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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
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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