Section 1
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Percent of HHS budget to Medicaid
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Last updated
6 years ago
Date created
Mar 1, 2020
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Section 1
(50 cards)
Percent of HHS budget to Medicaid
31%
Supply sensitive care
doctor visists, hospital beds etc
PROs and QIOs
1982/1992
Year medicaid and meducare enacted
1965
Approximate budget for HHS
Around $900,00 (like $964,000) billion
Quality Assurance
Inspecting and throwing out bad products, find source of mistake (inspection)
CARE Act
1990 Support for ppl with HIV/AIDS
Name change to AHRQ
1999
State responsibility - physicians
Licensing boards (physicians and hospitals), discipline
Triple Aim of Transformative Care
patient experience, health of populations, reducing costs
preference sensitive care
care with tradeoffs- patients need to choose which things they value more
COBRA
1986 Consolidated Omnibus Reconciliation Act continuation of coverage option for families who lose employer benefits
Private Reg- managed care
National COmmittee on Quality Assurances (NCQA)
Percent of HHS budget that goes to Medicare
54%
kinds of quality problems
misuse, overuse, underuse
Pure Food and Drug Act
1906 in response to the jungle
Year medcare extended to cover renal disease
1972
Things required for health care transformation
Use of EHR, health info exchange with providers, knowledge and data driver learning system
WHere does regulation happen in US Healthcare?
Federal, state, private orgs
regulatory capture
Regulatory agency gets dominated by the industry they are meant to regulate
Fed reg - managed care
HMO Act of 1973 - stimulated growth of HMOS
Quality Improvement
don't react to indivudal defects - analyze system and fix it (prvention)
CMS responsibilities
Administer Medicare, Medicaid, SHCIP, regulate lab testing on humans
Balanced Budget Act
1997 SCHIP,
State reg - hospitals
liscensure,
federalism
system of gov with both central authority and autonomous constituent jurisdiction
What percent of HHS budget is CMS
88%
HRSA
Health Resources and Services Administration focuses on uninsured, underserved and special needs populations
Kefauver-Harris Efficacy Amendment
1962 in response to thalidiomide required evidence of efficacy not just safety
HMO Act passed in
1980
State reg - managed care
insurance
Hatch-Waxman Act
1984 Generics only need to prove equal bioavailability
Medicare Prescription Drug Improvement and Modernization Act (MMA)
2003 Creaed medicare part D and medicare advantage`
What branch is responsible for implementation and regulation of health care
Executive
Donabedian Model
Model to evaluate quality of health care Structure, Process, Outcome
AHRQ
Agency for Healthcare Research and Quality created in 1989
Most important driver of regulation
Cost
Fed responsibility - physicians
coordinate discipline, workforce management
What is most of HHS Budget
entitlements
HHS Duties
Medicare, Medicaid, medical and social science research, preventing outbreak of infectious diseases (and immunizations), food and drug safety, financial assistance and services for low income families, improve maternal and infant health, head start, preventing domestic violence, susbtance abuse treatment and prevention, services for older americans, health service for native americans,
McCarran Ferguson Act
State regulation of insurance,
ERISA
1974 Employee Retirement Income Security Act exemption of employer insurance from state regulation
Most wuality measures and why
Process measures simplicity
Fed reg - hospitals
medicare, economic (Hill Burton) (CON),
What domains of healthcare does regulation focus on?
Cost, Quality, Access
EMTALA
1985 Have to treat everyone who comes to ER
Private reg- hospitals
Quality oversight, accreditation
Federal power in health regulation (2 areas)
General welfare spending (Medicare etc.) Commerce between states (like food and drug!!)
Medical Device Amendments
1976 exapnded fda authority
HMO Act
1973 federal action to make HMOs more available
Section 2
(13 cards)