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exam 4 review - Personal Health Exam 4 review A Health Care...

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Personal Health Exam 4 review A. Health Care a. Primary: Diagnosis/treatment of simple illness b. Secondary: use of specialist c. Tertiary: complex medical care B. Prevention a. Primary: education/vaccinations b. Secondary: early detection c. Tertiary: rehabilitation C. Insurance a. Premium: Cost of health insurance policy b. Deductable: Amount insure pays before insurance policy c. Managed Care: Gatekeeper for services d. Capitation : Maximum amount insurance will pay for a service D. Health Insurance a. Traditional (Basic and Major Medical) i. Fee for service (FFS) ii. Typical components are basic and major medical b. HMO: provides all services needed after premium i. Staff model: doctors are salaried and work for HMO. ii. Independent practice association (IPA): doctors have their own practice and see HMO patients as well as their own. iii. Group model network: HMO contracts with one of several groups of doctors
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c. PPO (preferred provider organization) i. Financial incentives for using preferred providers. ii. Coordination of care (Primary care provider –PCP) d. Medicare (Health coverage/insurance for elderly) e. Medicaid (health coverage/insurance for poor) E. Nutrition (Amy Freel’s guest lecture) a. Essential nutrients = proteins, carbs, fats, vitamins, minerals & water b.
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