1. Health Care Systems

2. HEALTH CARE
Health care - one of largest and fastest growing industries in the United States
Health care facilities include hospitals, LTCF’s, assisted living facilities, medical offices, dental offices, clinics, labs, industrial services, school health services

3. How are hospitals classified?
By the services they provide
The source of income received
Private or Proprietary
Religious
Nonprofit or Voluntary
Government

4. Classifications and types can overlap
Types of hospitals
General - treat wide range of conditions, age groups
Specialty - care for specific conditions or age groups ( cancer, pediatric, psychiatric, rehab)
Government - operated by government agencies (ex. Veterans Admin)
University or college medical center - provide research, education, along with services
Classifications and types can overlap

5. Assisted Living Facility (ALF)
Individuals that can care for themselves but need assistance with meal preparation, housekeeping, laundry and transportation

6. Long Term Care Facility ( LTCF)
Residential Care Facility - ex. Nursing home, helps residents with ADL’s, can provide care to those no longer able to care for themselves, promote opportunities for social interactions,
Extended care or skilled care - designed to rehabilitate patient for return to home or another long term care facility, help patients recover from an illness or surgery

8. Medical Office - can be large or small, can include services that diagnosis, treat, provide exams, lab testing, minor surgery and other care. Examples - pediatric office, cardiology office, ob/gyn office
Dental Office - can be an office of one dentist or a dental clinic that has many dentists

9. Clinics are also called satellite clinics or satellite centers - can be a group of doctors or can be operated by a private group who provide special care.
Examples are surgical centers, urgent care, rehab clinics, substance abuse, outpatient, health department clinic, specialty clinics (dialysis center)
Surgical Center or Surgicenter

10. Optical centers - provide vision exams, contact lens, glasses
Emergency Care - Provide care for accidents and sudden illness. Examples, ER department in the hospital, rescue squads ( like the fire department ), ambulance services
Laboratory - can be separate or a part of a facility, perform special diagnostic tests such as blood and urine tests
Mental Health - help those with mental disorders, examples are chemical, physical, alcohol and drug abuse centers, counseling centers, and psychiatric clinics

11. Hospice - an agency that provides care to patients with a life expectancy of 6 months or less
Home Health Care - provide care in a patient’s home, examples include respiratory, physical and speech therapy, and nursing care
Genetic Counseling Centers Can perform prenatal screening, check for genetic abnormalities and birth defects
Rehabilitation Facility - can be in a hospital, clinic, or private center. May include speech, occupational, hearing therapy.

12. Health Maintenance Organization (HMO)
A provider of managed care. It is a type of health insurance and a health care system.
Services include exams, basic medical services, hospitalization, or rehab services, aimed at preventive care
Industrial Health Care Center also called Occupational Health Clinic
Found in large companies or industries, may provide basic exams for their employees, accident prevention and safety and provide emergency care
School Health Services Found in school and colleges, check for speech, vision and hearing problems, provide care in an emergency, maintain a safe school environment

13. Government Agencies

14. Centers for Disease Control and Prevention (CDC)
Concerned with the causes, spread, and control of diseases in populations
Food and Drug Administration (FDA):
Regulate food and drug products sold to the public
National Institutes of Health (NIH):
Involved with research on disease

15. Occupational Safety and Health Administration (OSHA)
Establish and enforce standards that protects workers from job related injuries and illnesses
U.S. Department of Health and Human Services (USDHHS):
A national agency that deals with health problems in the United States
World Health Organization (WHO)
An international agency sponsored by the United Nations. Investigate health problems throughout the world

16. https://quizlet.com/_5kgnri
Quizlet Practice
Government Agencies

17. Voluntary Agencies
Also called a nonprofit agency, can be at national, state or local level
Supported by donations, fund raisers, membership fees, and/or grants
Examples: March of Dimes, American Red Cross, Autism Speaks, American Diabetes Association

18. Health Insurance Plans
To help pay for costs of health care, most people rely on health insurance plans.
Premium - fee that the person pays for insurance coverage
Deductible - amount out of pocket a person pays before insurance will pay
Co-insurance - specific percentage of expenses are shared by the patient and ins company
Co-payment - specific amount person pays at the time of service

19. Preferred Provider Organization (PPO) - insurance has a contract with certain providers, which are the doctors and hospitals the employee is to use. If employee uses a provider outside of network, employee may pay more
A managed care that may be provided to employees of a large company or industry.

20. Federal Government Health Insurance Programs
Medicare - for persons over the age of 65 and those with a disability that has received Social Security benefits
Medicaid operated by each state but jointly funded by state and federal government

21. Workers’ Compensation - for workers injured on the job, it is paid for by employers and the state.
It also covers lost wages because of an on the job injury
TRICARE - a U.S. government health insurance plan for military personnel. The Veterans Administration provides for military veterans.

22. Managed Care
A health care delivery system designed to reduce the cost of health care while providing access to care through designated providers.
Provide quality care at the lowest possible cost.
Person is restricted in their choice of providers.
PPO’s and HMO’s are providers of managed care.

23. Health Insurance Plans and Organizational Structure
Quizlet Review
Health Insurance Plans and Organizational Structure

24. The Health Insurance Portability and Accountability Act
This act was passed in 1996.
Federal regulations that protect confidentiality of patient information and the ability to retain health insurance.
Has five main components
HIPAA

25. HIPAA

26. Patient Protection and Affordable Care Act
Designed to expand access to affordable health coverage in the United States
Signed into law in 2010
Young adults can be covered under their parents until 26 yo
Requires insurance to charge the same premium to all applicants regardless of preexisting conditions

27. Organizational Structure
All health care facilities have organizational structure
It can be simple or complex
Organizational structure is the line of authority, or chain of command
Indicates areas of responsibility
Should lead to the most efficient operation of the facility