HOSA Chapter 2 – Flashcards
Unlock all answers in this set
Unlock answersquestion
Hospitals
answer
Vary in size and shape and types of services provided
question
General hospitals
answer
Treat a wide range of conditions and age groups; usually provide diagnostic, medical, surgical, and emergency care
question
Specialty hospitals
answer
Provide care for special conditions or age groups (burn hospitals, cancer hospitals, pediatric hospitals)
question
Government hospitals
answer
Operated by federal, state, and local government agencies located throughout the world that provide care for government service personnel and their dependents
question
University of college medical centers
answer
Provide hospital services along with research and education; can be funded by private and/or governmental sources
question
Long-term care facilities
answer
Mainly provide assistance and care for elderly patients or residents; also care for individual as with disabilities, handicap, chronic, or long-term illness
question
Residential care facilities
answer
(Nursing home) provide basic physical and emotional care to individuals who can no longer care for themselves
question
Extended care facilities or skilled care facilities
answer
Designed to provide skilled nursing care and rehabilitative care to prepare patients a residence for return to home environments or other long-term care facilities
question
Independent living and assisted living facilities
answer
Allow individuals who can care for themselves to rent or purchase an apartment in the facility; a la carte
question
Medical offices
answer
Very from offices that are privately owned by one position too large complex is that operate as corporations and employee many physicians and other healthcare professionals
question
What services do medical offices provide?
answer
Diagnosis, treatment, examination, basic laboratory testing, minor surgery, and other similar care
question
Clinics or satellite centers
answer
Healthcare facilities found in many types of health care; some clinics are composed of a group of medical or dental doctors who share a facility or other personnel
question
Surgical clinics
answer
Perform minor surgical procedures; frequently called one day surgical centers
question
Emergency care clinics
answer
Provide a first aide or emergency care to ill or injured patients
question
Rehabilitation clinics
answer
Offer physical, occupational, speech, and other similar therapies
question
Substance abuse clinics
answer
Provide rehabilitation for drug and alcohol abuse
question
Specialty clinics
answer
Provide care for specific diseases; examples include diabetic clinic's, kidney dialysis centers, and oncology clinics
question
Outpatient clinics
answer
Usually operated by hospitals or large medical groups and provide care for outpatients
question
Health department clinics
answer
Offer clinics for pediatric health, respiratory disease, immunizations, and other special services
question
Medical Center clinics
answer
Usually located in colleges or universities; offer clinics for various health conditions; offer care and treatment and provide learning experiences for medical students
question
Emergency care centers
answer
Provide special care for victims of accidents or sudden illness; these services include ambulance services, rescue squads, helicopter services, and airplane services
question
Laboratories
answer
Are often a part of other facilities but can operate a separate healthcare services; can perform special diagnostic tests such as blood or urine tests
question
Home health care
answer
Provide care in patients home, frequently used by elderly and disabled, provide nursing care, personal care, therapy, and homemaking; offered by health departments, hospitals, private agencies, government agencies, volunteer groups, and nonprofits
question
Hospice
answer
Provide care for terminally ill persons who usually have life expectancy is of six months or less; can be provided in the person's home or in a hospice facility
question
Mental health facilities
answer
Treatment for patients with mental disorders or disease; examples include guidance and counseling centers, psychiatric clinics and hospitals, and chemical abuse treatment centers
question
Genetic counseling centers
answer
Work with couples or individuals who are pregnant or considering a pregnancy; can perform prenatal screening tests, check for genetic abnormalities, and explain the results of the tests
question
Rehabilitation facilities
answer
Provide care to help patients with physical or mental disabilities obtain maximum self-care and function
question
Health maintenance organization (HMOs)
answer
Both healthcare delivery systems and types of health insurance; provide total healthcare services that are primarily directed toward preventative healthcare for fee that is usually fix and prepaid; services include exams, basic medical services, health education, and hospitalization or rehabilitation services
question
Industrial healthcare centers
answer
Found in large companies are industries and provide health care for employees of the industry or business by performing basic exams, teaching accident prevention and safety, and providing emergency care
question
School health services
answer
Provide emergency care for victims of accidents or sudden illness, Promote health education, and maintain a safe and sanitary school environment
question
Government agencies
answer
Health services offered at international, national, state, and local levels; tax supported
question
World Health Organization (WHO)
answer
International agency sponsored by the United Nations; compiles stats and information on disease, publishes health information, and investigates and addresses serious health problems throughout the world
question
U.S Department of Health and Human Services (USDHHS)
answer
National agency that deals with the health problems in the United States
question
National Institutes of Health (NIH)
answer
The division of the USDHHS; involved in research on disease
question
Centers for Disease Control and Prevention (CDC)
answer
Another division of the USDHHS; concerned with the causes, spread, in control of diseases and populations
question
Food and Drug Administration (FDA)
answer
A federal agency responsible for regulating food and drug products sold to the public
question
Agency for Healthcare Research and Quality (AHRQ)
answer
The federal agency established to improve the quality, safety, efficiency, and effectiveness of health care for Americans
question
Occupational Safety and Health Administration (OSHA)
answer
Establishes and enforces standards that protect workers from job-related injuries and illness
question
Health departments
answer
Provide health services as directed by the US Department of Health and Human Services; also provide specific services needed by the state or local community; examples include vaccinations, inspections, healthcare clinics, and prevention
question
Voluntary or nonprofit agencies
answer
Supported by donations, membership fees, fundraisers, and federal or state grants; provide health services at national, state, and local levels; Examples include the American Cancer Society, March of Dimes, American Red Cross
question
Health insurance plans
answer
Insurance plan to help pay for the cost of healthcare
question
Premium
answer
A fee the individual pays for insurance coverage to the insurance company
question
Deductibles
answer
Amounts that must be paid by the patient for medical services before the policy begins to pay
question
Co-insurance
answer
Requires that specific percentages of expenses are shared by the patient and insurance company; For example, in an 80-20% co-insurance, The insurance company pays 80% of it and you pay 20%
question
Co-payment
answer
A specific amount of money a patient pays for a particular service, for example, $10 for each physician visit regardless of the total cost of the visit; Paid at the time of service on top of the deductible; before the bill
question
If you meet your premium what happens?
