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Foundations Exam 3 > Health Care > Flashcards

Flashcards in Health Care Deck (27)
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1
Q

What school was used as the model school for the Flexner Report 1910

A

John’s Hopkins Medical School

2
Q

What did the Flexner Report 1910 do?

A

Solidified an educational model that favored the lab over bedside, hospital over home and physician as researcher over practitioner

3
Q

A lot of med schools closed after the report, especially schools that educated….

A

female, black and working class students

4
Q

Who was the founder of the PA profession?

A

Eugene Stead MD

5
Q

Most medical care is delivered in …

A

small healthcare settings.

32% solo or 2 physicians
60% practice of 5 physicians or less

6
Q

What are social determinants of health?

A

NOTE THE THINGS IN () ARE JUST EXAMPLES.

  • economic stability (employment, debt, income)
  • education (language, levels of education, literacy)
  • food (hunger, access to health)
  • social & community (social integration, support system, discrimination)
  • neighborhood & environment (housing, transportation, parks, safety)
  • health & healthcare (coverage, quality of care, provider availability)
7
Q

Affordable Care Act did what?

A

Gave uninsured way to be insured.

  • income based subsidies to uninsured
  • employer mandate
  • individual mandate
  • medicated expansion
8
Q

Mechanisms for Affordable Care Act

A

Private: each state creates insurance exchange for individuals w/o coverage and small employers

Public: The medicaid expansion. Medicare, Medicaid, CHIP, VA

9
Q

Under the Affordable Care Act health insurers …

A
  • couldn’t turn applicants down with a h/o illness or charge more
  • cannot terminate coverage
  • must renew coverage
  • return at least 80% of premiums in form of health service benefits
10
Q

What is the most common type of health insurance provider

A

Employer based coverage

11
Q

What makes you qualified for Medicare if you are 65

A

Disabled or if you need hemodialysis and are eligible for social security

12
Q

Describe A, B, C & D parts of medicare

A

A: hospital services
B: Outpatient, physician services
C: HMOS that administer benefits “Medicare Advantage” (approved by medicare run by private)
D: Meds, rx drugs

13
Q

Who is eligible for Medicaid

A

Varies by state. Usually low income, children, parents of dependents, pregnant women, disabled

14
Q

Can someone have dual eligibility with Medicare and Medicaid?

A

Yes, if they are chronically ill and need long term care

15
Q

What does Medicaid cover?

A

most clinical services and Rx

16
Q

Define “Churn”

A

movement in and out of the program. Occurs bc of changes in income and employment.

17
Q

What population is most likely affected by churn?

A

hourly paid employees

18
Q

Who is the primary payer for long term services and support?

A

Medicaid

19
Q

How is Medicare financed?

A

federal income tax, payroll taxes, premiums paid my enrollees

20
Q

How is medicaid financed?

A

state and federal taxes. Every dollar the state spends the federal government matches it

21
Q

Does medicare or medicaid give low reimbursement rates for providers?

A

Medicaid

22
Q

What is S-CHIP?

A

The state childrens health insurance program developed in 1997

23
Q

Who does S-CHIP cover?

A

children in low income families who do not qualify for Medicaid

24
Q

How is private health insurance sponsored ?

A

Employer sponsored or private, nongroup (individual market

25
Q

Private employer sponsored insurance is financed…

A

jointly through employer and employee

26
Q

who uses private non group/individuals financed?`

A

self employed or retired

27
Q

How does the premium work for those in private non group insurance?

A

Premium correlates with risk.

Low risk people= low premium