1. Chapter 02
Health Care Systems

2. 2:1 Private Health Care Facilities
Health care is one of the largest and fastest-growing industries in the United States
Will employ over 22.1 million workers in over 200 careers by 2020
2013 U.S. health care spending was over $2.9 trillion
Query to editor: here and throughout, okay that complete sentences do not end in a period?
“2.9 trillion dollars” changed to “$2.9 trillion”

3. Hospitals General hospitals Specialty hospitals Government hospitals
University or college medical centers

4. Long-Term Care Facilities
LTC or LTCF provide assistance and care for residents
Residential care facilities
Extended care or skilled care facilities
Independent living and assisted living facilities

5. Medical Offices
Vary from offices privately owned by one physician to large complexes
Services include diagnosis, treatment, examination, basic lab testing, minor surgery
May offer general or specialized care

6. Concierge Medicine Personalized health care
Annual or monthly fee paid to primary care provider for enhanced level of care

7. Dental Offices
Vary in size from privately owned by one or more dentists to dental clinics
Include general care for all ages and specialized care for certain age groups or dental conditions

8. Clinics or Satellite Centers
Surgical clinics or surgicenters
Urgent, walk-in, or emergency care clinics
Rehabilitation clinics
Substance abuse clinics

9. Clinics or Satellite Centers
Specialty clinics
Outpatient clinics
Health department clinics
Medical center clinics

10. Optical Centers May be individually owned or part of chain
Services include vision examination, prescription of glasses or contact lenses, screening for eye diseases

11. Emergency Care Services
Special care for accident victims or those with sudden illness
Ambulance services
Rescue squads
Emergency care clinics
Emergency departments

12. Laboratories May be part of other facilities or stand-alone
Medical laboratories
Diagnostic tests
Dental laboratories
Dentures and other devices

13. Home Health Care Provide care in a patient’s home
Frequently used by elderly and disabled
Provide nursing care, personal care, therapy, homemaking
Offered by health departments, hospitals, private agencies, government agencies, volunteer groups, nonprofits

14. Hospice Provide care for terminally ill persons
Care in a patient’s home or in a facility
Palliative care, psychological, social, spiritual, financial counseling to patient and family
Support for family members following patient’s death

15. Mental Health Facilities
Treatment for patients with mental disorders or diseases
Examples include guidance and counseling centers, psychiatric clinics and hospitals, clinical abuse treatment centers, physical abuse treatment centers

16. Genetic Counseling Centers
Independent facilities or located within another facility
Prenatal screening for couples or individuals who are pregnant or considering pregnancy
Check for genetic abnormalities and birth defects, explain results and options

17. Rehabilitation Facilities
Located in hospitals, clinics, private centers
Care for patients with physical or mental disabilities
Therapies include physical, occupational, recreational, speech, hearing

18. Health Maintenance Organizations
Health care delivery system and type of health insurance
Preventive care for a fixed, prepaid fee
Services include examinations, basic medical services, health education, hospitalization, rehabilitation

19. Industrial Health Care Centers
Also called occupational health clinics
Located in large companies or industries
Health care for employees
Services include examinations, accident prevention and safety, emergency care

20. School Health Services
Located in schools and colleges
Provide emergency care in case of accident or illness, tests for health conditions, health education, maintenance of a safe and sanitary environment, counseling

21. Pharmaceutical Services
Prepare and dispense medications
Provide expertise on drug therapy
Found in many settings: hospitals, clinics, nursing homes, online, etc.
Changed “Prepares” to “Prepare.” Changed “Provides” to “Provide.” Added period to “etc.”

22. 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)

23. 2:2 Government Agencies Food and Drug Administration (FDA)
Agency for Healthcare Research and Quality (AHRQ)
Occupational Safety and Health Administration (OSHA)
Health departments

24. 2:2 Government Agencies
Office of the National Coordinator for Health Information Technologies (ONC)
Health departments

25. 2:3 Voluntary or Nonprofit Agencies
Supported by donations, membership fees, fund-raisers, and grants
Health services are provided at national, state, and local levels
Examples include American Cancer Society, American Red Cross, Autism Speaks

26. 2:3 Voluntary or Nonprofit Agencies
Organizations often focus on specific diseases
Study the disease
Provide research funding
Educate the public
Provide special services to those with the disease
Staffed by health care workers and volunteers

27. 2:4 Organizational Structure
Line of authority or chain of command
Indicates areas of responsibility
Essential for most efficient operation of facility
Structure determined by size and needs of organization
Refer to Figures 2-4 and 2-5 in text

28. 2:4 Organizational Structure
Lines of authority must be clearly indicated in any organizational structure
Workers must identify and understand their position in the structure
Workers must take problems, reports, and questions to their immediate supervisor
“Text” changed to lowercase

29. 2:5 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
Without insurance, the cost of an illness can result in financial disaster

30. Insurance Terminology
Deductible
Co-insurance
Co-payment

31. Types of Plans Employer-sponsored or group insurance plans
Health maintenance organization (HMO)
Preferred provider organization (PPO)
Medicare
Medigap
Medicaid

32. Types of Plans Children’s Health Insurance Program (CHIP)
Worker’s compensation
TRICARE
U.S. government plans for military personnel and their families
Managed care plans

33. Types of Plans Fee-for-service compensation Value-base compensation
Provider paid a set amount for each service provided
Value-base compensation
Physician paid based upon performance
Paid a certain amount for each disease or diagnosis

34. Health Insurance Portability and Accountability Act (HIPAA)
Five components
Health care access, portability, renewability
Preventing health care fraud/abuse
Tax-related health provisions
Application and enforcement of group health plan requirements
Revenue offsets

35. Patient Protection and Affordable Care Act
Law of 2010 changing health care insurance regulation
Provisions include
Guaranteed issue
Expanded Medicaid eligibility
Improved benefits for Medicare