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
CEO and Dept. Heads
Business Office
Billers, Coders, Medical Records, Social Services
Insurance filers, Admission clerks
Maintance/Housekeeping
Janitors
Heating and Air
Maintance
Nursing
RN
LPN
CNA or MNA , Unit secretary
Central Supply
Stockers
Inventory
Delivery
Dietary
Dietician
Food service manager
cooks, chef, servers
Pharmacy
Pharmacists
Pharmacy Tech
Labratory
Phelebotomists
Lab Techs
Pathologist
Radiology
CT/MRI techs
Sonographers
X-ray tech, Radiologist
Therapy
Physical Therapist, PTA's
Occupational Therapist, OTA's
Speech Therapists, Child Life, Chaplins
Volunteers
Gift shop workers
Greeters
mail delivery
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)