HHP 4040 Exam 1 Spring 2019
Study Guide
public hospitals - Answer receives money from governments
non-profit hospitals - Answer provides services to the community
private hospitals - Answer can be for profit or not; operated by churches, corporations,
or other charitable investors
medicare - Answer federal program of health insurance for persons 65 years of age and
older
medicaid - Answer federal and state funded program that provides medical benefits for
low-income persons
CHIP - Answer Childrens Health Insurance Program - health insurance for children
under 18 whose parents earn too much to qualify for Medicaid, but not enough to afford
private insurance
affordable care act date - Answer march 23, 2010
health insurance marketplaces - Answer online marketplace where individuals can go
for insurance. states can decide to set up individually, regionally, or not at all. try to
make it easier by dividing bronze, silver, gold, and platinum
external forces affecting health care delivery - Answer global influences, population
characteristics, physical environment, technology development, economic conditions,
political climate, social values & culture
characteristics of US health care system - Answer -no central governing agency
-multiple payers
-access to services selectively based on insurance
-care delivered under imperfect market conditions
-3rd party insurers act as intermediaries between financing and delivery functions
-new technology has automatic demand for use
-service settings evolved along a continuum
-quality is not accepted as unachievable
continuum of health care services - Answer 3 categories of medical care services:
, -curative
-restorative
-preventative
why national health insurance has never gone through - Answer -lack of bipartisan
support
-different ideological values
-lobbying of special interest groups
major events in health care reform - Answer new deal, fair deal, medicare/medicaid,
cost containment, HSA, ACA
affordable care act title v. - Answer -health care workforce
-establish a national healthcare workforce commission to analyze and plan for needs
-fund scholarships and loans to increase number of workers
-fund expansions for community health centers and national health service corps
health care reform under trump administration - Answer -eliminate insurance
noncompliance fees
-cut funding for navigators in the marketplace
-half the open enrollment period for federal programs
medicaid work requirements - Answer -KY = first state to approve
-require all able bodied individuals to be working
-may affect many with income below poverty level
-sometimes no longer qualify for coverage after start working
if patients present with no insurance.... - Answer can be processed through a
presumptive eligibility program and either
-placed on medicaid for 30 days, and assigned a managed care organization (MCO:
AmeriGroup or UHC)
-if not eligible, meet with financial counselors to be placed on payment plan
transparency - Answer -1/19 all facilities required to post Charge Description Master
online
-forces organizations to set rates comparably
Study Guide
public hospitals - Answer receives money from governments
non-profit hospitals - Answer provides services to the community
private hospitals - Answer can be for profit or not; operated by churches, corporations,
or other charitable investors
medicare - Answer federal program of health insurance for persons 65 years of age and
older
medicaid - Answer federal and state funded program that provides medical benefits for
low-income persons
CHIP - Answer Childrens Health Insurance Program - health insurance for children
under 18 whose parents earn too much to qualify for Medicaid, but not enough to afford
private insurance
affordable care act date - Answer march 23, 2010
health insurance marketplaces - Answer online marketplace where individuals can go
for insurance. states can decide to set up individually, regionally, or not at all. try to
make it easier by dividing bronze, silver, gold, and platinum
external forces affecting health care delivery - Answer global influences, population
characteristics, physical environment, technology development, economic conditions,
political climate, social values & culture
characteristics of US health care system - Answer -no central governing agency
-multiple payers
-access to services selectively based on insurance
-care delivered under imperfect market conditions
-3rd party insurers act as intermediaries between financing and delivery functions
-new technology has automatic demand for use
-service settings evolved along a continuum
-quality is not accepted as unachievable
continuum of health care services - Answer 3 categories of medical care services:
, -curative
-restorative
-preventative
why national health insurance has never gone through - Answer -lack of bipartisan
support
-different ideological values
-lobbying of special interest groups
major events in health care reform - Answer new deal, fair deal, medicare/medicaid,
cost containment, HSA, ACA
affordable care act title v. - Answer -health care workforce
-establish a national healthcare workforce commission to analyze and plan for needs
-fund scholarships and loans to increase number of workers
-fund expansions for community health centers and national health service corps
health care reform under trump administration - Answer -eliminate insurance
noncompliance fees
-cut funding for navigators in the marketplace
-half the open enrollment period for federal programs
medicaid work requirements - Answer -KY = first state to approve
-require all able bodied individuals to be working
-may affect many with income below poverty level
-sometimes no longer qualify for coverage after start working
if patients present with no insurance.... - Answer can be processed through a
presumptive eligibility program and either
-placed on medicaid for 30 days, and assigned a managed care organization (MCO:
AmeriGroup or UHC)
-if not eligible, meet with financial counselors to be placed on payment plan
transparency - Answer -1/19 all facilities required to post Charge Description Master
online
-forces organizations to set rates comparably
