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MCOs manage - - Financing - Insurance - Delivery - Payment MCOs exercise formal control over the utilization of - Health Care Services The most common methods used for reimbursing providers are: - - Capitation - Discounted fees - Salaries Capitation - - The provider is paid a fixed monthly sum per enrollee - Often called a per member, per month (PMPM) payment Discounted Fees - - A modified form of fee-for-service - Discounts are offered in exchange for a certain volume of business Sa...

The US health care industry - LARGEST and MOST POWERFUL employer in the nation employs more than 13% of total labor force in the US growing demand for health services professionals - growing in population -aging of population -expansion of health insurance under the ACA populations of 65 years and older - have grown for the past years. and baby bombers are getting older and will disappear by 2060 problems with aging population - - decline in working age population - increase in health c...

THE US HEALTH CARE INDUSTRY - -largest and most powerful employer in the nation -employs more than 13% of the total labor force in the US -growing demand for health services: 1)growth of overall population, mainly due to immigration 2)aging of the population, as baby boomers continues to turn ages 65+ through 2029 3)increased life expectancies PROBLEMS WITH AGING POPULATION - -decline in working-age population -increase in health care cost -increase in dependency ratio -changes to the e...

US HC Industry - largest and most powerful employer in the nation % of US labor force being HC related - 13 Growing demand for health service professionals because of - Growth in population Aging of population Expansion of health insurance under the ACA problems with the aging population? - Decline in working-age population Increase in health care cost Increase in dependency ratio Changes to the economy physicians - All states require physicians to be licensed to practice physicians li...

What is the focus of public health? - people (population health, community health, prevention) also focuses on prevention! What does someone in public health do? - Everyone does different things. -Environmental health, epidemiology, occupational safety and health, policy makers, educators, scientists, etc. Public health - The science and art of preventing disease, prolonging life, and promoting physical health and efficiency through organized community efforts for the sanitation of the env...

Long-term care is needed under three main circumstances... - 1-physical or mental deficits/cognitive impairment 2-continuity of care after hospitalization 3-care in specialized environments Who are the primary clients of LTC services? - the elderly, but most elderly do not need LTC LTC services are provided in both... - Institution-based and community-based Most LTC is provided by... - informally by family and friend LTC includes... - 1-meals on wheels 2- finances/money management 3- me...