Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:Introduction to Health Care and Public Health in the U.S.
Unit:Introduction and History of Modern Health Care in the U.S.
Lecture:Components of Health Care Delivery and Finance
Slide content:How Health Care is Financed - 2 Payment methods Private fee-for-service Private managed care, a.k.a., HMOs Government-financed, a.k.a., single-payor Government-provided 18
Slide notes:Different payment methods have evolved over the years. The predominant method in the United States in the last century was private fee-for-service insurance. In this approach, individuals who had insurance would go to the physician or the hospital. Whatever care was provided to them was paid for by the insurance company. Pure fee-for-service started to become unsustainable due to a move towards managed care, manifested in the 1990s by health maintenance organizations, or HMOs, or other types of models such as preferred provider organizations, or PPOs, where patients needed to get their care within a network. In PPOs, the physicians and hospitals that were part of the network would have some financial constraints put on them. Another payment method is government-paid insurance. The most common app roach is single-payor, where basically the individual gets health care and the government reimburses the physician or hospital. Finally, there is government-provided care, were there are government owned and run physician offices, hospitals, and other parts of the health care system. Health IT Workforce Curriculum Version 4.0 18