HTH 354 EXAM 4 GRADED A+
%GDP - ANSWER-GDP is total economic production
17.5% of US GDP goes to health care
3 major outcomes of health care system - ANSWER-quality, access, cost
Access up, quality down in terms of wait times
Costs up access down
5 Dimensions of access to health care - ANSWER-availability
accessibility
affordability
accommodation
acceptability
8 main forces that will determine change in health care. - ANSWER-these are outside of
the health care system but do effect it. Interact with one another
1. social and demographic forces
2. politcal forces
3. economic
4. technological
5. informational
6. ecological
7. global
8. anthro-cultural
ACA effect on cost of care - ANSWER-Unclear; cost savings with Medicare payment
cuts to providers but other costs have increased (health insurance premiums)
some areas costs down- especially in medicare
Some up to consumers- premiums, deductibles up
ACA future reform - ANSWER-ACA likely to be rolled back. 58% of americans favor
replacement with federally funded HC system for all Americans.
ACA impact on access to - ANSWER-Insurance and access to care have increased
Still gap in access and affordability for low income.
More than 25% of elderly report having no usual source of care- 1/3 couldn't find a doc
to tx them
7/10 delayed care bc they couldn't get an appointment.
,ACA impact on quality - ANSWER-New patient care models and organizations
incentivized to provide high quality care
many provisions focusing on improving quality and increased reimbursement to
providers- for demonstrating quality outcomes
Moving away volume based system to more of a value based system.
ACA update insurer based coverage - ANSWER-less employer-based health
insurance(big and small)
ACA update premiums - ANSWER-•costs in the exchanges increased to unaffordable
levels ---adverse selection
ACA update uninsured - ANSWER-Reduced number of uninsured but only certain
people benefited:
1.Medicaid expansion, 2.private insurance on the exchanges
3. young adults under 26
Acceptability - ANSWER-is based on the attitudes of both patients and providers.
do you feel respected, do they accept your beliefs.
access - ANSWER-Timely use of needed, affordable, convenient, acceptable, and
effective personal health services.
Accessibility - ANSWER-refers to the fit between the location of a provider and the
location of patients.
how far away is it, is there transportation difficulites. Does the provider have
accommodations for disabled
accommodation - ANSWER-refers to the fit between the manner in which resources are
organized to provide services and individuals' ability to take advantage of the
arrangement.
if you're sick can you get into PCP in a day. Do their hours meet your needs.
administrative costs - ANSWER-—Costs associated with the management of the
financing, insurance, delivery, and payment functions. These costs include
management of the enrollment process, setting up contracts with providers, claims
processing, utilization monitoring, denials and appeals, and marketing and promotional
expenses.
, adverse selection and gov exchange insurance - ANSWER-sick people signed up for
exchange policys, only ones buying it so theyreexpensive to insure, caused coasts of
plans to increase.
Affordability - ANSWER-refers to individuals' ability to pay.
Allocative Health Policy - ANSWER-Designates a use of health policy in which there is a
direct provision of income, services, or goods to groups of individuals who usually reap
benefits in receiving them.
Health policies that involve the direct provision of income, services, or goods to groups
of individuals who usually reap benefits in receiving them.
distributive or redistributive
anthro cultural impact on future changes - ANSWER-societys beliefs, values, ethos ,
traditions and experiences. US opposes radical change.
anthrocultural shift - ANSWER-About 50/50 on belief that gov should provide insurance
to all Americans.- gradual shift away from typical American view.
65% satisfaction rate of care, 2% drop since 2016 since ACA
availability - ANSWER-refers to the fit between service capacity and individuals
requirements.
in your health insurance plan, is there enough specialists in your network. Are there
PCP in your network that are accepting new patients.
Boeing - ANSWER-jet company , cut costs by 20%
bottom-up control - ANSWER-US uses
where each provider and insurer establishes fees
cost control efforts in the US are characterized by combination of government regulation
and market-based competition
Certificate of Need - ANSWER-Certificate of need (CON)—Statutes were state-enacted
legislation whose primary purpose was to control capital expenditures by health
facilities. The CON process required prior approval from a state government agency for
new construction of facilities, expansion of existing facilities, and purchase of expensive
equipment. Approvals were based on the demonstration of a need for additional
services by the community
clinical practice guidelines - ANSWER-Also called medical practice guidelines; explicit
descriptions representing preferred clinical processes. They are standardized guidelines
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