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Questions and Answers
Questions and Answers
What is the purpose of managed care?
What is the purpose of managed care?
- To increase healthcare costs
- To decrease the quality of care
- To limit access to healthcare providers
- To ensure patients receive appropriate care for their needs (correct)
What is the primary goal of managed care?
What is the primary goal of managed care?
- To improve the quality of care while controlling healthcare costs (correct)
- To reduce the quality of care while increasing healthcare costs
- To increase the number of healthcare providers in the network
- To provide unlimited access to healthcare services
What is the key feature of managed care?
What is the key feature of managed care?
- No physician gatekeeping
- Unlimited provider networks
- Utilization review (correct)
- No regulation of hospital stays
What are some key features of managed care?
What are some key features of managed care?
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Who is eligible for Medicare?
Who is eligible for Medicare?
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What are the three types of managed care plans?
What are the three types of managed care plans?
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Who is eligible for Medicare?
Who is eligible for Medicare?
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What are the four parts of Medicare?
What are the four parts of Medicare?
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What is Medicaid?
What is Medicaid?
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What is Medicaid?
What is Medicaid?
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What is negligence?
What is negligence?
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What is negligence?
What is negligence?
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What is malpractice insurance?
What is malpractice insurance?
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What is malpractice insurance?
What is malpractice insurance?
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What is the purpose of the Affordable Care Act (ACA)?
What is the purpose of the Affordable Care Act (ACA)?
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What is the primary goal of the Affordable Care Act (ACA)?
What is the primary goal of the Affordable Care Act (ACA)?
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Questions and Answers
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Study Notes
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.
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