Types of Health Care Providers General Hospital Short hospitalization Run diagnostic tests Provide medical care Perform surgery Emergency Room (ER)

Specialty Hospitals  Care for a specific illness  Illinois Cancer Care - Cancer Diagnosis and Treatment ‎ Illinois Cancer Care - Cancer Diagnosis and Treatment ‎  Psychiatric Hospitals and Medical Centers - The Agape Center Psychiatric Hospitals and Medical Centers - The Agape Center  Children's Hospital of Illinois: Welcome To Children's Hospital of Illinois: Welcome To

Convalescent Care  Nursing Homes  Physically ill or injured people of all ages

Ambulatory care/clinics Where a variety of physicians work to combine practices Springfield Clinic - SpringfieldClinic.com ‎

Physician and Dental facilities  Promote wellness and diagnosis of illness

Rehabilitation Centers  Patients who need physical therapy or hydrotherapy  Patients who have lost a limb or organ function

Health Maintenance organizations (HMO)  Preventative health care  Avoid unnecessary hospitalization

Home Health Care Agencies  For patients who need health services but not hospitalization

Senior Day Care  They live at home but need a place to be cared for during the day.  Provide meals  Administer medication

World Health organization  Agency founded by the United Nations  Concerned with world health problems  Compiles stats  Investigates serious health problems  Publishes health information

Hospice  They care for terminally ill patients  Their clients are nearing the end of life  Provide care in the home or a hospice facility

Government Agencies  Federal, state and local governments provide health services.  Funded by taxes  Direct Health Care  Safeguard our food and water supply  Promote health education

Veterans Administration Hospital  Federally supported hospitals for all veterans who served in the armed forces

US Public Health Department  Research on diseases that kill, handicap, or cripple  Preventative, and treat alcohol and drug abuse  Preventing and controlling diseases that are transmitted by insects, animals, air, water, and people  Check the safety of the food and drugs we purchased  Effective ways to deliver health services  Provide quality care that is affordable by encouraging providers to work in underserved areas.

State Psychiatric Hospitals  Serve the mentally ill

State University Medical Centers  Provide training for health care workers  Provide medical care  Medical research

State Public Health Services  Health Education materials  Responsible for water and food purity  Communicable disease control  Alcohol and drug abuse  Maternal health  Licensing of various health agencies

County Hospitals  Provide care for the ill and injured  Patients who require financial help

Local Public Health Department  Focus on reporting of communicable diseases  Public health nursing  Health education  Environmental sanitation  Maternal education  Child health services  Ch 1-2Types of Health Care Providers.pptx Ch 1-2Types of Health Care Providers.pptx

Seniors Centers  Provide care geriatric patients

Volunteer Agencies  Donations  Gifts  Membership fees  Fundraisers  Endowments – gift of property or money  No government support  Many workers are volunteer  Raise funds for medical research  Public education  Various health problems

Volunteer Agencies  American Cancer Society  March of Dimes  American Red Cross  American Heart Association  American Diabetes Association  National Association of Mental Health

Managed Care: Quality Care at Reasonable Costs  Preventative Care – care that helps keep a patient healthy  Routine physicals  Well baby care  Immunizations  Wellness education-good nutrition, exercise, weight control

Managed Care: Quality Care at Reasonable Costs  Primary Care Providers- care for all routine medical problems and refer patients to specialists  Family and general practice physicians  Internists  Nurse practitioners, and physician’s assistance

Managed Care: Quality Care at Reasonable Costs  Specialty Care- given by a provider trained in one special area  Surgery-repair or remove a body part by cutting the body open  Podiatry – care of feet  Audiology -hearing  Obstetrics- pregnancy, childbirth, post partum  Orthopedics - care of the bones  Chiropractic - specializing in the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. [ [  Urology –specializes in the male and female urinary tract and male reproductive organs

Managed Care: Quality Care at Reasonable Costs  Emergency Care (ER) – life- threatening conditions that require hospitalization (costs are high)  Urgent care- non-emergencies that require prompt treatment (costs lower)

Managed Care: Quality Care at Reasonable Costs  Preadmission authorization requirement for hospitalization – allows for necessary and prevents for unnecessary  Good quality outpatient care is encouraged

Ambulatory Care  Want to keep patients home for care whenever possible  Hospitalize only the very ill and severely injured  Send patients to facilities that provide ambulatory care.  Rehabilitation  Outpatient surgery  Outpatient clinics  Physicians offices  Day Care  Home health care

Health Plan Employer Data Information  National Committee for Quality Assurance  Health Plan Employer Data and Information  Set guidelines and give a report card that  Measures health performance  Identifies physicians who give high quality medical care  Identifies physicians who do not meet quality care guidelines

Diagnostic Related Groupings  1983 Federal government passed legislation regulate medical care.  Group medical conditions, reasonable cost, standard treatment  Diagnostic related groupings DRG’s  Reduce unnecessary procedures and promote more self care

Health Insurance  Medical care is expensive  Pay fee for insurance coverage and in return agree to pay for specific medical care.  Each company decides what it will and will not pay and how much it will pay.  Patient pays the fees the insurance does not pay.

Health Maintenance Organizations (HMOs)  Members have to pay a co-pay  Must go to the doctors, hospitals, labs, etc. that the insurance company has an agreement with.  If you get care outside of the plan then patient has to pay.

Preferred Provider Organizations  Physicians and hospitals work with an insurance carrier to provide health care at reduced cost.  Agree to only see providers on that list.

Medicaid  Health Insurance provided by the federal and state government.  People who are blind, disabled or of low income qualify

Medicare  Health insurance is provided to those over the age of 65  Some health care providers will accept Medicare as full payment  Most do not accept as full payment so those on Medicare usually require additional insurance.