars per month to provide services to an enrolled number regardless of the number of services provided. HMOs covered preventive services, and is argued to do a better job of keeping people healthy. Preferred Provider Plans (PPO) - Answer - an insurance system that works with a limited number of clinicians. These providers agree to a set of conditions that usually includes reduced payments and other conditions. Patients may choose to use other clinicians but they often need to more pay more out of pocket Point of Service Plans - Answer - a type of health plan that is a modification of staff model HMOs that allow enrollees to obtain care outside the HMO but require that the patient pay for a portion of the cost of the care received State Child Health Insurance Program - Answer - (SCHIP)- a federally funded health insurance program that provides funds to the states to use to expand or facilitate the operation of Medicaid or other used to serve the health needs of lower income children ` Universal coverage - Answer - provision of at least basic or medically necessary health insurance for an entire population Affordable Care Act - Answer - Effective March 23, 2010; Through this plan Insurance Companies can no longer: deny coverage to kids with pre-existing conditions, put lifetime limits on benefits, cancel your policy without proving fraud, and deny claims without a chance for appeal. Consumers in the new health plan can receive cost-free preventive services, keep young adults on a parent's plan until age 26, choose a primary care doctor, OB/GYN and pediatrician, use the nearest emergency room without penalty. Core Public Health Functions - Answer - Describes Governmental public health functions that cannot be delegate and remain the responsibility of governmental public health. The Institute of Medicine has defined these functions as ASSESSMENT, ASSURANCE, and Policy Developement Assessment - Answer - includes obtaining data that defines the health of the overall population and specific groups within the population, including defining the nature of new and persisting health problems.