U.S. Health Care Access, Payment Models, and Community Care Strategies

All flashcards

Medicare

Federal health insurance primarily for people aged 65 and older, plus certain other eligible individuals.

Medicaid

Public insurance for eligible low-income populations and some people with disabilities; states administer it, so rules vary.

Telehealth

Health services provided remotely using technology; access depends on suitable devices, connectivity, and appropriate services.

Medical home

An integrated, team-based approach to primary care that addresses the whole person.

Care desert

An area where people have limited access to health care services.

Quiz questions

1. How does a bundled payment generally organize reimbursement?Answer: It pays for an episode of care involving defined services over a set period.
2. What is a central responsibility of an accountable care organization?Answer: To improve outcomes and manage spending for a defined population.
3. What does an integrated service line organize care around?Answer: A particular disease or health condition across the continuum of care.
4. What can happen to hospitals with higher-than-expected readmission levels under the Hospital Readmissions Reduction Program?Answer: They may receive a financial penalty.
5. Which services cannot be replaced by telehealth alone?Answer: Emergency, inpatient, and surgical care requiring in-person infrastructure.