Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Medical Ethics Ch 3
Key Terms
| Term | Definition |
|---|---|
| Accountable care organization (ACO) | A health care payment and delivery model that could reward doctors and hospitals for controlling costs and improving patient outcomes by allowing them to keep a portion of what they save if standards of quality are met. |
| accreditation | Official authorization or approval for conforming to a specified standard, for health care education programs, health care facilities, and managed care plans. |
| certification | A voluntary credentialing process whereby applicants who meet specific requirements may receive a certificate. |
| exclusive provider organization (EPO) | A managed care plan that pays for health care services only within the plan’s network of physicians, specialists, and hospitals (except in emergencies). |
| health maintenance organization (HMO) | A health plan that combines coverage of health care costs and delivery of health care for a specific payment. |
| health reimbursement account (HRA) | An employer-funded, tax-advantaged employer health benefit plan approved by the Internal Revenue Service (IRS) that reimburses employees for out-of-pocket medical expenses and individual health insurance premiums. |
| health savings account (HSA) | Offered to individuals covered by high-deductible health plans, these accounts let these individuals save money, tax free, to pay for medical expenses. |
| high deductible health plan (HDHP) | A plan with a higher deductible than a traditional insurance plan. The monthly premium is usually lower. |
| independent practice association (IPA) | A type of HMO that contracts with groups of physicians who practice in their own offices and receive a per-member payment (capitation) from participating HMOs to provide a full range of health services for members. |
| licensure | A mandatory credentialing process established by law, usually at the state level, that grants the right to practice certain skills and endeavors. |
| managed care | A system in which financing, administration, and delivery of health care are combined to provide medical services to subscribers for a prepaid fee. |
| managed care organization (MCO) | A corporation that links health care financing, administration, and service delivery. |
| medical services organization (MSO) | A physician group purchases a hospital, which then contracts with employers to provide full health care services. |
| open access plan (OAP) | Subscribers may see any in-network health care provider without a referral. |
| patient centered medical home (PCMH) | A form of managed care with a primary care provider developing a team-based approach to health care with an emphasis on preventive services, care coordination, and access to care. The primary care provider receives higher reimbursement if goals are met. |
| physician-hospital organization (PHO) | A health care plan in which physicians join with hospitals to provide a medical care delivery system and then contract for insurance with a commercial carrier or an HMO. |
| point of service plan (PSO) | A primary care physician determines necessary services for the patient within a network. |
| practice acts | State laws written for the express purpose of governing the practice of specific health care professions. |
| preferred provider organization/association (PPO/PPA) | A network of independent physicians, hospitals, and other health care providers who contract with an insurance carrier to provide medical care at a discount rate to patients who are part of the insurer’s plan. |
| primary care physician (PCP) | The physician responsible for directing all of a patient’s medical care and determining whether the patient should be referred for specialty care. |
| professional boards | Bodies established by the authority of each state’s practice acts for the purpose of protecting the health, safety, and welfare of health care consumers through proper licensing and regulation of health care practitioners. |
| reciprocity | The process by which a professional license obtained in one state may be accepted as valid in other states by prior agreement without reexamination. |
| registration | Similar to certification, individuals must meet certain educational requirements, as well as possibly successfully completing a national exam. |
| scope of practice | The determination of the duties/procedures that a person may or may not perform under the auspices of a specific health care professional’s license. |
Created by:
Tagcal