Mha 707 Exam D

HIPPA {Ans: also created national standards for certain electronic health care transactions to improve efficiency and privacy Important to constrain discrimination because of poor health status}community rating {Ans: Consistent with their charitable mission, Blue Cross and Blue Shield plans used _______, not experience rating, to set prices for their products [data was too poor to do anything else]}Indemnity health insurance {Ans: reimburses an individual for fees paid for medical services after they are performed Payments may be made to the patient or directly to the provider, on a retrospective, fee-for-service basis. Providers not employed by, contracted to, or owned by the payer (insurer) Insurer simply pays for care according to some agreed-to schedule Financial responsibility (or risk) for the cost of health care is born by the insurer}Capitation {Ans: Practice of paying flat fee to health care provider in exchange for stipulated range of services during a given time period, usually a year Flat fee guarantees medical coverage for that person regardless of how much or how little care the individual needs or uses}1899 {Ans: Founding of Association of Hospital Superintendents in_____ Became the American Hospital Association (AHA)}Taxation Private sector (employers) or individual contributions (OOP