Pharm Management

  1. Does health care have a finite supply and infinite demand?
  2. WHO definition of good health?
    • Goodness
    • Fairness
    • US sucks at fairness no $$ no doctor
  3. 3 things that HC system should accomplish?
    • 1. Improve health of population
    • 2. Respond to peoples expectations
    • 3. Provide financial protection against the costs of ill health (cheaper so people can afford)
  4. How to measure outcomes of health?
    • Look at (US sucks at fair and access)
    • 1. fair financing
    • 2. access
    • 3. responsiveness
    • 4. equitable
    • 5. good quality
    • 6. affordable
  5. How is a patient/dr/insurance interrelated?
    • Dr's provide health services
    • Insurance provides payment
    • Patient provides the $$
    • (Patient pays insurance and when patient see Dr they get money from insurance)
    • Insurance loves healthy patients (don't pay dr keep all profit)
  6. T/F Is health care regulated on a state level?
  7. HOW to decrease expenditure growth?
    • 1. Managed care utilization controls (tell you how much we pay you)
    • 2. Hospitial prospective payment (pay one set price for service)
    • 3. Managed care physician fee restriction (this much for this treatment only)
  8. THINGS increase health spending?
    • 1. new technology
    • 2. more old fucks
    • 3. medical specialization
    • 4. uninsured/underinsured
    • 5. labor intensity
  9. What is supplier induced demand?
    Physician controls both supply and demand on goods and services based on reimbursement so they would do what pays them the most.
  10. What best describes the US health care system?
    High tech and high cost
  11. What best describes the current status in the US?
    Need for hc exceeds what we can provide
  12. What are the 3 purposes of healthcare reform?
    • 1. rein in high costs
    • 2. improve quality
    • 3. increase access to insurance
  13. What is the medical tort system?
    Dr's getting sued for everything and malpractice payments.
  14. What is defensive medicine?
    Md's doing all the tests and stuff to protect themselves from medical tort system. 
  15. What are the 2 types of insurance?
    • 1. indemnity - pt sumbits bill to ins, expensive for ins, premiums increase
    • 2. service benefit - dr submit claims cost controled by contracts
  16. 5 Types of managed care programs?
    • 1. Health maintenance organization (HMO) - most restrictive
    • 2. Independent practice associations (IPA)
    • 3. Preferred provider organization (PPO)
    • 4. Point of service (POS)
    • 5. Managed indemnity - least restrictive
  17. What is HSA?
    health savings account where its patient funded and patient get tax benefits
  18. What is HRA?
    Health reimbursement account - employer funded - employer gets tax benefit
  19. What is value based insurance design?
    • Tier based on type of care.
    • Little to no co pay for preventive and maintenance care.
  20. What is the core components of a business plan?
    • Business strategy
    • Mission statement
    • external and internal environments
    • opportunities and threats to practice
Card Set
Pharm Management