HMGT 3301 Question with accurate
answers, 100% Accurate, rated A+
Health Services Professionals - ✔✔-The US health care industry is the largest and most powerful
employer
9% of the total labor force**
17.9% of the
...
HMGT 3301 Question with accurate
answers, 100% Accurate, rated A+
Health Services Professionals - ✔✔-The US health care industry is the largest and most powerful
employer
9% of the total labor force**
17.9% of the Gross Domestic Product in 2011
Health care will continue to grow because: - ✔✔-growth in population
aging of the population
Types of professionals - ✔✔-Physicians
Nurses
Dentists
Pharmacists
Optometrists
Psychologists
Podiatrists
Chiropractors
Nonphysician practitioners
Health administrators
Allied health professionals
Allied health professionals - ✔✔-Therapists
Social Workers
Educators
Health Personnel: Physicians - ✔✔-Play a central role in evaluating the patient
States require licensure
Graduate from an accredited medical school
Pass licensure
Complete residency, paid graduate medical education 2-6 years
Number of active physicians increased
See Table 4-2
Two types of physicians - ✔✔-MD - Doctor of Medicine
Views medical treatment as active intervention to counter reaction to neutralize the effects of disease
Most are Specialist
DO - Doctor of Osteopathic Medicine
Emphasizes the musculoskeletal system of the body such corrections of joints or tissue
Most are Generalist
Similarities and differences between physicians - ✔✔-Both use accepted methods of treatment (drugs,
surgery)
They differ in their philosophies and approach to medicine
Health Services Professionals Work Places - ✔✔-Hospitals
Managed Care Organizations
Nursing Homes
Mental health facilities
Insurance firms
Pharmaceutical Companies
Outpatient
Community Health Centers
Mental Health Centers
School Clinics
Osteopathic Medicine - ✔✔-Practiced by DO's
Stresses preventative medicine (i.e. diet, environment, other factors)
Takes a holistic approach
< 6% of physicians are osteopaths
Physicians: Generalists and Specialists - ✔✔-Primary Care Physicians (Primary Care Provider) /
Generalists
Train in family medicine/general practice, general internal medicine and pediatrics
Provide preventative medicine (i.e. exams, immunizations, mammographies, pap smears)
Patients problems less severe and occur less frequently
Specialists - ✔✔-Physicians in nonprimary care specialties
Must seek certification in a medical specialization
Takes more years of advanced residence training plus years of practice
General Practitioner/Family Practice accounts for greatest proportion of ambulatory care visits
Obstetrics/Gynecology:
spent most hours in patient care per week
highest in operating expense and malpractice premium
Surgeons paid most (over $220,540 per year)
Specialists
Six Functional Groups: - ✔✔-1) Internal medicine
2) Medical
3) Obstetrics/Gynecology
4) Surgery
5) Hospital based radiology, anesthesiology, pathology
6) Psychiatry
Primary Care - ✔✔-Different according to time, focus and scope of service to patients
Primary Care
Five Areas of Distinction: - ✔✔-1) the first contact to the health care system
2) in managed care, primary care providers are
"gate-keepers"
3) primary care is longitudinal, they follow up in treatment and coordinate care (they serve as patient
advisors and advocates)
4) focuses on the whole person (holistic, integrates)
5) spend much time in ambulatory care settings
Specialty Care
Five Areas of Distinction - ✔✔-1) Seen after patient has seen a General Practitioner usually
2) Requires referral from a Primary Care Provider to see a patient
3) Episodic, more focused and intense
4) Limited to an illness episode
Deal with specific disease or body organs
5) Time spent in inpatient hospitals, using state-of art technology
Issues in Medical Practices
Consequences of Too Many Specialists: - ✔✔-High volume of intensive, expense and invasive
procedures
Rises health care costs
Surgeries grew at two times the rate of population growth
Health Services Professionals Employment - ✔✔-40.5% employed by hospitals
12.1% by nursing and personal care facilities
10.0% physician offices and clinics
Nurses Reasons for Shortfall - ✔✔-sluggish wages
low job satisfaction
inadequate career mobility
falling nursing enrollments
demand from other alternative hospital sites
Allied Health Professionals - ✔✔-Includes many health-related areas
Constitutes 60% of U.S. health care workforce
Two Broad Categories:
1) Technicians/assistants
2) Therapists/technologists
Health Service Administrators - ✔✔-Employed at various levels of organizations
Manage integrated delivery organizations that are complex
MHA - Master in Health Administration
MHSA - Master in Health Service Admin
MBA - Master in Business Administration
MPH - Master in Public Health
MPA - Master in Public Administration/Affairs
HSA Challenges - ✔✔-financing and payment structures
work with decreasing levels of reimbursement
pressure of uncompensated care
high quality
community health service
demands by both public and private payers
new policy developments
changing competitive environment
maintaining integrity
What are the four principles of risk: - ✔✔-Risk is unpredictable
Risk can be predicted with some accuracy in a large group
Insurance can transfer risk from the individual to group through pooling of resources
Losses are shared by all members
List two reasons that Medicare is in jeopardy - ✔✔-Rising cost of delivering health care
An aging population
Shrinking workforce to support tax revenues
What is a disadvantage of fee-for-service health care? - ✔✔-Provider induced demand, uncontrollable
costs
Why was there growth in Managed Care? - ✔✔-Flaws in fee for service
Weakened economic position of providers
Demand to control healthcare spending
What is an ACO? - ✔✔-Accountable Care Organization
Complexity of financing in the US: - ✔✔-many private plans
many government programs
many payment methods
loss of insurance by many under the ACA
government is expected to facilitate the purchase of insurance under the ACA
Role and Scope of Health Care Financing - ✔✔-Financing influences supply of health care
Production of health care services - capital expenditures, renovations, expansions
New services and technology proliferate when they are covered by health insurance
New models of health care organization may form
Supply and distribution of health care professionals is affected
Effect on total health care expenditures
Financing and Cost Control - ✔✔-Expenditures are increased by
Expansion of health insurance
Increase in health insurance premiums
Expenditures can be reduced by
Restricting insurance (demand-side rationing)
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