Health Care Facilities

Hospitals

Provide Diagnosis, Treatment, Education, Research, Cure

Hospitals

• Private (central Baptist)

• Religious (St. Mary’s and Elizabeth's)

• For profit (Lifepoint)• Nonprofit (Norton)• Government (VA)

• General – treat many different ages and diseases ( UofL)

• Specialty – treat a specific age group or disease (Kosairs)

Long Term Care Facilities

• LTC , Nursing Homes, Retirement Homes, Assisted Living

• Serve the elderly or disabled population

• They are called Residents instead of Patients

Medical Offices

• One MD or several Doctors together offer diagnosis, treatment, exams, labs, minor surgeries

• Many different specialties now, we will study in the next chapter, how many can you name now?

Dental Offices

• One dentist or several dentists practicing in an office

• Orthodontics, Peridontics, Prostodontics, Oral surgery

Clinics• Group of doctors or special care healthcare

workers

• Urgent treatment centers

• Minor surgery centers

• Physical therapy clinics

• Oncology clinics

Health Departments

• Provide health care to the community and low income families

• Treat and Track STD’s and communicable diseases

• Provide Immunizations for children

Optical Centers

• Provide exams and treatment for the eyes

Emergency Care Services

• Ambulance, rescue squad, fire department, helicopter ambulance, police

Laboratories

• Medical labs perform tests such as blood tests

• Dental labs make false teeth and crowns

Home Health Care

• Provide nursing care, personal care, therapies such as PT, OT, ST, and homemaking in the patients home

Hosparus

• Hosparus can be home health care or facility care

• Hosparus is care for the terminally ill (usually 6 months or less to live)

• Focus is on pain management/comfort and dying with dignity

• Assist families with grieving process

Mental Health Facilities

• They treat chemical (drug) abuse

• They treat physical abuse

• They treat mental disorders

Genetic Counseling Centers

• Treat and provide education for those having trouble conceiving a baby

• Also treat those who have had a baby with a birth defect caused by genetics

HMO (Health maintenance Organization)

• HMO’s are directed toward preventive health care

• Focus on Education and keeping persons well before illness occurs

• Example: Ephraim McDowell has some wellness centers

Industrial Health Care Centers

• Large companies may have health care centers to care for their employees.

• Focus on teaching and basic care (flu shots, first aid, etc.)

School Health Services

• Provide emergency care, speech and vision tests, education, maintain student health records, promote health related activities for students

Government Health Agencies

NIH – WHO - CDC – FDA - OSHA

Government in Healthcare

• NIH – National Institute of Health performs research

• WHO- World Health Organization – concerned with world health issues

• CDC- Center for disease control & prevention

• FDA- Food and Drug Administration• OSHA- Occupational Safety & Health

Administration (standards that protect workers from job related illness or injury)

Health Insurance Plans

What do they pay?

• Deductible – the amount paid by the patient before policy pays

• Co-Insurance – Insurance pays certain percentage of bill and patient pays certain percentage (80/20)

• Co-Payment – A specific amount paid by the patient for a particular service

• Premium – The amount paid to your insurance company for the cost of having insurance

Kinds of Insurance

• HMO’s – usually have a monthly fee or membership fee, emphasis is on preventive care

• PPO’s – preferred provider organization, large companies often offer this form of insurance to their employees, the insurance company contracts with certain health care agencies and the patient must use those to get full benefit of the insurance

Kinds of Insurance

• Medicare – provided by the federal government for people over 65 or disabled and having received SSI for 2 years

• Medicare Type A pays for Hospital care, Type B is pays for medical care

• Medicaid – governed by individual states, insurance for low income, children who qualify for public assistance, physically disabled or blind

Kinds of Insurance

• KCHIP – provides insurance to uninsured children of working families who earn too little to afford private insurance but make too much to qualify for Medicaid

• Worker’s Comp – pays if you are injured on the job

• Tricare – Insurance for military personnel and their families

Managed Care

• Managed Care came about due to rising costs of healthcare

• They are a secondary company hired by insurance companies to negotiate costs with healthcare facilities , they review charges, needs, etc.

Organizational Chart for Health Care

Hospital Organizational Chart

R a d io lo gyC T /M R I te chsS o no gra ph e rs

X -ra y te ch , R a d io lo g ist

D ie ta ryD ie tic ian

F o o d se rv ice m a na g erco o ks , che f, se rve rs

M a in ta n ce /H o u se ke ep ingJa n ito rs

H e a tin g a nd A irM a in ta n ce

T h e ra pyP h ys ica l T h e ra p is t, P T A 's

O ccu pa tio n a l T h era p is t, O T A 'sS p e ech Th e ra p is ts , C h ild L ife , C ha p lins

P h a rm a cyP h a rm a c is ts

P h a rm acy T e ch

N u rs ingR N

L P NC N A o r M N A , U n it se c re ta ry

V o lu n te e rsG ift sho p w o rke rs

G re e te rsm a il d e live ry

L a b ra to ryP h e leb o tom is ts

L a b Te chsP a tho log ist

C e n tra l S u p p lyS to cke rsIn ven to ryD e live ry

C E O a n d D e pt. H e a dsB u s ine ss O ffice

B ille rs , C o d e rs , M e d ica l R e co rd s, S o c ia l S e rv icesIn su ra nce f ile rs , A d m iss io n c le rks

Cost Containment

Trying to Control the Rising Cost of Health Care!

Things that drive up the cost of Health care

• High tech equipment

• People living longer require more services

• Increase in lawsuits

• Increase in settlements from malpractice

• Malpractice insurance driven up

Cost Containment Strategies

• DRG’s – Diagnostic Related Groups

• Certain diagnosis are grouped together in one payment (used by Medicare and Medicaid)

• For example: Medicare may offer $3000 for a pneumonia stay, if the cost of care rises above that the hospital loses money

More CC • Combination of services – “one stop

shopping”• Outpatient services – no admission to

hospital is cheaper, sent home with home health (mom’s use to stay 1 week in hosp. After birth, now 24-48 hours)

• Mass or Bulk purchasing – cheaper price• Energy conservation – bills cost less• Early intervention and preventive services

(HMO’s)