PAS 3301- Midterm Exam Guide - Comprehensive Notes for the exam ( 27 pages long!)

90 views27 pages

Document Summary

Private health insurance: without health insurance, many americans could not afford the services they need to stay healthy and continue working as productive members of society. In 1950s, the health insurance industry came full circle by reemphasizing income replacement through long-term disability insurance policies: these policies were designed to help offset expenses incurred because of catastrophic illness or injury. Indemnity vs. service benefit insurance: health insurers initially reimburse subscribers not providers for a portion (usually 80%) of their medical expenses. Doesn"t make risk disappear, transfer risk from person insurance: drug therapy is often preventative in nature and less expensive than other medical alternatives, adverse selection: situation in which individuals and companies purchase insurance because they expect a loss. So physicians do bear risk but it"s reduced. Independent practice association (ipa) model hmo: physicians form a separate legal entity, usually a corporation or partnership, that then contracts with the mco.