Chapter 2
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Chapter 2. Health Care Systems. 2:1 Private Health Care Facilities. Growth—one of the largest and fastest growing industries in the United States Employment opportunities—employs over 13 million workers in over 200 careers Expenditures—it is a four-billion-dollar- per-day business and growing.

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Chapter 2

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Chapter 2

Chapter 2

Health Care Systems


2 1 private health care facilities

2:1 Private Health Care Facilities

  • Growth—one of the largest and fastest growing industries in the United States

  • Employment opportunities—employs over 13 million workers in over 200 careers

  • Expenditures—it is a four-billion-dollar-per-day business and growing

(continues)


Private health care facilities continued

Private Health Care Facilities(continued)

  • Hospitals

  • Long-term care facilities (LTC or LTCF)

  • Independent living and assisted living

  • Medical offices

  • Dental offices

  • Clinics or satellite centers

  • Optical centers


Private health care facilities continued1

Private Health Care Facilities(continued)

  • Emergency care services

  • Laboratories

  • Home health care

  • Hospice agencies

  • Mental health facilities

  • Genetic counseling centers

  • Rehabilitation facilities

(continues)


Private health care facilities continued2

Private Health Care Facilities(continued)

  • Health maintenance organizations (HMOs)

  • Industrial health care centers or occupational health clinics

  • School health services


2 2 government agencies

2:2 Government Agencies

  • Government services are tax supported

  • World Health Organization (WHO)

  • U.S. Department of Health and Human Services (USDHHS)

  • National Institutes of Health (NIH)

  • Centers for Disease Control and Prevention (CDC)

(continues)


Government agencies continued

Government Agencies(continued)

  • Food and Drug Administration (FDA)

  • Agency for Health Care Policy and Research (AHCPR)

  • Occupational Safety and Health Administration (OSHA)

  • Health Departments


2 3 voluntary or nonprofit agencies

2:3 Voluntary or Nonprofit Agencies

  • Supported by donations, membership fees, fundraisers and grants

  • Health services are provided at national, state, and local levels

  • Examples include the American Cancer Society, March of Dimes, American Red Cross and many more

(continues)


Voluntary or nonprofit agencies continued

Voluntary or Nonprofit Agencies(continued)

  • Organizations focus on specific diseases

  • Educate the public

  • Provide special services

  • Purchase medical equipment

  • Staffed by many health care workers

    and volunteers


2 4 health insurance plans

2:4 Health Insurance Plans

  • Health care costs are rising faster than other costs of living

  • Most people rely on health insurance plans to pay for health care costs

  • Without insurance, the cost of an illness can become a financial disaster


Insurance terminology

Insurance Terminology

  • Deductible

  • Co-insurance

  • Co-payment


Types of plans

Types of Plans

  • Health insurance plans

  • Health maintenance organization (HMO)

  • Preferred provider organization (PPO)

  • Medicare

  • Medigap

(continues)


Types of plans continued

Types of Plans(continued)

  • Medicaid

  • The State Children’s Health Insurance Program (SCHIP)

  • Worker’s Compensation

  • U.S. government plans for all military personnel and their families

  • Managed care plans


Hipaa

HIPAA

  • Five components

    • Health care access

    • Preventing health care fraud

    • Tax-related health provisions

    • Application and enforcement of group health plan requirements

    • Revenue offsets


2 5 organizational structure

2:5 Organizational Structure

  • Line of authority or chain of command

  • Indicates areas of responsibility

  • Goal: most efficient operation of facility

  • Complex or simple structure determined by size and needs of organization

  • Sample organizational charts (See Figure 2-4 and 2-5 in text)

(continues)


Organizational structure continued

Organizational Structure(continued)

  • The line of authority must be clearly indicated in any organizational structure

  • Workers must identify and understand their position in the structure

  • To follow proper channels of communication, workers must take problems, reports, and questions to their immediate supervisor


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