Components of the Health Care System:
o Who are they?
o Why are they singled out?
o Why should we care?
o Major players.providers, hospitals, and insurance companies
Critical thinking.critical que
Fee For Service
o Unbundled services & paid for separately
o Bundled charges (global fees)
o AKA package pricing, related services included in one price, eg. Eye
exam, frames, corrective lenses, etc.
o For HMOs: Capitati
Managed care defined
A mechanism of providing health care services in which a single
organization takes on the management of financing, insurance, delivery,
Health insurance that utilizes management and oversight of the medical
Federally Qualified Health Center
A safety net provider that enhances the provision of primary care services
in underserved urban and rural communities.
First defined by 1989 amendments to the Social Security Act
o FQHCs receives funds unde
PPD 230: Midterm Review
1.What does HMO stand for? What does it do?
- Health Maintenance Organization - Purpose: to control costs and encourage competition among health plans - A type of managed care organization - Capitation reimbursement - Assume
Private and Public Health Insurance
PPD 230 - Intro to Health Policy & Management Frankie Augustin Pernell Jones 9/24/2008
Insurance: a mechanism to protect against unpredictable loss. The basic function is to spread infrequent, large loss
Health Policy, Outpatient Services, and Emergency Care
Lectures 3 & 4
Roll Call All readings are posted. Also check out supplemental readings posted. Sicko due beginning of class! Lecture
Who are the
PPD 230 Frankie Augustin, M.S.
History of Prevention: The Healthy Lifestyle
Obama-Healthcare Reform Cannot WaitFebruary 24, 2009
What is prevention? What are we preventing? Why is prevention
Evolution of Managed Care
PPD 230 Frankie Augustin
What does EMTALA stand for? What is EMTALA? What is the difference between the prospective payment system and the retrospective payment system? What is the main goal for changing the reimb
Hospitals & Health Insurance
Frankie Augustin, M.S.H.A. PPD 230
Emergency Medical Treatment and Active Labor Act passed by Congress in 1986 to combat patient dumping. Hospitals and ambulance services are REQUIRED to provide care to ANYONE n
Overview and Trends. the U.S. Healthcare System
Professor: Frankie Augustin
Roll Call Room (circle seating?) Phones Contact Cards Sign ups for Current Events Presentationstake a moment to find a partner Lecture-Sum up beliefs,
Kathleen Ma & Tina Phung
Skirmish over state prison yoga rooms intensifies
Clark Kelso, previously a professor of law, is currently the California Prison Healthcare Receiver PROPOSES an $8 billion plan to improve the medical
environment for the ment
Emergency Medical Treatment and Active Labor Act passed by Congress in
1986 to combat patient dumping.
Hospitals and ambulance services are REQUIRED to provide care to
ANYONE needing emergency treatment regardless of ability to pay or