D391 Healthcare Ecosystem Exam 8 Questions
With Correct Answers!!
What is the healthcare ecosystem?
The whole structure that supports heathcare
5 P's of US Healthcare?
Patients
Providers
Admin, board members
Policymakers, state and federal agencies
Payers, insurance companies
Healthcare ecosystem
A system composed of elements that create a community
Healthcare system
the organization of individuals, institutions, and resources that deliver services to clients
Stakeholders
A group of people with a common interest, especially in business
Legislation covers
Patient population delivery
Operations
Optimization of patient privacy information
Regulates patient costs and insurance
ERISA
Employee Retirement Income Security Act of 1974
Employee Retirement Income Security Act of 1974 (ERISA)
, sets standards for pension plan management and provides federal insurance if pension plans go
bankrupt
Children's Health Insurance program (CHIP) 1997
Clinton administration
Included in the balance budget act 1997
Provides benefits to children
Varies by state within federal guidelines
MMA
Medicare Prescription Drug, Improvement, and Modernization Act
MMA (Medicare Prescription Drug Improvement and Modernization Act)
Most notable was the creation of Medicare Part D
False Claims Act
When providers file false claims with insurance companies
Anti-kickback
When a physician receives financial incentives for referrals or drives a patient to a specific
product or service that is paid for by a federal healthcare program
Affordable Care Act of 2010 goals
Decrease the number of uninsured
Slow the rising cost of healthcare
Increase the quality and efficiency of healthcare
ACA there were 3 new sources of health insurance
Expansion of Medicaid
Marketplace or Health Exchanges
Allowing young adults to remain on their parents insurance policy until 26
HIPPA (Health Insurance Portability and Accountability Act)
With Correct Answers!!
What is the healthcare ecosystem?
The whole structure that supports heathcare
5 P's of US Healthcare?
Patients
Providers
Admin, board members
Policymakers, state and federal agencies
Payers, insurance companies
Healthcare ecosystem
A system composed of elements that create a community
Healthcare system
the organization of individuals, institutions, and resources that deliver services to clients
Stakeholders
A group of people with a common interest, especially in business
Legislation covers
Patient population delivery
Operations
Optimization of patient privacy information
Regulates patient costs and insurance
ERISA
Employee Retirement Income Security Act of 1974
Employee Retirement Income Security Act of 1974 (ERISA)
, sets standards for pension plan management and provides federal insurance if pension plans go
bankrupt
Children's Health Insurance program (CHIP) 1997
Clinton administration
Included in the balance budget act 1997
Provides benefits to children
Varies by state within federal guidelines
MMA
Medicare Prescription Drug, Improvement, and Modernization Act
MMA (Medicare Prescription Drug Improvement and Modernization Act)
Most notable was the creation of Medicare Part D
False Claims Act
When providers file false claims with insurance companies
Anti-kickback
When a physician receives financial incentives for referrals or drives a patient to a specific
product or service that is paid for by a federal healthcare program
Affordable Care Act of 2010 goals
Decrease the number of uninsured
Slow the rising cost of healthcare
Increase the quality and efficiency of healthcare
ACA there were 3 new sources of health insurance
Expansion of Medicaid
Marketplace or Health Exchanges
Allowing young adults to remain on their parents insurance policy until 26
HIPPA (Health Insurance Portability and Accountability Act)
