1. Chapter 2
Health Care Systems

2. 2:1 Private Health Care Facilities
Growth—one of the largest and fastest growing industries in the United States
Employment opportunities—employs over 13 million workers in over 200 careers
Expenditures—it is a four-billion-dollar- per-day business and growing
(continues)

3. Private Health Care Facilities (continued)
Hospitals: treat a wide range of conditions & age groups
Long-term care facilities (LTC or LTCF): care & assistance for elderly patients or individuals with disabilities
Independent living and assisted living: rent an apartment, meals & other services are provided

4. Medical office : privately owned or owned by co-ops…
Medical office : privately owned or owned by co-ops….may be specialty offices as well
Dental offices: private or group owned
Clinics or satellite centers: group of health care providers in one facility
Optical centers: privately owned. Provide vision support

5. Emergency care services: rescue squads
Laboratories: may be part of another facility, some however are large contracting labs
Home health care: provide care in a patient’s home
Hospice agencies: provide care for the terminally ill, usually 6 months or less to live
Mental health facilities: treat patients with mental diseases and disorders
Genetic counseling centers: works with diseases that are inherited and counseling parents to be
Rehabilitation facilities: located in hospitals, physical, occupational, & speech therapy
(continues)

6. Private Health Care Facilities (continued)
Health maintenance organizations (HMOs): health care delivery systems and health insurance….large industries & corporations
Industrial health care centers or occupational health clinics: on-site health care
School health services: found in schools & colleges

7. 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)
(continues)

8. Government Agencies (continued)
Food and Drug Administration (FDA)
Agency for Health Care Policy and Research (AHCPR)
Occupational Safety and Health Administration (OSHA)
Health Departments

9. 2:3 Voluntary or Nonprofit Agencies
Supported by donations, membership fees, fundraisers and grants
Health services are provided at national, state, and local levels
Examples include the American Cancer Society, March of Dimes, American Red Cross and many more
(continues)

10. Voluntary or Nonprofit Agencies (continued)
Organizations focus on specific diseases
Educate the public
Provide special services
Purchase medical equipment
Staffed by many health care workers
and volunteers

11. 2:4 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 costs
Without insurance, the cost of an illness can become a financial disaster

12. Insurance Terminology
Deductible
Co-insurance
Co-payment

13. Types of Plans Health insurance plans
Health maintenance organization (HMO)
Preferred provider organization (PPO)
Medicare
Medigap
(continues)

14. Types of Plans (continued)
Medicaid
The State Children’s Health Insurance Program (SCHIP)
Worker’s Compensation
U.S. government plans for all military personnel and their families
Managed care plans

15. HIPAA Five components Health care access Preventing health care fraud
Tax-related health provisions
Application and enforcement of group health plan requirements
Revenue offsets

16. 2:5 Organizational Structure
Line of authority or chain of command
Indicates areas of responsibility
Goal: most efficient operation of facility
Complex or simple structure determined by size and needs of organization
Sample organizational charts (See Figure 2-4 and 2-5 in text)
(continues)

17. Organizational Structure (continued)
The line of authority must be clearly indicated in any organizational structure
Workers must identify and understand their position in the structure
To follow proper channels of communication, workers must take problems, reports, and questions to their immediate supervisor