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Chapter 8

Health Care Delivery System

QuestionAnswer
ACO Accountable Care Organization: One bill applies to entirety of patient care. Promotes quality or quantity
Ambulatory Care Example = Clinic in a mall. Outpatient medical care
Capilation Gives providers a fixed amount per enrollee of health plan
Care Cordination Deliberate organization between two or more participants involved in a patients care
Community Health Center Regionalized services for vulnerable geographic populations
DRG Diagnosis-Related Groups: Fixed amounts for procedures. Hospital makes or loses money depending on how they charge.
Entitlement Reform Reconstruction of medical budget.
Extended Care Services Services geared for chronic illnesses and disabilites
Fee-For-Service Service requires payment. Promotes more work, not great work to make money
Health Insurance Marketplace Visit Healthcare.gov. An overview of healthcare options
HMO Heath Maintenance Organization: Low premium, low flexibility. You are assigned and Personal Care Provider who must give a referral for outside help/care.
Hospice Care for dying people
Inpatient Patient is admitted to hospital and stays for undetermined time overnight
Managed Care System where patients only visit a select group of clinicians and phyicians
Medicaid 1965, Social Security; low income insurance
Medical Home Model of organization to provide patient-centered care.
Medical Neighborhood Patient Centered Medical Home along with a constellation of other clinicians
Medicare 1965 amendment to Social Security act. Health insurance to 65+
Multi-Specialty Group Practice When physicians from different specialties combine resources into one building
Multipayer System Inclusion of private and government sectors for healthcare
Outpatient Patients not hospitalized overnight
Palliative Care Focuses on relief of physical, mental, and spiritual distress
PPACA Patient Protection and Affordable Care Act. Provide Healthcare or subsidize for folks up to 400% the poverty rate.
Pay for Performance Reward hospitals for quality care. Penalty for discharging an unhealthy patient.
PPO Preferred Provider Organization: More flexibility, Higher cost. Do not need referrals for outside network care.
Respite Care Relief for primary caregiver at a daycare.
Single Payer System Describes the funding mechanism from a single public body collect all health fees/costs and pay for it.
QSEN Quality and Safety Education for Nurses; defined quality and safety competencies
Created by: 1182886658401564