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Community Chapt 8
Vocab words and study material
Question | Answer |
---|---|
Capitation | a payment system whereby one fee is charged the client to pay for all services received or needed. |
Covered Lives | persons enrolled in a health care plan who are eligible for services under that plan |
Diagnosis-related groups (DRGs) | a patient classification scheme that defines 468 illness categories and the corresponding health care services that are reimbursable under Medicare. |
Economics | social science concerned with the problems of using or administering scarce resources in the most efficient way to attain maximum fulfillment of society's unlimited wants. |
Effectiveness | a measure of an organization's performance as compared with its philosophy, goals, and objectives. |
Efficiency | the process of meeting goals in a way that minimizes costs and maximizes benefits. |
Enabling | the act of shielding or preventing the addict from experiencing the consequences of the addiction. Also applies to shielding individual from the consequences of their actions more generally. |
Fee-for-service | list of health care services with monetary or unit values attached that specifies the amounts third parties must pay for specific services. |
Gross domestic product (GDP) | a statistical measure used to compare health care spending among countries. |
Health Care Rationing | a method to reduce health care costs by controlling the use of health care services and technologies. |
Health Economics | concerned with how scarce resources affect the health care industry. |
Human Capital | Measure of macroeconomic theory invoving improving human qualities, like health, focus for developing and spending money on goods and services, increases productivity, enhances the income-earning ability of people, & improves economy. |
Inflation | sustained upward trend in the prices of goods and services. |
Intensity | the use of technologies, supplies, and health care services by or for the client. |
Managed Care | method of organizing a number of different health care services together long a continuum of care. The client pays for services through insurance plan. |
Means Testing | a method used to assess whether a client's income level qualifies him or her for Medicare and or Medicaid |
Medicaid | jointly sponsored state and federal program that pays for medical services for the aged, poor, blind, disabled, and families with dependent children. |
Medical Technology | the set of techniques, drugs, equipment, and procedures used by health care professions in the delivery of medical care to individuals |
Medicare | federally funded health insurance program for the elderly and disabled and personsd with end-stage renal disease. |
Prospective Payment System (PPS) | diagnosis-related group payment mechanism for reimbursing hospital for inpatient health care services through Medicare. |
Public Health Economics | Focuses on the producing distributing, and consuming of goods and services as related to public health. |
Retrospective Reimbursement | method of payment to an agency based on units of service delivered. |
Return on Investment | improved health outcomes as a result of the resources provided for a program or intervention. Resources include money, providers, time, equipment. |
Safety Net Providers | those community providers that offer services to the uninsured and underinsured. |
Third-Party Payers | reimbursement made to health care providers by an agency other than the client for the care of the client. (insurance companies, governments, and employers). |
The goal of public health finance is | "to support population focused preventive health services" |
When government provides the money but the private sector decides how it is used | the money comes from business and individual tax savings r/t private spending for illness prevention care. |
When the private sector proveides the money but the government decides how it is used | the money is used for preventive care services for specific populations. |