Test Your Knowledge on Healthcare Policies and Systems

Study Notes

Managed care is a healthcare delivery system designed to control healthcare costs and improve the quality of care.
Managed care emphasizes coordination and efficiency in the provision of healthcare services.
Key features of managed care include limited provider networks, utilization review, physician gatekeeping, regulating hospital stays, and reimbursement to providers at discounted negotiated fees.
Medicare is a social insurance program for individuals aged 65 and older, those requiring kidney dialysis, and certain disabled individuals.
Medicare is divided into four parts, each covering specific healthcare services.
Medicaid is a government-funded health insurance program designed to provide subsidized or socialized health insurance for low-income individuals.
Negligence occurs when an injury to the plaintiff was preventable, and it was reasonable to undertake the activity that would have prevented the injury.
Malpractice insurance provides coverage for healthcare providers for liability arising from malpractice lawsuits.
The Affordable Care Act (ACA) has several key components designed to expand healthcare access and control costs.
The ACA's policies include Medicaid expansion, health insurance exchanges, quasi community rating, premium credits, employer plans, and individual mandate.- The ACA aimed to achieve universal coverage and control healthcare expenditures.

Policies introduced include Medicaid expansion, health insurance exchanges, employer plans, individual mandate, and changes to Medicare.
Penalties collected from large employers and individuals who don't purchase qualifying insurance, increased FICA tax for high earners, and industry fees fund the ACA.
Children can stay on parents' plan until 26.
Under Trump, the individual mandate penalty was set to $0, and alternative health insurance options were introduced.
Biden has invested in marketing and outreach and provided funding for increased premium credits and more incentives for states to expand Medicaid.
The Federal government pays 95% of newly eligible for states that decide to expand Medicaid, but only for 2 years.
The Inflation Reduction Act extended the increase in premium credits from the American Rescue Plan Act until 2025.