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Chapter 8
Health Care Delivery System
| Question | Answer |
|---|---|
| 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 |
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