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MED 149
chapter 3 terms
| Question | Answer |
|---|---|
| Primary Care Medical Home (PCMH | A type of HMO where a patient’s primary care needs are supported 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 |
| managed care organization (MCO) | A corporation that links health care financing, administration, and service delivery |
| health maintenance organization (HMO) | A health plan that combines coverage of health care costs and delivery of health care for a specific payment |
| 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 |
| preferred provider organization (PPO) | 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; also called preferred provider association (P |
| 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 |
| 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 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 |
| 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 |
| 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 |
| Accountable Care Organization (ACO) | A type of HMO that requires coordination and affiliation among multiple practices to lower costs and improve outcomes and receives a predetermined payment to care for a designated patient population |
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Felicia26