Test Bank For Health Policy Issues: An Economic Perspective
7th Edition By Paul J. Feldstein, PhD 9781640550100 Chapter
1-38 Complete Guide .
PCORI - ANSWER: Patient-Centered Outcomes Research Institute
Performs Comparative Effectiveness Research
Forbidden to perform Cost-effectiveness Analysis
Why is health care so controversial & reform so difficult in USA? - ANSWER: Special interests
National Values
Complexity
Trust issues
3 Aims of Health Systems - ANSWER: 1. Improving the health of populations
2. Responding to people's expectations
3. Providing financial protection against the costs of ill-health.
Problems with International Comparisons - ANSWER: 1. different meanings of health system
2. different types and quality of data
3. different values
Components of US health system - ANSWER: government
hospitals/systems/practices
health professionals
industries
biomedical research
insurers
patients
employers
NGOs
Continuum of Health Services - ANSWER: prenatal care/healthy birth --> health promotion ->
primary/secondary/tertiary prevention --> diagnosis --> treatment --> rehab care --.> palliative care
Executive Branch - ANSWER: policy development
regulation
enforcement
funding
Legislative Branch - ANSWER: debating and passing bills
executive branch oversight
Judicial Branch - ANSWER: Constitutionality of laws
Primary Care - ANSWER: general practice
first line of care
longitudinality, comprehensiveness, coordination
Secondary Care - ANSWER: Specialists
Tertiary Care - ANSWER: Super specialized/advanced care
Vertical Integration - ANSWER: Consolidation of health services under 1 roof (HMO)
, Virtual Integration - ANSWER: Coordination of health services via contractual relationships (PPO)
Berwick's Triple Aim - ANSWER: 1. Improving Individual Experience of Care
2. Improving the Health of Populations
3. Reducing the Per Capita Costs of Care for Populations
Berwick's proposal for achieving triple aim - ANSWER: providers being held fiscally/clinically
responsible for health outcomes
Perspective of "Cost" in health care - ANSWER: Consumer
Provider
National
Consumer Perspective of health care costs - ANSWER: price ==> bills for care, cost of medication
National (health system) perspective of costs - ANSWER: health care expenditures = (all health
services) x (price of each service)
Provider perspective of costs - ANSWER: staff salaries, facility cost, supplies, technology
OECD - ANSWER: Organization for Economic Cooperation and Development
(developed countries club!)
What do we spend on most in healthcare? - ANSWER: Hospital Care #1
Physician Services #2
Pharmaceutical drugs #3
Reasons for escalating healthcare costs - ANSWER: GROWTH OF TECHNOLOGY
but also
increasingly elderly/chronically ill population
increased prices for the same services
moral hazard
provider incentives
defensive medicine
practice variation
Alternatives to fee-for-service - ANSWER: Capitation
Pay for Performance
Accountable Care Organizations
Capitation - ANSWER: Pay per patient
--> but may under-treat
Pay for Performance - ANSWER: Based on outcomes
--> but may preferentially treat less sick patients
Accountable Care Organizations - ANSWER: group of providers who jointly engage in contracts with
insurers to determine accountability for costs & care of a given population (mainly used for medicare)
providers assessed for quality, if they pass the muster they get reimbursed from shared savings
Choosing Wisely - ANSWER: American Board of Internal Medicine & friends
we should promote dialogue on avoiding unnecessary & wasteful treatments & tests
Chargemasters - ANSWER: charge uninsured patients more for the same procedures etc
7th Edition By Paul J. Feldstein, PhD 9781640550100 Chapter
1-38 Complete Guide .
PCORI - ANSWER: Patient-Centered Outcomes Research Institute
Performs Comparative Effectiveness Research
Forbidden to perform Cost-effectiveness Analysis
Why is health care so controversial & reform so difficult in USA? - ANSWER: Special interests
National Values
Complexity
Trust issues
3 Aims of Health Systems - ANSWER: 1. Improving the health of populations
2. Responding to people's expectations
3. Providing financial protection against the costs of ill-health.
Problems with International Comparisons - ANSWER: 1. different meanings of health system
2. different types and quality of data
3. different values
Components of US health system - ANSWER: government
hospitals/systems/practices
health professionals
industries
biomedical research
insurers
patients
employers
NGOs
Continuum of Health Services - ANSWER: prenatal care/healthy birth --> health promotion ->
primary/secondary/tertiary prevention --> diagnosis --> treatment --> rehab care --.> palliative care
Executive Branch - ANSWER: policy development
regulation
enforcement
funding
Legislative Branch - ANSWER: debating and passing bills
executive branch oversight
Judicial Branch - ANSWER: Constitutionality of laws
Primary Care - ANSWER: general practice
first line of care
longitudinality, comprehensiveness, coordination
Secondary Care - ANSWER: Specialists
Tertiary Care - ANSWER: Super specialized/advanced care
Vertical Integration - ANSWER: Consolidation of health services under 1 roof (HMO)
, Virtual Integration - ANSWER: Coordination of health services via contractual relationships (PPO)
Berwick's Triple Aim - ANSWER: 1. Improving Individual Experience of Care
2. Improving the Health of Populations
3. Reducing the Per Capita Costs of Care for Populations
Berwick's proposal for achieving triple aim - ANSWER: providers being held fiscally/clinically
responsible for health outcomes
Perspective of "Cost" in health care - ANSWER: Consumer
Provider
National
Consumer Perspective of health care costs - ANSWER: price ==> bills for care, cost of medication
National (health system) perspective of costs - ANSWER: health care expenditures = (all health
services) x (price of each service)
Provider perspective of costs - ANSWER: staff salaries, facility cost, supplies, technology
OECD - ANSWER: Organization for Economic Cooperation and Development
(developed countries club!)
What do we spend on most in healthcare? - ANSWER: Hospital Care #1
Physician Services #2
Pharmaceutical drugs #3
Reasons for escalating healthcare costs - ANSWER: GROWTH OF TECHNOLOGY
but also
increasingly elderly/chronically ill population
increased prices for the same services
moral hazard
provider incentives
defensive medicine
practice variation
Alternatives to fee-for-service - ANSWER: Capitation
Pay for Performance
Accountable Care Organizations
Capitation - ANSWER: Pay per patient
--> but may under-treat
Pay for Performance - ANSWER: Based on outcomes
--> but may preferentially treat less sick patients
Accountable Care Organizations - ANSWER: group of providers who jointly engage in contracts with
insurers to determine accountability for costs & care of a given population (mainly used for medicare)
providers assessed for quality, if they pass the muster they get reimbursed from shared savings
Choosing Wisely - ANSWER: American Board of Internal Medicine & friends
we should promote dialogue on avoiding unnecessary & wasteful treatments & tests
Chargemasters - ANSWER: charge uninsured patients more for the same procedures etc
