Term
| What can you prescribe for almost any problem? |
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Definition
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Term
| How good is the message in the chain of communication? |
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Definition
| Its as good as the poorest communicator. |
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Term
| What is the definition of communication? |
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Definition
| Communication focuses on how people use messages to generate meanings within and across various contexts, cultures, channels, and media... to promote the effective and ethical practice of human communication. |
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Term
| What has the greatest impact on effective communication? |
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Definition
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Term
| How does communication vary in effectiveness and comfort when speaking to a co-worker vs speaking to a boss? |
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Definition
| We are more comfortable speaking with a coworker and have more effective communication than speaking with a boss. |
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Term
| What are the 3 basic tasks of communication? |
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Definition
- To inform
-To entertain
- To persuade |
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Term
| What is the primary motivation for communication? |
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Definition
Power and Profit
Power: personal, employer, professional
Profit: monetary, credibility, career
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Term
| What are secondary motivations for communication? |
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Definition
- self expression
- warning
- celebration
- questioning/challenging |
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Term
| What happens to information when you add emotions to the content? |
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Definition
| It becomes memorable or motivational. |
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Term
| How does communication change when information becomes active? |
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Definition
| Information shifts from passive education to active collegial. |
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Term
| What are the 3 tasks of business communication? |
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Definition
To record information
To transfer information
To present information |
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Term
| What are 3 common elements to a service, product, or proposal? |
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Definition
Feature: characteristics that make it what it is, ie patient counseling
Advantage: something that has value to the end user, ie patient understands medications
Benefit: perceived value, ie better patient outcome |
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Term
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Definition
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Term
| Benefits are the message. What do they add? |
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Definition
They add interest by adding perceived value.
The benefits we listen for reflect things about us. |
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Term
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Definition
| Its a value for the end user. |
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Term
| What needs are satisifed by benefits? |
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Definition
Economy: saving time and money
Achievement: the results that you want
Safety/security: avoid problems, minimal risk
Esteem: gain respect, recognition, admiration |
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Term
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Definition
| - A perceived value that satisfies a need. |
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Term
| Where is the emphasis in communication? |
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Definition
- On the "you"
What does this mean for you? |
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Term
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Definition
| Its a request for more information and its an opportunity for you. |
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Term
| What functions do objections play in professional communication? |
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Definition
- Test credibility
- slow down communication
- show a need for more information |
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Term
| What are the typical objections? |
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Definition
- Misunderstanding: issue of rephrasing
- stalling: issue of needing more infomation
- skepticism: issue of trusting you or the information |
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Term
| If you have an objection what should you do? |
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Definition
- listen actively
- don't argue
- don't attack
- don't lose confidence
- do iluminate |
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Term
| How do you welcome an objective? |
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Definition
- be open, not defensive
- show comfort and confidence
- encourage more dialogue |
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Term
| How should you confirm an objective? |
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Definition
| - By Rephrasing, you should never guess |
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Term
| What are the steps in dealing with an objection? |
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Definition
welcome it
rephrase it
present/ transfer information
Test: close ended question
Ask: open ended questions |
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Term
| After presenting new information in dealing with an objection what is the next step? |
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Definition
| Test it with a close ended question. |
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Term
| What is the most important thing in communication? |
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Definition
| To hear what is not being said |
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Term
| What are health disparities? |
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Definition
- population-specific differences in the presence of disease, health outcomes, or access to health care
- refers to gaps in quality of health and health care across racial and ethnic groups |
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Term
| How does the death rate correspond to low income inequity? |
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Definition
| The death rate is also low. |
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Term
