HCM549 WS 5 Questions 4
HCM549 WS5 Questions
1. What is the main source of funding in the U.S. for health care services?
The main source of funding for healthcare in the US is the people. Though there is funding from the government; the funds ultimately come from the people through tax money.
2. What are some of the factors that affect the health status of people? Include at least two access (to health services) related factors and two non-access (to health services) related factors.
Access to preventative care and quality of provider care are two access related factors. Non-access related factors are misdiagnosis due to incorrect coding and high insurance cost resulting in lack of care.
3. In what ways can good leadership and management control health care costs?
Proper management of data and information can control costs. The National Committee for Quality Assurance (NCQA) developed the Healthcare effectiveness Data and Information Set (HEDIS). HEDIS relies principally on administrative data to measure six dimensions of prepaid managed care plans: quality management, physicians’ credentials, members’ rights and responsibilities, preventive health services, utilization management, and medical records.
4. How are quality issues affecting facilities?
Two national organizations that monitor quality of care are the Joint Commission and the NCQA. Participation in the Joint Commission is voluntary, but states may link their facility licensure requirements to Joint Commission participation, or payers may link their reimbursement to facilities that have attained Joint Commission accreditation. The Joint Commission has established performance standards and quality indicators that facilities must meet, and regular site visits by Joint Commission teams assess facility compliance with these standards.
5. Name at least three of the six types of legislation that govern a health care system.
Authorizing or enabling legislation to provide governmental authority to carry out a program
1. What is the main source of funding in the U.S. for health care services?
The main source of funding for healthcare in the US is the people. Though there is funding from the government; the funds ultimately come from the people through tax money.
2. What are some of the factors that affect the health status of people? Include at least two access (to health services) related factors and two non-access (to health services) related factors.
Access to preventative care and quality of provider care are two access related factors. Non-access related factors are misdiagnosis due to incorrect coding and high insurance cost resulting in lack of care.
3. In what ways can good leadership and management control health care costs?
Proper management of data and information can control costs. The National Committee for Quality Assurance (NCQA) developed the Healthcare effectiveness Data and Information Set (HEDIS). HEDIS relies principally on administrative data to measure six dimensions of prepaid managed care plans: quality management, physicians’ credentials, members’ rights and responsibilities, preventive health services, utilization management, and medical records.
4. How are quality issues affecting facilities?
Two national organizations that monitor quality of care are the Joint Commission and the NCQA. Participation in the Joint Commission is voluntary, but states may link their facility licensure requirements to Joint Commission participation, or payers may link their reimbursement to facilities that have attained Joint Commission accreditation. The Joint Commission has established performance standards and quality indicators that facilities must meet, and regular site visits by Joint Commission teams assess facility compliance with these standards.
5. Name at least three of the six types of legislation that govern a health care system.
Authorizing or enabling legislation to provide governmental authority to carry out a program