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Hcm549 Ws5 Questions

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HCM549 WS5 Questions

1. What is the main source of funding in the U.S. for health care services?

The main source of funding for healthcare in the US is the people. Though there is funding from the government; the funds ultimately come from the people through tax money.

2. What are some of the factors that affect the health status of people? Include at least two access (to health services) related factors and two non-access (to health services) related factors.

Access to preventative care and quality of provider care are two access related factors. Non-access related factors are misdiagnosis due to incorrect coding and high insurance cost resulting in lack of care.

3. In what ways can good leadership and management control health care costs?

Proper management of data and information can control costs. The National Committee for Quality Assurance (NCQA) developed the Healthcare effectiveness Data and Information Set (HEDIS). HEDIS relies principally on administrative data to measure six dimensions of prepaid managed care plans: quality management, physicians’ credentials, members’ rights and responsibilities, preventive health services, utilization management, and medical records.

4. How are quality issues affecting facilities?

Two national organizations that monitor quality of care are the Joint Commission and the NCQA. Participation in the Joint Commission is voluntary, but states may link their facility licensure requirements to Joint Commission participation, or payers may link their reimbursement to facilities that have attained Joint Commission accreditation. The Joint Commission has established performance standards and quality indicators that facilities must meet, and regular site visits by Joint Commission teams assess facility compliance with these standards.

5. Name at least three of the six types of

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...HCM549 WS5 Questions 1. What is the main source of funding in the U.S. for health care services? Medicare, Medicaid and private insurance are the main sources of funding for the U.S. healthcare services. 2. What are some of the factors that affect the health status of people? Include at least two access (to health services) related factors and two non-access (to health services) related factors. There are multiple factors that affect the health status of people and attaining access can be difficult due to income disparity, lack of health insurance coverage and lack of available locations particularly when people are living in rural areas. Two non-access related factors would include lack of transportation for individuals to seek care or even being too ill to travel to seek care. 3. In what ways can good leadership and management control health care costs? Excellent leaders drive accountability and efficiencies that result in controlled costs in the healthcare environment. Good leaders provide accurate and timely communication, clear expectations, attainable and incentive-driven goals resulting in controlled costs due to a well-managed environment in which to provide care. 4. How are quality issues affecting facilities? Many facilities are financially stressed and facilities are in need of improvements that management are unable to make due to lack of funding. In addition, providing care equals high expense for supplies and equipment as well...

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