| What are the acute domestic agenda priorities? |
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Definition
- health care reform
-education
- economy |
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Term
| What percentage of health care spending does the government cover? |
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Definition
About 50%
- 2009 47%
-2016 over 50% |
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Term
| How does the US health care system compare to other countries in health status and cost? |
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Definition
| - highest costs and worse health status in the developing world. |
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Term
| Why is there an increasing growth of the uninsured? |
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Definition
- downturn in the economy and increased unemployment
- rising health care costs
- fiscal constraints on public health insurance coverage |
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Term
| There are higher rates of rising chronic illness in Detroit, what happens if these are not managed in a Primary Care setting? |
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Definition
- increased utilization of ED
- 69% preventable hospitalization rate
- these things result in higher healthcare costs |
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Term
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Definition
- There is a 15% decrease in the number of ERs
- increase number patients going to ERs
- 50% of ER visits are not urgent
- only 12% of ER visits result in hospital admission |
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Term
| Where in MI has the most preventable hospitalizations? |
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Definition
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Term
| What are the benefits of having a regular source of care? |
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Definition
- improves the utilization of ambulatory care
- encourages the receipt of preventable services
- reduces ER visits and preventable hospitalzations |
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Term
| Why do most uninsured delay seeking health care? |
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Definition
- they dont know where to find affordable health care in their local community
- they avoid care because of prohibitive costs |
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Term
| What are the 5 outcomes sought by the Kellogg Foundation's Community Voices grant initiative? |
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Definition
1. increases in acess to care for the uninsured and vulnerable
2. strengthening of the community safety net
3. Building of cost-effective and high quaility delivery systems
4. new model should provide system change so that it will be sustainable beyond the 5 yr grant
5. Develop practices to share with other communities |
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Term
| What is the objective of the Voices of Detroit Initiative? |
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Definition
| - providing leadership that helps organize care delivery and expand and improve access to cost-effective, high quality health care, for the uninsured and the underserved. |
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Term
| What is included in the VODI intervention model? |
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Definition
- Kellogg Grant
- Intevention
- VODI providers provide Primary care at no or a significantly reduced cost
- VIM active outreach in ERs >>> PC sites |
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Term
| What is the summary of the typical VODI patient? |
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Definition
| - singel, AA women, less employed, poor, sicker, supporting multiple family members |
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Term
| How much did the VODI shift active enrollees out of the ER and into a primary care setting? |
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Definition
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Term
| What kind of savings was seen with the VODI intervention model? |
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Definition
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Term
| What is VODI's premise with national implications? |
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Definition
| We prove that you can cover everyone and simultaneously decrease healthcare costs. |
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Term
| What are Obama's Health Care Reform Goals? |
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Definition
- lower costs
- cover everyone
- increase quality |
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Term
| What congressional committees are working on major health care reform legislation? |
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Definition
3 House committees: Education and Labor, Energy and Commerce, Ways and Means
2 Senate Committees: Finance Committee, HELP Committee |
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Term
| Can we cover everyone, control costs and make HC premiums afforable? |
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Definition
| Yes, but not with the current status quo |
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Term
| By covering everyone, what is the impact on me? |
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Definition
| The insured are already covering the uninsured |
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Term
| Where does health care reform need to focus? |
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Definition
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Term
| What is the public option? |
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Definition
- option that would be available through a public health insurance exchange
- allows families that make between 133% to 400% of the federal poverty level to have some subsidized health care |
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Term
| How will Americans benefit from new health reform laws? |
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Definition
- End the practice of denying insurance because of pre-existing conditions
- ends the practice of allowing the termination of insurance if you become seriously ill |
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Term
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Definition
| - Create health care affordability tax credits to help low and middle income families purchase insurance in the private market. |
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Term
| What are Health Care Co-Ops? |
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Definition
- non-profit, membership owned groups of individuals and small businesses who join together to negotiate healthcare rates as a group
- the annual rate increase of 12% is coming close to the 15% associated with private insurance plans.
