Introduction to us health care
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Introduction to US Health Care. Text by Dennis D. Pointer, Stephen J. Williams, Stephen L. Isaacs & James R. Knickman with Tracy Barr PowerPoints by Robin Pickering Eastern Washington University. Introduction to US Health Care. Chapter 3 Health Care Provision. Types of Care.

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Introduction to us health care

Introduction to US Health Care

  • Text by

    Dennis D. Pointer, Stephen J. Williams, Stephen L. Isaacs &

    James R. Knickman

    with Tracy Barr

  • PowerPoints by

    Robin Pickering

    Eastern Washington University


Introduction to us health care1

Introduction to US Health Care

Chapter 3

Health Care Provision


Types of care

Types of Care

  • Primary

  • Secondary

  • Tertiary


Comparing care models

Comparing Care Models

  • Consult with primary care provider first

  • Send difficult problems with secondary or tertiary

  • Benefits

    • Quality of care

    • Cost containment

    • Public sentiment

  • Primary Care Model

  • Specialty Care Model


Comparing care models1

Comparing Care Models

  • More dispersed model

  • Does not require patient to consult first with primary care provider

  • Contributed to the rising cost of health care

  • Primary Care Model

  • Specialty Care Model


Managed care model

Managed Care Model

Health organizations control costs by funneling all medical necessities through the PCP


Effective primary care systems

Accessibility

Continuity

Comprehensiveness

Coordination

Accountability

Effective Primary Care Systems


Primary care team approach

Health Educators

Medical Assistants

Nurse Practitioner

Primary Care Team

Receptionist

Physicians

Clinicians

Medical Assistant

Primary Care Team Approach


Chronic care model

Chronic Care Model

  • Disease registries

  • Performance feedback

  • Case management

  • Chronic care visits

Collaborative Care


Primary care specialties

Family Physicians

General Internists

General Pediatricians

Primary Care Specialties


Nonphysician clinicians

“Nonphysician” Clinicians

  • Nurse Practitioners

  • Physician Assistant


Access to health care

Access to Health Care

  • Too few generalists

  • Lack of health insurance

  • Maldistribution of PCPs -(HPSAs)

*Rural

*Inner City

Two-thirds of all HPSAs are

in rural regions


Strategies to improve distribution

Strategies to Improve Distribution

  • National Health Service Corps and Loan Repayment Program

  • Grants

  • Focused Recruiting of Medical Students


Introduction to us health care2

Introduction to US Health Care

Chapter 4

Financing the U.S. Health Care System


Increased health care expenditures

Increased Health Care Expenditures

  • Inflation in economy

  • Inflation in medical component of consumer price index

  • Growth of population

  • Changes in the type and quality of health care service


Change in health care financing

Change in Health Care Financing

Present and Future:

Employer Financing

Past: Individual Financing


Differentiate

Purchaser

Pays for the service (insurance company or the government)

Consumer

Differentiate…

  • Receives the service (patient)


Financing health care

Financing Health Care

  • Individuals

  • Government

  • Private Businesses


Financing health care1

Financing Health Care

  • Individuals

  • Government

  • Private Businesses


Financing health care2

Financing Health Care

  • Individuals

  • Government

  • Private Businesses


Insurance coverage

Insurance Coverage


Factors affecting coverage

Factors Affecting Coverage

  • Age

  • Race and Ethnicity

  • Poverty Level

  • Residence

Predict Coverage


Types of health insurance

Types of Health Insurance

  • Voluntary Health Insurance

  • Social Insurance

  • Public Welfare Insurance

Categories…

  • Indemnity Plan

  • Service Benefit

  • Managed Care


Voluntary health insurance vhi

Voluntary Health Insurance (VHI)

  • Commercial

  • Blues

  • HMOs

  • Self-funded


Compare programs

Compare Programs

*adapted from table 4-5 in text


Hmo models

HMO Models

  • Independent Practice

  • Group

  • Network

  • Staff

  • Mixed


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