Imagine you are sharing Sunday dinner with your extended
family. Over dinner, the discussion turns to health care….
Managed Care and Integrated Organizations
1. Grandpa has heard about this new-fangled expression,
managed care. Explain managed care to him in terms that he can understand.
2. Grandpa also wants to know if the military is a managed
care system. Give him two reasons why it could be, and two reasons it may not
3. Grandma, overhearing the conversation, says that managed
care is too complicated for her. She simply wants to know two key differences
between her traditional health insurance and managed care.
4. Grandma is intrigued. Now, she wants to know why she
should opt for managed care over her current insurance. Give her two reasons
why this may be so.
5. During your conversation, the concepts of utilization
monitoring and control come up. Explain two methods used to monitor and control
the utilization of services under managed care.
6. Aunt Jeanne has been listening quietly and recognizes
you’re an expert in health care administration. She wants to know the
difference between Medicare and Medicaid. Define each.
7. Aunt Jeanne wants to know how many of her older seemingly
(financially) comfortable friends ended up using Medicaid for nursing home
care. Give her two potential explanations of circumstances under which they may
have decided to use Medicaid.
8. Aunt Jeanne then says, There’s no way in heck I’m
going to a nursing home! Rather, she’d prefer some alternatives to staying
in a nursing home. List two alternatives for her (from the text) and describe
Health Services for Special Populations
9. Aunt Jeanne says that she’s a long way from needing
long-term care. She’s more interested in the new Women’s Center at Central
Hospital, but can’t understand why they need a special clinic just for women.
She thinks it has something to do with interior decorating. Identify four
health concerns women face, which could be why the hospital has an interest in
providing specialized services for women.
10. Uncle Rodger pipes up, We live out there in the
boonies. We have our own health challenges, and they’re different for us than
for the city slickers. Identify two challenges of rural health that he
may be referencing.
11. Uncle Rodger doesn’t think they need a Women’s Center;
rather, they need to deal with real health problems. He’s inferring that the
challenges of rural health constitute more immediate problems associated with
health care. You know that there are many differences between the two
populations. Provide two examples of measures that have been taken to improve
access to care in rural areas.
Cost, Access, and Quality
12. Aunt Marjorie then says that she’s fed up with the whole
business and is moving to Canada. Identify two reasons why she might want to
move to Canada for healthcare, but then you tell her that there are reasons why
she may want to reconsider (list two as well).
13. Aunt Marjorie listens intently to the ongoing
discussion. She’s convinced that managed care is about making money. You know
it’s a matter of perspective. Identify four key stakeholders that may benefit
from providing healthcare in a managed care environment.
14. Describe briefly how each stakeholder listed above
(Question 13) would view the issue of cost.
15. Aunt Marjorie has a new job in real estate and will be
enrolling in her company’s managed care plan. Explain to her four ways in which
she might assess her plan using measures of cost, access, or quality.
16. Aunt Marjorie doesn’t understand the terms premium or
co-pay. Define each term using an explanation she can understand.
17. Cousin Greg, a student at the local community college,
is more interested in how these issues relate to the next Presidential
election. He wants to know how social issues become government policy. Just
having finished an outstanding health systems class at Wayland Baptist, you
provide a short outline of the policy cycle, to include the general steps.
18. Cousin Greg wants to know how the government has gotten
involved in healthcare over the years. You provide him with four (4) examples
from your U.S. Health Care Systems class (list only).
19. You learn that Cousin Greg is writing a paper for his
introductory health class. He’s confused about the term political
will . Explain the meaning of political will.
20. Cousin Greg’s last question has to do with national
health insurance and socialized health insurance. He wants to know what the
difference is and who is using these models. Provide one explanation and one
example for each.
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