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MHA 707 Exam D Study Guide/77 Q’s and A’s
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MHA 707 Exam D Study Guide/77 Q’s and A’sDescribe HC in America at turn of 20th century. - --Dr. had solo practices
-Hospitals were nonprofits
-LTC services were at home
-Small businesses for medical devices and pharmaceuticals
-Surgeries improved
-Control of infectious diseases
-Medical Tool Box - --Vaccines
-Medicine
-Surgery
-American Medicine Association (AMA) - --Established education
requirements for MD
-Professionalized those in the healthcare workforce
-Research advances for diagnosis and treatment
-Industry providing healthcare supplies and therapeutics
-Classification and data collectors to evaluate performance
-Blue Cross Blue Shield - --Employer-based insurance
-Hospital care for those in Dallas
-Community rating over experienced rates to set rates for products
-WWII influence on Healthcare - --Caps were made on wages which fostered
employee-based systems to attract scarce workers
-Developed nationwide
-1940 became one company with 24 million members and grew to 92 million
in 1960
-Community Rating on Health Insurance - -insurer using community rating
to set insurance premiums ignores any differences in expected costs among
insured groups or people, same across the board
-Experience Rating - -Rating system that bases insurance rates on claims
history
-HIPAA (Health Insurance Portability and Accountability Act) - -Brings
improvements for access, privacy standards,and standards for EHC transfer
to improve efficiency and privacy
-Hill-Burton Act - -the "Hospital Survey and Construction Act" enacted by
Congress in 1946; this legislation provided federal money to determine the
need for more hospitals and to pay for their construction
, -What is EMTALA designed to do? - -Prohibited dumping by Medicare
participating hospital with active emergency room
-What are some major pressures on HC in the last 20th century? - --Solo
physician practice and single hospitals
-Increase in HC demand
-Population at 180 million
-More people can afford insurance
-Medicare/Medicaid
-How did the financing and organization of HC change in later 20th century?
- --Expansion on capitation and increase in Managed Care
-Increase in vertical and horizontal integration of health care
-Increase of for-profit healthcare org
-Capitation - -System of payment used by managed care plans in which
physicians and hospitals are paid a fixed, per capita amount for each patient
enrolled over a stated period regardless of the type and number of services
provided; reimbursement to the hospital on a per-member/per-month basis
to cover costs for the members of the plan
-Fee-for-service (FFS) - -set of fees for services established by a health care
provider and paid for by the patient
-Value Equation - -value = quality/cost
-Modified Value Equation - -Value= outcome/cost
Outcome: quality, efficacy, safety
Cost: resource tallies
-What is the impact on Value if changes occur in quality, cost, efficacy,
safety, etc? - -Success depends on the success of the enterprise (leads to
behavior changes and following protocols and formularies)
-Crowding out - -Substitution of private funds that otherwise would have
been spent on HC
-NHI (National Health Insurance) - -Single, countrywide healthcare financing
system ran by the government. This has been on the US agenda since 1912
with T. Roosevelt. Everyone in the population has insurance established by
the federal government. Administered by a federal/state level, private
sector, both funded through tz or private sector, or individual contributions
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