HCD 303 Final Midterm Study Guide
Study online at https://quizlet.com/_784y8v
1: A set of procedures according to which something is
done; an organized scheme or method
Study
2: A set of connected things or parts forming a complex
whole
the degree to which health care services for individuals
and populations increase the likelihood of desired health
Quality
outcomes and are consistent with current professional
knowledge
concerned with helping people to command appropriate
Access health care resources in order to preserve or improve their
health
the actual costs of providing services related to the delivery
Cost of health care, including the costs of procedures, thera-
pies, and medications
is a health care system that provides health care and fi-
Universal coverage nancial protection to all residents of a particular country
or region
Social solidarity and willingness to tolerate risk- and in-
Social Solidarity
come-related cross- subsidies within health insurance
an organizing principle that matters ought to be handled
Subsidiarity by the smallest, lowest or least centralized competent of
government
giving and receiving goods with no immediate or specific
Generalized Reciprocity
return expected
Centralized organized and run at the federal level
Decentralized organized and run at the state/regional level
ederal, state, or local governments in which people have
Public Health Services/Insurance
some or all of their healthcare costs paid for by the gov-
,HCD 303 Final Midterm Study Guide
Study online at https://quizlet.com/_784y8v
ernment. The two main types of public health insurance
are Medicare and Medicaid.
plans marketed by the private health insurance industry,
as opposed to government-run insurance programs. Pri-
Private Health Services/Insurance vate health insurance currently dominates the U.S. health
care landscape, covering more than half of the US popu-
lation.
Copayment pay at point of service; fixed dollar rate
a type of insurance in which the insured pays a share of
Co-insurance
the payment made against a claim.
a specified amount of money that the insured must pay
Deductible
before an insurance company will pay a claim.
German insurance programs offered by nonprofit groups
Sickness funds to serve a given occupation, geographic location, or em-
ployer. Otherwise known as social insurance.
government programs that protect people experiencing
Safety net
unfavorable economic conditions
when patients pay for a portion of health care costs not
Cost-sharing
covered by health insurance.
government incentive is a form of financial aid or support
Subsidy extended to an economic sector generally with the aim of
promoting economic and social policy
the function of a health system concerned with the mobi-
lization, accumulation and allocation of money to cover the
Health Financing
health needs of the people, individually and collectively, in
the health system
how much a countries spends on health care based on
Health spending as a % of the GDP
gross domestic product
, HCD 303 Final Midterm Study Guide
Study online at https://quizlet.com/_784y8v
FFS) is a payment model where services are unbundled
Fee-for-service
and paid for separately.
(Latin for "per day" or "for each day") or daily allowance is
a specific amount of money an organization gives an indi-
Per Diem
vidual, often an employee, per day to cover living expenses
when traveling for work.
is an umbrella term for initiatives aimed at improving the
quality, efficiency, and overall value of health care. These
arrangements provide financial incentives to hospitals,
Pay-for-performance
physicians, and other health care providers to carry out
such improvements and achieve optimal outcomes for
patients.
physicians are paid a predetermined salary based upon
Salary
their level of expertise and experience
Bundled Payments DRG, EDRG, Reference Pricing
1. A prospective payment model in which hospitals are
reimbursed with a fixed fee regardless of the actual costs.
Diagnosis-related groups (DRGs)
2. Includes hospital expenses only.
ACA required 30-day readmission penalty
1. the bundled payment = hospital + all physician pay-
ments + longer period of time (e.g. 6 - 12 months after
hospitalization)
Extended Diagnosis Related Groups (EDRGs)
2. the EDRG acts as a forcing function - encouraging physi-
cian and hospital collaboration on improving both patient
outcomes and cost
1. the payment amount now going to medical centers with
high quality and low cost
Reference Pricing
2. medical centers can charge more than reference price
3. patients told which medical centers charge more than
Study online at https://quizlet.com/_784y8v
1: A set of procedures according to which something is
done; an organized scheme or method
Study
2: A set of connected things or parts forming a complex
whole
the degree to which health care services for individuals
and populations increase the likelihood of desired health
Quality
outcomes and are consistent with current professional
knowledge
concerned with helping people to command appropriate
Access health care resources in order to preserve or improve their
health
the actual costs of providing services related to the delivery
Cost of health care, including the costs of procedures, thera-
pies, and medications
is a health care system that provides health care and fi-
Universal coverage nancial protection to all residents of a particular country
or region
Social solidarity and willingness to tolerate risk- and in-
Social Solidarity
come-related cross- subsidies within health insurance
an organizing principle that matters ought to be handled
Subsidiarity by the smallest, lowest or least centralized competent of
government
giving and receiving goods with no immediate or specific
Generalized Reciprocity
return expected
Centralized organized and run at the federal level
Decentralized organized and run at the state/regional level
ederal, state, or local governments in which people have
Public Health Services/Insurance
some or all of their healthcare costs paid for by the gov-
,HCD 303 Final Midterm Study Guide
Study online at https://quizlet.com/_784y8v
ernment. The two main types of public health insurance
are Medicare and Medicaid.
plans marketed by the private health insurance industry,
as opposed to government-run insurance programs. Pri-
Private Health Services/Insurance vate health insurance currently dominates the U.S. health
care landscape, covering more than half of the US popu-
lation.
Copayment pay at point of service; fixed dollar rate
a type of insurance in which the insured pays a share of
Co-insurance
the payment made against a claim.
a specified amount of money that the insured must pay
Deductible
before an insurance company will pay a claim.
German insurance programs offered by nonprofit groups
Sickness funds to serve a given occupation, geographic location, or em-
ployer. Otherwise known as social insurance.
government programs that protect people experiencing
Safety net
unfavorable economic conditions
when patients pay for a portion of health care costs not
Cost-sharing
covered by health insurance.
government incentive is a form of financial aid or support
Subsidy extended to an economic sector generally with the aim of
promoting economic and social policy
the function of a health system concerned with the mobi-
lization, accumulation and allocation of money to cover the
Health Financing
health needs of the people, individually and collectively, in
the health system
how much a countries spends on health care based on
Health spending as a % of the GDP
gross domestic product
, HCD 303 Final Midterm Study Guide
Study online at https://quizlet.com/_784y8v
FFS) is a payment model where services are unbundled
Fee-for-service
and paid for separately.
(Latin for "per day" or "for each day") or daily allowance is
a specific amount of money an organization gives an indi-
Per Diem
vidual, often an employee, per day to cover living expenses
when traveling for work.
is an umbrella term for initiatives aimed at improving the
quality, efficiency, and overall value of health care. These
arrangements provide financial incentives to hospitals,
Pay-for-performance
physicians, and other health care providers to carry out
such improvements and achieve optimal outcomes for
patients.
physicians are paid a predetermined salary based upon
Salary
their level of expertise and experience
Bundled Payments DRG, EDRG, Reference Pricing
1. A prospective payment model in which hospitals are
reimbursed with a fixed fee regardless of the actual costs.
Diagnosis-related groups (DRGs)
2. Includes hospital expenses only.
ACA required 30-day readmission penalty
1. the bundled payment = hospital + all physician pay-
ments + longer period of time (e.g. 6 - 12 months after
hospitalization)
Extended Diagnosis Related Groups (EDRGs)
2. the EDRG acts as a forcing function - encouraging physi-
cian and hospital collaboration on improving both patient
outcomes and cost
1. the payment amount now going to medical centers with
high quality and low cost
Reference Pricing
2. medical centers can charge more than reference price
3. patients told which medical centers charge more than
