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Health Care words

Services Intangibles that are produced and used simultaneously.
Private HCOs Services consumed by individuals. Enhance and protect the health of the individuals. Provide services, not products.
Gross Goods Medications and medical supplies.
Gross domestic product The total value of good and services in the U.S.
Vertical systems Combine different organizations where patient outputs of one organization in the system (a physician group) are inputs of another (hospital).
Nominating Committee Responsible for nominating new board members and officers.
Finance Committee deals with budgeting guidelines and performance.
Chief Executive Officer (CEO) responsible for the day-to-day operation of the facility for health system.
Board of directors A group of people who oversee the affairs of a corporation.
Public health Agencies Government agencies that promote health and prevent disease in populations, such as the centers for disease control & prevention.
World Health Organization (WHO) United Nations agency whose functions is to act as a coordinating authority on global health issues, established in 1948.
Sarbanes Oxley Act Act passed in 2002, intended to protect investors by improving the accuracy and reliability of financial statements and by establishing harsher penalties for those who violate the law.
Individual providers Offer private health care, such as physicians, dentist, chiropractors and nurses.
Hospitalists Doctors, employed by a hospital who handle all general inpatient services.
Horizontal Systems Combine functionally similar organizations.
Continuity of Care The systematic ability to have relevant informations about previous episode of care.
Specialty Care Model A model where patients are not required to consult with a primary care provider before seeking general or specialty care.
Executive Committee Standing committee consisting of senior-level board members, which conducts the business of the board.
Board Infrastuture The resources and systems that support the performance of the board's work.
Mission Statement The statements of purpose for an organization. Provides the context under which all decisions are made and the standard against which all strategies and outcomes are evaluated.
Quality credentialing committee Deals with ensuring that privileges, credentials, licensures, and certifications are appropriate, up-to-date, and in compliance.
Planning or Strategy committee responsible for long-range institutional planning and organizational strategic planning.
Organization's Strategic Plan Decreasing the average wait-time of patient visits. In creasing the number of professional staff in clinical areas. Increasing the quality of medical equipment. Provide fee-free services.
Causes of disease genetic flaws, progressive biological breakdown, trauma, personal habits, external habits, external agents.
Suppliers Organizations that provide products and services to the health care industry, such as hospital supplies, equipment, companies, medical consulting firms.
Financing Reimburses health care providers.
Public HCOs Services targeted towards health & well-being of populations or communities.
Institutional Providers Provide private health care, such as physician office, medical groups, hospitals and nursing homes.
Board Structure Board size, number & type of committees, number of boards & relationships.
Regulators Government agencies and private organizations that regulate health care institutions and professionals. State licensing boards, state insurance departments, federal agencies (FDA)
Board Composition The characteristic, knowledge, skills, perspectives and experience of board members. Focuses on board members.
Managed Care Model Model in which health organizations manage care & cost by funneling all medical necessities through primary care.
Enablers Organizations that support and facilitate the provision of health services.
Governing Board The enity charged with overseeing the affairs of a corporation.
Primary Care General preventive and care that is provided to a person over and extented period of time.
Secondary Care Care that is typically provided in a hospital by medical specialists who generally don't have first contact with patients.
Tertiary Care Specialized consultative care, usually on referral from primary or secondary health care providers. Tertiary care is typically delivered at teaching institutions.
Specialty Care Model A model where patients are not required to consult with a primary care provider before seeking general or specialty care.
populations based medicine A concept that requires PCPs be concerned with every patient on their panel.
Chronic Care Model Addresses health concerns of people with chronic illness.
Accessibility How easily a patient can obtain and make use of medical care from his or her physician, and how timely such access is.
Capitation A fixed amount of money paid in advance to a physician for delivery of health care services.
Comprehensiveness of Care The breadth and depth of care that primary physicians provide directly to their patients.
Evidence based medicine A medical movement that bases care decisions for individual patients on evidence from clinical studies.
Health Profession shortage Area (HPSA) A federal designation meaning that population lacks adequate access to health care.
Primary Care Team A team approach to primary care in which divisions of labor is shared among a group of primary caregivers.
Group HMO Model HMO model in which professional services are provided by the physicians who are employed by the HMO and /or by groups that are under exclusive contract to the HMO.
Beneficiaries Individuals receiving health care services.
Self-funded Plans Insurance plans in which employers provide health care benefits without purchasing insurance from or paying premiums to a health plan.
Service Benefit Plan An insurance plan in which a purchaser 9employer) contracts with a health plan and pays it a premium for each beneficiary (employee & family members).
Purchasers The primary payers (typically employers and federal, state and local governments).
Providers The health care organizations and individual professionals who deliver health care services.
Medicare Part B A voluntary, supplemental health plan that covers professional (primarily physician) services. Physician services.
Medicare Part A A compulsory health plan that covers hospital based services. Hospitalization.
Medicare A federally sponsored program that provides health insurance to eligible Americans who are elderly or disabled. It's an entitlement program.
Medicaid A federa/state program that provides health care services to poor people. Administered by the state.
Independent practice Association HMO (IPA HMO) Model HMO model in which services are provided by medical groups and physicians who are contract independent.
Indemnity Plan An insurance plan in which the beneficiary pays a premium to the health plan. Primary reason is to prevent financial lost.
Health maintenance Organizations (HMO) Managed care plans that combine the insurance function (underwriting) with delivery of health services through an owned or contract network of providers.
Allopathic Physician A medical designation for physicians who graduate from allopathic schools of medicine and focus on treating disease.
Clinical Education The last 2 years medical training that takes place in patient care settings (hospitals & ambulatory care facilities) under the supervision of physician faculty members.
Pre-Clinical Education The period during the first two years in medical school when students study basic sciences that are fundamental to medical practice and learn how to take patient histories and conduct basic physical examinations.
BlueCross BlueShield Health insurance plans that are closely tied to the hospital industry and medical profession.
Combined HMO model Includes both independent physicians (IPA) as well as physicians or groups employed by the HMO or under exclusive contract to it (group model).
Board-certified A physician who has passed the medical board specialty exam.
Generalist Traditionally, a general practitioner. Today, a physician-usually a primary care or family physician-who coordinates, or manages, the health services available to plan members.
General practitioner Doctors who focus their practice on primary care of individuals and families.
Nurse midwife Oversees pregnancies and births, in some cases, deals with other gynecological issues.
Nurse practitioner Licensed to perform physical exams and other medical services, including writing prescriptions, usually under a physician's supervision. Almost like doctors.
Specialist A physician who completes a residency program and passes a medical specialty exam, which qualifies him or her to specialize in a particular medical field.
Created by: nrod