Ethics and Public Health

Chapter 8 Healthcare Financing 200

Introduction 200

Healthcare Spending by Service Type 201

Healthcare Spending by Sources of Funds 202

Health Insurance as a Payer for Healthcare

Services 202

Types of Health Insurance 203

Cost Sharing of Health Services 203

Types of Health Insurance Plans 204

Public Financing of Healthcare Services 206

Reimbursement Methods of Private Health

Insurance Plans 209

Governmental Reimbursement Methods for Healthcare Services 210

Healthcare Financial Management 213

Funds Disbursement 213

Conclusion 213

Vocabulary 214

References 214

Notes 216

Student Activities 217

Chapter 9 Managed Care Impact on

Healthcare Delivery 229

Introduction 230

History of Managed Care 230

The Managed Care Organization Payment

Plan 232

Cost-Control Measures of Managed Care Organizations 232

Medicare and Medicaid Managed Care 233

Assessment of Managed Care Models 234

Managed Care Accreditation 235

Issues with Managed Care Operations 235

Challenges to Managed Care 235

Conclusion 236

Vocabulary 236

References 237

Notes 238

Student Activities 239

vi Contents

Chapter 10 Information Technology

Impact on Health Care 251

Introduction 252

History of Information Technology in the

Healthcare Industry 252

Electronic Health Records 253

Barriers to Electronic Health Record

Implementation 254

Clinical Decision Support Systems 255

Pharmacy Benefit Managers 256

Drug–Drug Interactions 256

Telehealth 257

Avera Ecare 257

Million Hearts 257

Chief Information Officer 258

Council for Affordable Quality

Health Care 258

Other Applications 258

Applied Health Information Technology 259

The Importance of Health Information Technology 260

Conclusion 261

Vocabulary 261

References 261

Notes 264

Student Activities 265