Health Care Finance Models
A COMMUNITY OF LEARNERS’ 6
There are two broad approaches to financing health care: a market-based approach and a government-financed approach. Answer the 12 questions, providing 3-4 sentences minimum for each approach.
Include any references used at the end of the chart.
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Market-based (HMO, POS, PPO, etc.) |
Government-financed (Medicare, Medicaid, Tricare, etc.) |
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Who is provided access? |
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How much coverage is provided? |
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How are the services paid for? |
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How does reimbursement apply? |
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Are there limitations of care? |
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What guides care decision for patients? |
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What is the quality of services (use HEDIS website for answer)? |
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Are there competitive options? |
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How much are prevention and wellness emphasized and measured? |
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How are health care costs managed and controlled? |
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How are medical advances generated? |
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How is health care reform established? |
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