Update ) Healthcare
Policy | Questions & Verified
Answers | 100% Correct | Grade A –
LSUS
Question:
Who is eligible by age and income level?
Answer:
•Children in uninsured families whose income falls at or below 170% of the
federal poverty level (FPL)
Question:
What is CHIP?
Answer:
Children's Health Insurance Program
,Question:
Can the income level for eligibility differ from state to state?
Answer:
•States can expand eligibility - some states up to 400% FPL
•18 y.o. or younger
Question:
How many children are uninsured?
Answer:
the ACA was expected to lowering the number of the uninsured nonelderly by
32 million by 2019
Question:
Can you summarize the impacts of health care reform (ACA)?
Answer:
-Reduced the uninsured
-New funding mechanisms (State exchanges + tax credits)
-Kids < 26 can be on parents plan
-No pre-existing conditions exclusion (after 2 months)
,Question:
What are some common types of managed care plans?
Answer:
-Managed care plans expanding (1981 = 5%, now = 75%)
-Safety net providers - public, teaching and children's hospitals; FQHCs +
local charity groups
-Public Health and Community programs
-School-based services
-Care delivery for members of the military and their families
-Local ED!
-Most prevalent method of healthcare delivery in the United States
---HMO
---PPO
---Point-of-service (POS) plans
---High-deductible health plans
, Question:
Payment schemes?
Answer:
•Capitation: fixed fee for each patient (providers share risk)
•Discounted fee-for-service: providers accept discounted fees in exchange for
a guaranteed pool of patients
•Salary
Question:
What is a gatekeeper?
Describe this role and who typically acts as a gatekeeper.
Answer:
•Primary care providers are gatekeepers
Aprove / Limit visits to specialist