intro to HC midterm (1)

What was the most significant change in health care access in the United States over the past five years?

The implementation of the Affordable Care Act (ACA).

According to the WHO, what is the best 'vaccine' against common diseases?

An adequate diet.

What critical issues are present in the current health care system?

Inefficiencies and disparities. comparisons w/ other countries show variations in spending w/o differences in health outcomes

The downside to improving health care and longevity is that

One-third of the population over age 65 with multiple chronic conditions.

What is essential for improving the health of all Americans?

Collecting data on health components, documenting trends, health status, access/ utilization of healthcare services; disseminating reliable and accurate info abt the health of our population. also gaining an understanding of healthcare needs of pops in subgroups especially w/ changes in access to health care w/ healthcare reform

what has increased the prevalence of chronic & degenerative diseases associated w/ aging?

longevity and an increased # of elderly

What has contributed to greater use of prescription drugs?

The development of new drugs to treat chronic diseases and growth of drug coverage by private and governmental health insurance

What are some examples of zoonotic diseases?

Coronavirus (COVID-19), avian (bird) influenza, and Ebola. can be transmitted to humans by an infected animal (bat or nonhuman primate) or a sick/ dead person infected w/ virus

What does the federal government prefer regarding direct health services?

To support improved services through funding rather than provide direct services.

What are the exceptions to the federal government providing health services?

TRICARE thru department of defense, Civilian health & medial program of dept. of veterans affairs (CHAMPVA), and the Indian Health Service (IHS).

congress plays a key role in this federal activity by (3)

making laws

allocating funds

doing investigative work thru committees

What percentage of federal health funding goes to hospitals for Medicare or Medicaid reimbursement?

Approximately 40%.

exercise and aerobic classes offered by city recreation dep. adult education programs, & private/ nonprofit gyms encourage what?

consumers to exercise &maintain cardiovascular fitness, promoting better health thru lifestyle changes

What are community hospitals?

The majority of hospitals in the U.S., with over 5,000 being community hospitals and nearly 3,000 of community hospitals being non-profit

What is the National Association of Free Clinics (NAFC)?

It was established in 2001 to support 1,200 free clinics across almost all states.

What did the Social Security Act of 1965 establish?

created Medicare and Medicaid programs. fund health care for those over 65 thru Medicare and for the indigent thru Medicaid

what is the U.S depart. of health and human services are responsible for?

public health, biomedical research, food & drug safety, disease control, and prevention, Indian health, & mental health services

How is healthcare funded in the United States?

Through a variety of private payers and public programs.

What was the traditional method of reimbursement for health services before the ACA?

Fee-for-service.- payment for each service at the time of service

What is Medicare?

A federal health program for people aged 65 and older and certain younger disabled persons such as kidney failure (endstage renal disease) or (asl or lou Ghrig’s disease)

When was the first private hospital insurance plan established?

In 1929 by group of Dallas teachers contracted by Baylor University to provide 21 days of hospitilization for a fixed $6 payment

How many Americans were covered by Medicaid in 2019?

1 in 5 Americans making it the nations largest pubic health insurance program

What was the significant change in government healthcare financing that occurred with the Social Security Act of 1965?

Approval of Medicare and Medicaid w/ passage of title 18 and 19

What does the fee-for-service model reward?

Volume of services performed rather than quality.the number of laboratory tests, number of surgeries, number of days in the hospital-rather than quality and cost control (value) of those services

What is a major drawback of Health Maintenance Organizations (HMOs)?

Enrollees must find a physician within the HMO group.

What is the projected growth of the older population by 2030?

Almost 50% growth & is likely change demands for health care and caregiving in the U.S

What will be the most important disabilities of the future?

Chronic diseases arising from emotional and physical causes.

what is part C and part D that many older adults purchase

medicare advantage and prescription medication from private insurance companies

What services does Medicaid cover that Medicare does not?

acts as supplemental insurance for older adults & disabled. pays for medicare premiums, including cost sharing requirements and prescription drugs.

What is PACE?

A form of integrated care for older individuals with chronic needs.improve care coordination, and reduce administrative burdens. PACE provides comprehensive preventive, primary, acute, and long-term care services so older individuals with chronic care needs can continue living in the community.

Why is case management critical for older adults?

To coordinate care for older adults with multiple health problems.

What do most older adults purchase to cover Medicare deductibles?

Medicare Supplemental Health Insurance (Medigap). from private company to cover deductibles & copayments for part A &B

what is Obama care ?

the patient protection & affordable care act was modified by the health care & education reconciliation act of 2010. the 2 collectively called the affordable care act signed into law by President Obama.

What health benefits are required by qualified health plans under by all qualified health plans

Ambulatory services, emergency services, hospitalization, maternity/ newborn care, mental health and substance use disorder services including behavioral health treatment, prescription drugs, rehabilitative services and devices, lab services, preventive and wellness services & chronic disease management, and pediatric services including oral and vision care

What were the three goals of the Affordable Care Act?

Decrease the number of uninsured, increase quality/ efficiency of care, and slow rising costs.

What does the Hospital Readmission Reduction Program do?

Lowers Medicare payments to hospitals that fail readmission standards for 3 diagnoses: heart attack, stroke, pneumonia

What products multitude medical technology?

Products used to diagnose & monitor conditions and diseases. also treat high risk diseases includes instruments used to perform less invasive operations.

what work is performed by biomedical engineers

usage of knowledge of biology, medicine, technology, & mechanical engineering to research & develop new equipment

What is telemedicine?

Use of electronic communications and info technologies to provide clinical care at a distance.

how are apps used in healthcare

some can stimulate surgical procedures or can conduct simple medical exams, such as vision & hearing tests. others help physician develop patient risk profiles & provide drug dosage & interaction info

Health IT applications

patient registration, electronic health records, electronic prescribing & bar coding

What does the Health Insurance Portability and Accountability Act (HIPAA) require?

electronic submission of most health care claims.

What does the HITECH Act emphasize?

The meaningful use program.

Object made thru 3D printing show promise bc

the blueprints can be customized to the patients situation thru use of patient specific data to create a physical solution

how is interoperability a significant challenge within the health IT field?

some proprietary systems dont communicate easily w/ other pro systems & interfaces are necessary

What does wearable technology allow for in health monitoring?

Inexpensive, continuous physiological monitoring w/ little manual intervention by the patient/ healthcare provide

What is health literacy?

The ability to obtain, process, and understand health information and services needed to make appropriate health decisions

What happens to ACOs that fail to meet standards?

They are financially accountable for patient healthcare costs instead of Medicare.

Under the Hospital Readmission Reduction Program, what influences Medicare reimbursement?

The hospital's readmission rate.