Trends, Technology, and Emerging Issues:

What are some trends in Healthcare

Technology

Epidemiology

Geriatric Care

Wellness

Cost Containment

Technology

Computers and Audiovisual devices

Telemedicine

Long distance surgery

Epidemiology

The study of diseases

Researchers are focusing of diseases that are influenced by lifestyle factors

Taking responsibility for ones own health is a growing trend in today’s world

Why is Geriatric Care in such high demand

people are living longer

What are some developments that geriatric facilities have done in recent years

Adult day care centers

Independent living facilities

Retirement Communities

Nursing homes

Wellness

Change in focus from sick care to health care

They have:

Weight control facilities

Health food stores

Nutritional Services

Stress reduction counseling

Habit Cessation management

Public health

Public health serves to protect the health of individual people and communities through

Prevention

Education

Treatment

Research

Safety standards and programs

Tracking outbreaks

Laws that help protect public health

What are the three types of cost containment

outpatient services

Preventive care

Energy Conservation

Outpatient services

Reduce the length of hospital stays to reduce costs

Preventive Care

Get regular check ups and vaccinations to prevent illness

Energy Conservation

Use energy efficient lighting, solar power, and automatic faucets

Who is all on the same team and why

health care providers and patients because they are all working towards the same goal which is healthy people

Patient centered care

Partnership between the healthcare providers and the patient

Empower patients

Communicate with patients

Advocate for patients

Patient Responsibilities

Patients should communicate with healthcare providers

Patients should advocate for themselves

Patients should comply with their treatment plan

What are some ways to practice self- advocacy

Request copies of medical records

Review your medical records and use patient portals

Ask questions

Research treatment options

Learn the pros and cons of options including costs

Patient compliance

Cooperation or obedience to a prescribed treatment plan

What are the 8 key points in the Bill of Rights

right to emergency treatment

Right to respect

Right to informed consent

Right to refuse treatment

Right to choose providers

Right to privacy

Right to appeal

Patient responsibilities

What is the impact of Emerging issues

emerging issues and technologies results in changes in healthcare delivery systems

Healthcare providers must be adaptable and learn new things quickly

What are some advancements in technology

Mobile stoke unit (MSU)

Wireless wearable sensors

Miniature wireless pacemakers

Spectral CT

What is bioethics

the application of ethics to healthcare

When making new discoveries what principles should be considered

autonomy

Justice

Beneficence

Non-Maleficence

Addiction

it is now viewed as a disease called substance abuse disorder

Treatments are broader and more accessible

Treated by a team of healthcare providers

What do emerging issues and new discoveries require of Healthcare providers and patients

to be flexible and always willing to learn new things

What is the rising cost of healthcare good for and what is it a burden to

economy

Individuals and families

When did the USA develop a system of health insurance to help cover the cost of medical expenses

1920

When was the Patient Protection and Affordable care act (ACA) passed and what did it help

2010

Helped reduce the number of uninsured in the US

Premium

The amount paid to an insurance agency for health insurance policy

Deductible

the amount paid by the patient before the insurance agency will begin to make payments

Co-Payment

an amount paid by the patient for a certain service

Co-Insurance

The percentage of costs of a healthcare service that is paid by the patient after they have paid the deductible

Out of Pocket Expenses

A Medical bill that must by paid by the patient before

Most insurances have policies that limit the amount of out of pocket payments during a year

Cost Sharing Reduction (CSR)

this discount applies to deductible, copayment and co insurance for qualified health plans

Lowers out of pocket expenses

Premium Tax Credit

Based on your annual income and household information, this credit lowers your monthly insurance premium payment on qualified health plans

healthcare fraud examples

using someone else’s health info as if it were your own

Billing for medical services that were not provided

Delivery of unnecessary medical services

Misrepresentation of medical services provided for higher reimbursement

Providing or receiving money for participation in any of the above fraud schemes

What is the difference between health insurance then and now

1st broad coverage was Workers compensation in 1914 and it provided cash payments to injured workers with job related injuries and illness and now the affordable care act required health insurance companies cover 10 essential health benefits

What are the 10 essential health benefits that the Affordable Care Act required

Outpatient care

Emergency services

Hospitalizations

Pregnancy, maternity and new born care

Mental health and substance abuse treatment

Prescription drugs

Rehab and habilitative services and devices

Laboratory services

Preventative health services

Pediatrics services

Individual insurance

a person purchases a policy and agrees to pay the entire premium for health coverage

Group insurance

generally purchased through an employer

The premium is split between the employer and the person being insured

Indemnity Insurance

Patients must pay for all healthcare expenses out of their own pockets and afterward the insurance agency will reimburse the patient for a percentage of the expenses s

Who doesn’t indemnity insurance work for everyone

many can’t afford to pay for their medical expenses out of pocket

What is managed care

managed care plans offer medical services through a system of healthcare providers the system of providers offers services at reduced rates

What are the 2 primary concepts of managed care

to promote good health

To practice preventive medicine

What are the differences in managed care and indemnity

payment for medical services through

Choosing a healthcare provider

Reimbursement

healthcare agencies do not always reimburse the full amount charged for services

Physicians will either absorb the loss or they will charge the patient for the amount that was not paid by the insurance agency

health maintenance organizations

Clients must pay a premium deductible and co payments

Clients must visit in network doctors and select a primary care physician

HMOs urge clients to practice healthy living and to receive preventive treatments

preferred provider organization

clients must pay a premium deductible and co payments

Clients do not have to choose a primary care physician

Clients may visit non network physicians but coverage is greater with in network physicians

PPOs often have other fees and co payments

Exclusive Provider Organizations

Coverage for healthcare services is limited to care from providers or hospitals in the plan’s network, except for emergencies

Referral is not required to see a specialist

No coverage for care from out of network providers

Point of Service

Clients must pay a premium deductible

Clients must choose a primary care physician

For in network physicians there is usually no deductible and co payments are low

Specialists may be non network physicians but coverage may be limited

What insurance plan is the most cost effective

the most effective plan depends on an individuals healthcare needs and the coverage included in the plan

What should anyone who plans to pay for insurance do

research and compare the types of plans that are available

What are some government healthcare services

Medicaid

Medicare

Military health System

TRICARE

Veterans. Health administration

What are the types of public medical assistance

Medicaid and Medicare

What did the affordable care act do

expanded eligibility criteria for Medicaid

Provided financial assistance for those who do not qualify for Medicaid for lack insurance from employer

Medicaid

Needs based program

Designed by the federal gov and administered by state government

Provides medical assistance to individuals and families who the state determines to be medically needy

What are some of the Medicaid services

hospital services

Prenatal care

Child vaccines

Pediatric services

Physician services

Diagnostic testing and x-rays

Rehab and physical therapy

Prescription drugs

Home healthcare

What is Medicaid expansion

The ACA provided the foundation for Medicaid expansion since its a voluntary program and states may decide whether or not to participate states also decide whether or not to expand Medicaid for their residents

How many states have elected to expand Medicaid

37 include Washington DC

Medicare

entitlement program for any citizen age 65 or older

Administered but the federal gov

After deductible Medicare will cover 80% of all medical expenses

What are the Medicare services for hospital care

hospitalization

Skilled nursing facilities

Home healthcare

Hospice care

Long term care facilities

What are the Medicare services for outpatient services

medical expenses, including therapy, medical equipment, and testing

Preventive care

What is the healthcare for military

the US department operates the Military Health System which provides medical services to active duty and retired military members of the armed forces and their families

What is the health insurance program of the military health system

TRICARE

What is the largest integrated health services system in the USA

Veterans Health Administration