chapter 11 Flashcards
accountable care organization (ACO)
group of healthcare entities organized via incentives to deliver the most efficient and high quality care for the population served
ambulatory care
health care settings that are located in areas that are convenient for people to walk into and receive care
entitlement reform
proposed legislation making changes in entitlement benefits, such as medicare and Medicaid, paid by the government to citizens
extended-care services
medical and nonmedical care for people with chronic illnesses who are physically/mentally unable to care for themselves
fee-for-service
system in which a bill is generated and a fee is paid every time a provider does something for a patient
health maintenance organizations
prepaid group managed care plan that allows subscribers to receive all the medical services they require through a group of affiliated provides
Medicaid
Title XIX (Social Security Act, 1965) to make health care available to those people with less than the minimum income who do not qualify for Medicare
Medicare
Title XVIII (Social Security Act, 1965) to provide a measure of health coverage to all Social Security recipients
multipayer system
a health care system in which care is paid for by both private insurance companies and the government
palliative care
hospice care; taking care of the whole person—body, mind, spirit, heart, and soul—with the goal of giving patients with life-threatening illnesses the best quality of life they can have through the aggressive management of symptoms
Patient Protection and Afordable Care Act (PPACA)
provide Medicaid to qualifying people with income up to 400% of poverty
preferred provider organizations (PPOs)
prepaid group practice that allows a third-party payer (such as an insurance company) to contract with a group of health care providers to administer services at a lower fee in return for prompt payment and a guaranteed volume of patients and services
single-payer system
health care system in which the government collects all health care fees via taxes and pays out all health care costs
primary level of healthcare
treating common health problems
secondary level of healthcare
treatment of problems requiring more specialized clinical expertise
