Health Care Finance Models
There are two broad approaches to financing health care: a market-based approach and a government-financed approach. Answer the 12 questions, providing 3-4 sentences minimum for each approach.
Include any references used at the end of the chart.
Market-based
(HMO, POS, PPO, etc.) |
Government-financed
(Medicare, Medicaid, Tricare, etc.) |
|
Who is provided access? | ||
How much coverage is provided? | ||
How are the services paid for? | ||
How does reimbursement apply? | ||
Are there limitations of care? | ||
What guides care decision for patients? | ||
What is the quality of services (use HEDIS website for answer)? | ||
Are there competitive options? | ||
How much are prevention and wellness emphasized and measured? | ||
How are health care costs managed and controlled? | ||
How are medical advances generated? | ||
How is health care reform established? |