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Fundamental ch 8 learning objectives/ key terms

Accountable Care Organization (ACO)Ambulatory CareHealth care settings located in areas that are convenient for people to walk into and receive care; may be provided in hospitals, clinics, or centers ONFUNDAMENTAL CH 8 LEARNING OBJECTIVES/ KEY TERMS SPECIFICALLY FOR YOUFOR ONLY$13. 90/PAGEOrder NowCapitationCare CoordinationCommunity Health CenterHealth care that is provided to people who live within a defined geographical region or who have common needs; designed to meet the needs of the people as they move between and among health care settingsConsumerThe person who uses health care services (the patient)Diagnosis-Related Group (DRG)Classification of patients by major medical diagnosis for the purpose of standardizing health care costsEntitlement ReformProposed legislation making changes in entitlement benefits, such as Medicare and Medicaid, paid by the government to citizens, with the goal of improving the nation’s budgetExtended-Care ServicesFee-For-ServicesSystem in which a bill is generated and a fee is paid every time a provider does something for a patientHealth Insurance MarketplaceFederal and state system designed to help people more easily find health insurance that fits their budget and needs with a plan offering comprehensive coverage, from doctors to medications to hospital visits; insurance options can be compared based on price, benefits, quality, and other features described inplain languageHealth Maintenance Organization (HMO)Pre-paid, group-managed care plan that allows subscribers to receive all the medical services they require through a group of affiliated providers; there may be no additional out- of -pocket costs, or subscribers may pay only a small fee, called a co-paymentHospiceA type of end-of-life care for persons who are terminally ill, characterized by the following:

1.) Patients are kept as free of pain as possible so that they may die comfortably and with dignity

2.)Patients receive continuity of care, are not abandoned, and do not lose personal identity

3.) Patients retain as much control as possible over decisions regarding their care and are allowed to refuse further life-prolonging technologic interventions

4.) Patients are viewed as individuals with personal fears, thoughts, feelings, values, and hopes

InpatientA person who enters a health care setting for a stay ranging from 24 hours to many yearsManaged CareAn organized, high-quality, cost-effective system of health care that influences the selection and use of health care services of a populationMedicaidTitle XIX (Social Security Act, 1965) to make health care available to those people with less than minimum income who do not qualify for MedicareMedical HomeAn enhanced model of primary care that provides whole-person, accessible, comprehensive, ongoing, and coordinated patient-centered careMedical NeighborhoodA patient-centered medical home and the constellation of other clinicians providing health care services to patients within it, along with community and social service organizations and state and local public health agenciesMedicareTitle XVIII (Social Security Act, 1965) to provide a measurable of health coverageMultipayer SystemA health care sysytem in which care is paid for by both private insurance companies and the governmentMultispecialty Group PracticeOrganization of physicians from different specialties joined to share income, expenses, facilities, equipment, and support staff; the group practice can better provide comprehensive careOutpatientPerson who requires health care services but does not need to stay in an institution for those servicesPalliative CareHospice care; taking care of the whole person – body, mind, spirit, heart, and soul- with the goal of giving patients with life-threatening illness the best quality of life they can have through the aggressive management of symptomsPatient Protection and Affordable Care Act (PPACA)2010 federal legislation designed for comprehensive health reform, with an intent to expand coverage, control health care costs, and improve the health care delivery systemPay for PerformanceA strategy using financial incentives to reward providers for achieving a range of payer objectives, including delivery efficiencies, submission of data and measures to the payer, and improved quality and patient safetyPreferred Provider Organization (PPO)Respite CareA type of care provided for caregivers of homebound ill, disabled, or elderly patientsSingle-payer systemElements of a well-functioning health care delivery system21 st Century the Institute of Medicine

*6 Outcomes*
Safe
Effective
Efficient
Patient-Centered
Timely
Equitable

Strategies to Increase Access to Affordable, High-Quality CarePrimary Health CareCommon Health Problems and preventive measures that account for 80% to 90% of visits to cliniciansSecondary Health CareProblems that require more specialized clinical expertiseTertiary Health CareManagement of rare and complex disorders4 Basic Ways Healthcare is Paid ForPhysicians and HospitalsPrepaid Group PracticesHealth Care Delivery Systems:*Physicians and Hospitals
*Multispecialty Practice Groups
*Community Health Centers
*Prepaid Group Practices
*Accountable Care Organizations
*Medical Homes
*Medial NeighborhoodsSettings that Provide Health CareAgencies that Provide Health CareMembers of the Interdisciplinary Health Care TeamTrends Affecting Health Care DeliveryIssues Affecting Health Care DeliveryRole of Nursing in meeting the Challenges of Health Care Reform

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