Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:Introduction to Health Care and Public Health in the U.S.
Unit:Financing Health Care - Part 1
Lecture:The history of the health insurance industry in the U.S.
Slide content:Roles of U.S. Government - 1 3 key roles: provider, payor , and lawmaker Provider of health care services Veterans Health Administration and TRICARE Indian Health System Supports research into new models of health care P ayor of third-party services Outsources health care services, claims paperwork, grants for research 26
Slide notes:The U.S. federal government has three key roles in health care. These include provider of health care services, payor for health care programs and services, and lawmaker. As mentioned, the government directly provides health care services through programs such as the Veterans Health Administration, TRICARE, and the Indian Health Service. These systems include federally- and state-supported hospitals, clinics, health centers, doctors, and other services. The government also grants money for research projects that explore new models of providing health care. In Medicare, Medicaid, TRICARE, and certain grants, the government provides funding for third-party services. One example is Medicare, whereby the government outsources the actual delivery of health care services for seniors to private organizations . Another example is that the government may contract with an insurance organization, such as BlueCross BlueShield, to handle claims processing on behalf of the government. Here, the commercial insurance organization acts as a third-party administrator. 26