Answers to insurance wkst

matching 1) b –health care cost containment 2) d—proprietary institution 3) a—co-insurance 4) c--TRICARE 5) e—prospective payment

Fill in the blank 6) government insurance plans 7) premium 8)co-pay 9)deductible 10) direct pay 11) non-profit 12) medicare 13) prospective payment 14) medicaid 15) managed care

SHORT ANSWER 16) Managed care is a system of health care plans that puts health care providers in the position of managing a patient’s use of health care. Examples include HMO, PPO, and POS plans.

SHORT ANSWER CONT. 17) Managed care plans are different than private insurance plans in the following ways: --offer a select group of primary care providers --provide broad range of services, focusing on primary & preventative care --eliminate duplicate services --encourage cost containment --provide profit for provider & insurance company --include utilization reviews

Short answer cont. 18) Most Americans are covered by private insurance plans which normally come from employers. Americans who are over 65, low income, disabled, or military are covered by government plans paid for by taxes. Services not covered by insurance or if a person does not have insurance must be covered through direct payment from the patient or responsible party. 19) Most Americans rely on employer-provided health insurance coverage to pay most of their medical bills.

SHORT ANSWER CONT. 20) The factors contributing to the increase in health care costs include: rising drug costs, technology costs, and professional costs as well as our aging population. 21) Health care professionals should understand the basic economic aspects of health care so that they can make conscious and practical decisions that promote affordable, quality care for every patient.