Healthcare Systems Health Occupations - 2014

10 20 30 40 50 Medical Facilities Insurance 1 Insurance 2 Managed Care Government Agencies Medical Facilities Managed Care Insurance 1 Insurance 2 10 20 30 40 50 Final Jeopardy

Government Agencies - 10 assures the safety of foods, cosmetics, pharmaceuticals, biological products, and medical devices

Government Agencies – 10 answer FDA

Government Agencies - 20 They impose safety and health legislation to prevent injury, illness, and death in the workplace.

Government Agencies – 20 answer OSHA

monitors and prevents disease outbreaks, including bioterrorism Government Agencies - 30 monitors and prevents disease outbreaks, including bioterrorism

Government Agencies – 30 answer CDC

Government Agencies- 40 Give an example of three “alien” things that were introduced to the Indian population (that ended up hurting their population in the end?)

Government Agencies - 40 answer Smallpox, weapons of mass destruction, alcohol, European style food

Government Agencies - 50 federally supported and provide care for veterans who served in the armed forces.

Government Agencies - 50 answer VA hospitals

Medical Facilities - 10 Convalescent care facilities generally help in the care of __________populations

Medical Facilities - 10 answer Geriatric/older

Medical Facilities - 20 provide end-of-life care to those patients expected to live six months or less.

Medical Facilities – 20 answer Hospice

Medical Facilities - 30 provides for elderly people who are able to live at home with their families but need care when the family is away.

Medical Facilities – 30 answer Senior Day Care

Medical Facilities - 40 This is one major difference between specialty hospitals and general hospitals

Medical Facilities – 40 answer Differences: -short term vs. long term -specialize in certain treatment vs. not

Medical Facilities - 50 offers medical services through interactive audiovisual media, such as computers to provide health care to remote areas.

Medical Facilities – 50 answer Tele-health care

Managed Care- 10 Specialty care is care given by a provider who is trained in one special area. Specialists usually limit their practice to treating one type of problem. 3 specialties are:

-Surgery. -Orthopedics. -Podiatry. -Chiropractic. -Audiology. Managed Care– 10 answer -Surgery. -Orthopedics. -Podiatry. -Chiropractic. -Audiology. -Urology. -Obstetrics.

Managed Care- 20 There are four Major Services in Health Care Each service has specialized departments. _______ are those that identify a particular condition or disease, with tools like x-rays or blood tests.

Managed Care– 20 answer Diagnostic Services

Managed Care- 30 What does the preadmission authorization requirement for hospitalization do?

Managed Care– 30 answer allows necessary hospitalization and prevents unnecessary hospitalization

Give three examples of preventative care Managed Care- 40 Give three examples of preventative care

Managed Care– 40 answer routine physicals, well-baby care, immunizations, screenings for patients with specific risk factors, and wellness education

Managed Care- 50 Emergency Care and Urgent Care provide different services. How are these types of services different?

Managed Care– 50 answer Emergency care is for life- threatening conditions that require hospitalization. These might include ambulance services, rescue squads, and helicopter or airplane rescue vehicles. Urgent care is for non-emergencies that require prompt treatment.

Insurance 1 - 10 People who are blind, disabled, or of low income are generally able to get this kind of insurance

Insurance 1 – 10 answer Medicaid

Insurance 1 - 20 Another example of a health care program is ___________________where employees who are injured or die at work are covered. It also covers illness that may result from the workplace.

Insurance 1 – 20 answer Workers Compensation

Insurance 1 - 30 ______require members to pay a co-pay for medical services, and the member must get medical care from the physicians, labs, hospitals, etc. that agree to the fee. If the member gets medical care outside the list, he or she will have to pay for the care.

HMOs (Health Maintenance Organization) Insurance 1 – 30 answer HMOs (Health Maintenance Organization)

Insurance 1 - 40 For this type of insurance, people over the age of 65 pay a monthly payment to the Social Security Administration.

Insurance 1 – 40 answer Medicare

Insurance 1 - 50 a health care program for active duty service members, retirees, and their families

Insurance 1 – 50 answer TRICARE

Insurance 2 – 10 2 of the reasons health care costs have risen so much in the last few decades.

technological advances Insurance 2 – 10 answer technological advances an aging population, and health-related lawsuits.

Insurance 2 – 20 What are two ways health care providers and systems can continue to help patients receive affordable care?

Insurance 2 – 20 answer encouraging less hospital time through outpatient services and early intervention HMOs and PPOs work with providers to offer patients reduced costs. Government also help by offering Medicaid, Medicare, TRICARE, workers’ compensation, etc.

Insurance 2 – 30 Two of the developed countries highlighted in the “Sick around the World” movie

Insurance 2 – 30 answer Taiwan Japan Germany Switzerland UK

Insurance 2 – 40 _____is the percentage of allowable charges for which you are responsible as determined by your policy VS. _______being a set fee for a particular service as determined by your policy

Co-insurance, Copayment Insurance 2 – 40 answer Co-insurance, Copayment

Insurance 2 – 50 Billy has met all but $100 of his $1000 deductible. He gets into an accident. Hospital bills are $4,380. His coinsurance is 30/70. His max out of pocket is $5000. What will Billy pay for this particular accident?

$100 (toward deductible) +(.3 x $4280) = $1284 $1384 Total Insurance 2 – 50 answer $100 (toward deductible) +(.3 x $4280) = $1284 $1384 Total

Final Jeopardy Bill’s insurance company pays for all major medical, prescription, and dental and vision. His deductible is $1000. Co-insurance was 20/80. How much will he pay when the following events happen? His Maximum Out of Pocket is $7000. January: Teeth cleaning ($150), March: X-Rays and Doctor’s Costs for Broken Collarbone ($895), July: Eye Exam and Contact Lenses ($350) 53

Final Jeopardy Answer $150 (teeth cleaning) $850 (of next bill to meet deductible…$45 is remaining of that bill) $9 (20% of $45) $70 (20% of $350) = TOTAL: $1079