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Published byJade Marsh Modified over 9 years ago
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Types of Health Care Providers General Hospital Short hospitalization Run diagnostic tests Provide medical care Perform surgery Emergency Room (ER)
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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
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Convalescent Care Nursing Homes Physically ill or injured people of all ages
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Ambulatory care/clinics Where a variety of physicians work to combine practices Springfield Clinic - SpringfieldClinic.com
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Physician and Dental facilities Promote wellness and diagnosis of illness
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Rehabilitation Centers Patients who need physical therapy or hydrotherapy Patients who have lost a limb or organ function
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Health Maintenance organizations (HMO) Preventative health care Avoid unnecessary hospitalization
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Home Health Care Agencies For patients who need health services but not hospitalization
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Senior Day Care They live at home but need a place to be cared for during the day. Provide meals Administer medication
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World Health organization Agency founded by the United Nations Concerned with world health problems Compiles stats Investigates serious health problems Publishes health information
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Hospice They care for terminally ill patients Their clients are nearing the end of life Provide care in the home or a hospice facility
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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
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Veterans Administration Hospital Federally supported hospitals for all veterans who served in the armed forces
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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.
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State Psychiatric Hospitals Serve the mentally ill
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State University Medical Centers Provide training for health care workers Provide medical care Medical research
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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
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County Hospitals Provide care for the ill and injured Patients who require financial help
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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
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Seniors Centers Provide care geriatric patients
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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
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Volunteer Agencies American Cancer Society March of Dimes American Red Cross American Heart Association American Diabetes Association National Association of Mental Health
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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
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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
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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
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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)
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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
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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
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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
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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
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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.
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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.
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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.
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Medicaid Health Insurance provided by the federal and state government. People who are blind, disabled or of low income qualify
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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.
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