UIUC CHLH 210 exam 1 2025
update|comprehensive questions and verified
answers (complete solutions) Exam|GRADE A+!!
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Terms in this set (87)
organizations involved in providing health
What is a community
information, education, resources, policy, services,
health organization
and care
1. medical model: focuses on diagnosis and
2 main types of health treatment of disease
models 2. wellness model: focuses on the prevention of the
disease
Health trends in the U.S. America has above average spending and below
compared to other average life expectancy. Japan has a high life
countries expectancy and they also pay less for healthcare.
* business oriented
* owned by the community, not the investors
* serve community, not maximize profit
* profits are invested back into the organizations or
held as cash reserves
* usually tax exempt from federal and property
taxes
Not-for-profits
* provide public benefit
* services may not be profitable - large number of
uninsured/underinsured patients
* in addition to patient revenue: fund raising, grants,
donations
* can be registered as a corporation
*
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* 501(c)(3) public benefit corporations
* various charitable, non-profit, religious, and
Not-for-profits educational organizations
exemption * provides donors of 501(c)(3)'s deduction for
federal taxes
* gifts must be verified
* establish written financial assistance and
emergency medical care policies
* limit amounts charged for emergency or other
medically necessary care to individuals eligible for
assistance under the hospital's financial assistance
policy
* make reasonable efforts to determine whether an
individual is eligible for assistance under the
hospital's financial assistance policy before
Not-for-profits engaging in extraordinary collection actions against
exemption criteria the individual
* conduct a community health needs assessment
and adopt an implementation strategy at least once
every three years
* not-for-profits tax must be a corporation
* unrelated business income is taxed
* can lose not-for-profit status
* often activities don't break even revenue
* exist primarily to provide programs and services of
benefit to others, not provided by the government
* investor owned, profits are main objective
* reinvested or redistributed to investor owners
* while providing quality service, managers are
For-profit
expected to maximize shareholder wealth
* company and the shareholders pay taxes
* can turn away non-emergent patients
* one party is exempted from incurred liabilities by
the other party
indemnity * insurer pays for services after they are used either
to reimburse patient or pay the provider, defined as
"fee for service"
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* prepaid health plan
* Capitation: predetermined amount of funds for
HMO (Health
* health maintenance act of 1976: strong incentive
Maintenance
for growth of HMOs - financial incentive, employers
Organizations)
required to also offer HMO plan as an alternative to
indemnity insurance
* combine paying for and providing services in one
business
* must see an in-network provider
Managed Care models
* dominant form of coverage: 95% of workers
covered by an employer plan were enrolled in
managed care, up 27% since 1988
* Delivery network that manages and negotiates
contracts on behalf of the providers, who provide
PPO (Preferred Provider
services at lower costs
Organizations)
* Great options of providers that are covered
* picking a provider in/out of network
* twice as likely to postpone a visit a physician due
to cost and limited access to clinics
insured vs. uninsured
* leads to progressed severity in disease and more
costly health care bills
* large companies (more than 200 employers):
almost all offer health care benefits, get better
deals on insurance plans
* small companies: only 59% offer health care
benefits
large companies vs. small * ACA: Employer Shared Responsibility Payment
companies (ESRP), Small Business Health Options Program
(SHOP)
* Only 81% of employees choose health care
benefits
* may opt out as they cannot afford the employee
share of the premiums
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