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:Payors in the U.S. Health Care System
Slide content:The Multi- payor U.S. Health Care System Contributors Private sources Employers and employees Contributions to private health insurance Out of pocket Public or government sources Federal, State, and local Payroll and general tax revenues Special tax, e.g. sales tax Pooled into large funds 9
Slide notes:As mentioned previously, contributors to health care financing include private and public or government sources. Private sources include employers who purchase insurance policies or pay directly for health care expenditures through a self-insured plan. Individuals and families contribute through the employee portion of health insurance premiums and through out-of-pocket expenses. Federal, state, and local governments collect payroll taxes from employers and employees, and general tax revenue that are used to fund government-financed insurance. Occasionally special tax methods are used, such as a sales tax. The money contributed from government and private sources is pooled into larger funds and distributed by payors. Payor was previously defined as a pool of funds, without reference to any specific payor. The next slides will expand this definition to include different organizations or plans that pay for the health care services either through a private health insurance plan or through a government insurance program. Each insurance pool or fund pays or reimburses on behalf of the individuals who meet the eligibility requirements for the group represented by the plan or program. For example, eligibility may be due to age, as in Medicare or the Childrens Health Insurance Program, or CHIP; socioeconomic category as in Medicaid; or employment status for a large corporation that self-insures. 9