IUB SPEA-H 124 - Exam 1 Study Guide (6 pages)

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Exam 1 Study Guide

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Exam 1 Study Guide


Used for exam 1 on September 16th

Study Guide
Indiana University, Bloomington
Spea-H 124 - Health Care Management and Policy
Health Care Management and Policy Documents

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SPEA H 124 1st Edition Exam 1 Study Guide Definitions to know throughout the semester Healthcare systems formal and informal system of delivery services to keep people functioning Medical care for profit enterprises hospitals Public health government that does what other programs wont do Health insurance a contract between health insurance company and an individual shifts costs of a risk to the company Claim how healthcare providers get paid Reimbursement healthcare company pays doctor used to be patient paid doctor then got paid back Uninsured underinsured no insurance people must take initiative to buy insurance Indigent a poor person with no insurance and can t pay Access cost quality the 3 legged stool Access can you get in to see a provider Cost large part of macro and micro budgets Quality is the service benefiting the person An improvement in one affects one or more of the others Provider healthcare organization company Private sector all healthcare providers Practitioner person with credentials to provide healthcare Patient client Payor third party payor insurance company Healthcare reform efforts by government or society to improve cost quality or access to health care Medicare old people assistance Medicaid poor people assistance Eligibility criteria to be met to receive benefits Means test financial means Diagnostic attachment of diagnosis by having tests done Therapeutic treatment prescription Mortality death Morbidity illness Stakeholders a person who can be affected by another person s action Managed care organization MCO insurance company with rules to how health services must be used and incentives as to how deductibiles are used used to encourage health and keep patients out of hospitals Health maintenance Organization HMO Preferred Provider Organization PPO Voluntary Not for profit community hospitals has to give free community benefits federally acknowledged no taxes Public hospital owned by county state VA clinic Acute short term illness 30 days

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