- not cheaper, too small to drive down costs, cant compete |
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Term
| What is the core issue of healthcare reform? |
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Definition
| Its about the Gov protecting the American people. |
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Term
| What are the negotiated rates of the health care reform bill? |
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Definition
| - reimbursement rate between Medicare plus 5% and commercial rates. |
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Term
| What is the reimbursement schedule of the health care reform bill? |
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Definition
| - Medicare plus 5% for the 45 million uninsured americans |
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Term
| What is the problem with negotiated rates? |
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Definition
It adds 85 billion over 10yrs to cost.
In order to cover this the house bill expands to 150% FPL as opposed to 133%. |
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Term
| What is the Robust Public Option? |
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Definition
| it equals the more affordable the health insurance product, the more people are covered |
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Term
| What is the benefit of removing the anti-trust exemption? |
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Definition
- helps increase the insurance affordability
- eliminates the monopoly status, therefore drives down pricing in the market |
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Term
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Definition
| - An organized healthcare program designed to manage both the quality and the cost of healthcare. |
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Term
| What is a Health Maintance Organization? |
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Definition
- type of managed care plan where access to care is controlled by a primary care doctor
- coverage is limited to approved medical services
- prepaid
- members assigned to a PCP
- speciality care or surgery may require a referral or PA
- includes programs to improve health |
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Term
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Definition
- A preferred provider organization
- similar to a HMO
- not restricted to network physicians
- richer benefits when in-network
- do not need referral for a specialist |
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Term
| What is a Point of Sale Plan? |
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Definition
- HMO/PPO hybrid
- option to choose PCP
- richer benefits if you choose PCP for referrals
- larger costs if you go out of the network
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Term
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Definition
| - Physicians are hired to exclusively serve the HMO population |
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Term
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Definition
| - Large multi-speciality practice forms relationship with one HMO |
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Term
| What is an individual practice association? |
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Definition
Individual or small group practices contract with mulitple plans
- the most common type of physician network |
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Term
| What are the different types of physician risk arrangements? |
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Definition
Capitated: physician group assumes 100% risk
Shared Risk: Physician group and HMO share the risk
No Risk: paid on a fee for service basis but usually incentivized to improve performance |
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Term
| Compare the Early HMO vs Traditional Indemnity Insurance |
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Definition
- Not necessarily low cost. Cost greater than or equal to fee for service plans
- Enhanced Benefits
- Emphasis on preventive care, immunizations |
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Term
| What are some things included in the Federal HMO Act of 1973? |
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Definition
- required firms with 25 employees to offer a HMO
- pre-empted state laws that banned prepaid groups
- provided 375 million in federal funds to help develop HMOs |
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Term
| What did the Balanced Budget Act of 1997 create? |
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Definition
Medicare + Choice (Part C)
- Allows beneficiaries to receive Medicare benefits through private plans
- This gives them lower premiums, co pays, and deductibles and more benefits.
- favored by low income seniors
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Term
| What is a problem for Medicare Part C? |
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Definition
| - federal reimbursments did not match the costs |
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Term
| What resulted in the 2003 Medicare Modernization Act? |
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Definition
- Medicare Plus choice became Medicare Advantage, with enhanced payment from CMS
- Part D coverage becomes available in 2006
- MAPD plans created to combine Medicare Advantage Plans with prescription drug coverage |
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Term
| How does the National Committee for Quality Assurance assess HMO's and PPO's? |
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Definition
- Plans reviewed against 60 standards: access & service, prevention, quaility of providers, chronic care etc.
- Online report cards
- Healthcare Effectiveness data and information set |
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Term
| What are managed care pharmacy roles? |
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Definition
- Pharmacy Benefit Manager
- manage pharmacy claims processing systems
- utilization management
- contracting with pharmacies
- rebate contracting with other drug companies
- electronic prescribing |
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Term
| What are some utilization management tools for managed care pharmacy? |
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Definition
- formularies
- quantity limits
- step therapy
- PA |
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Term
| What are some clinical pharmacy programs? |
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Definition
- Medication Therapy Management
- Chronic care initative
- Advanced Medical Home
- Speciality Drug Management
- Review PA and appeals |
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