answer
The insurance company send you checks in the mail; reimbursed
question
Employer - sponsored health insurance or group
answer
Insurance coverage through their places of employment, where the premiums are paid by the employer
question
Health maintenance organization (HMOs)
answer
Type of health service plan that provides a managed-care plan for the delivery of healthcare services; a monthly fee is paid for membership, and the fees stay the same regardless of the amount of healthcare used
question
What is one advantage of HMOs?
answer
They cover routine exams and preventative care
question
What is one disadvantage of HMOs?
answer
People can only visit HMO affiliated health care centers, basically a dictatorship of healthcare
question
How can an industry or company provide healthcare at lower rates?
answer
By using a PPO
question
Preferred provider organization (PPO)
answer
Another insurance plan usually provided by large industries or companies to their employees; forms a contract with certain health care agencies to provide certain types of healthcare at reduced rates, prefers
question
What do PPOs usually require?
answer
A deductible and a co-payment; Is in enrollee uses a nonaffiliated provider, The PPO may require co-payments of 40 to 60%
question
Medicare
answer
Offered for people 65 or older, Who has received Social Security benefits for 2+ years, or has end stage renal disease; elderly
question
Medicaid
answer
Offered for people with low incomes, children without public assistance, and disabled or the blind; financial aid
question
Medicare consists of how many types of coverage?
answer
Three
question
Type A coverage?
answer
Hospital insurance
question
Type B coverage?
answer
Medical insurance
question
Type D coverage?
answer
Pharmaceutical/drug expenses
question
How much does Medicare actually pay for?
answer
Only 80% of the services
question
Medigap
answer
Health insurance plans that help pay expenses not covered by Medicare; offered by private insurance companies require the payment of a premium by the enrollee; must meet specific federal guidelines
question
Children's Health Insurance Program (CHIP)
answer
For uninsured children of working families who don't have enough money for Medicaid
question
Worker's Compensation
answer
Health insurance plan providing treatment for workers injured on the job; administered by the state, and payments are made by the employers in the state
question
TRICARE
answer
US government health insurance plan for all military personnel, active-duty members and their families, survivors of military personnel, and retired members of the Armed Forces
question
Managed care
answer
Developed in response to rising healthcare costs; employers, as well as insurance companies who pay large bills, want to ensure that such money is spent efficiently rather than wastefully; basically that all health care provided to the patient must have a purpose
question
If you have a pre-existing medical condition and you lose your job, what act protects your excess ability to health insurance coverage?
answer
HIPAA
question
Health Insurance Potability and Accountability Act (HIPAA)
answer
Establishes guidelines for insurance companies to deny or except people for insurance based on five main components
question
How many main components are there in HIPAA?
answer
Five
question
Health care access, portability, and renewability
answer
Limits it's exclusions on pre-existing conditions to allow for the continuance of insurance even with job changes, prohibits discrimination against and enrollee or beneficiary based on health status, guarantees renewability in multiemployer plans, and provide special enrollment rights for individuals who lose insurance coverage in certain in situations such as divorce or termination of employment
question
Preventing healthcare fraud and abuse; administrative simplification, and medical liability reform
answer
Establishes message for preventing fraud and abuse and imposes sanctions or penalties if fraud or abuse does occur
question
Tax related health provisions
answer
Promote the use of medical saving accounts by allowing tax deductions for monies placed in the accounts, establishes standards for long-term care insurance
question
Application and enforcement of group health plan requirements
answer
Establishes standards that require group health care plans to offer portability, access, and renewability to all members of the group
question
Revenue offsets
answer
Provides changes to the International Revenue Code for HIPAA expenses
question
Organizational structure
answer
The line of authority or chain of command at a hospital that indicates areas of responsibility; essential for the most efficient hospitals
