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25 Cards in this Set
- Front
- Back
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Prospective payment system PPS |
Payment mechanism for reimbursing hospitals for inpatient healthcare services in which a predetermined rate is set for treatment of specific |
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Diagnosis related group DRG |
Group of patients classified to establish a mechanism for healthcare reimbursement based on length of stay. Classification is based on the following variables, primary and secondary diagnosis, Cole morbidities, primary and secondary procedures, and age |
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Capitation |
Providers receive a fixed amount per patient or enrollee of a health care plan. Aims to build a payment plan for select diagnosis or surgical procedures that consist of the best standards of care at the lowest cost |
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Managed care |
Health care system in which the program provider or healthcare system receives a predetermined capitated payments for each patient enrolled in the program |
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Medicare |
Insurance for people 65 years and older |
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Medicaid |
Health insurance to low income families, health assistance to low income people with long term care, and supplemental coverage in assistance to older adults and Medicare beneficiaries a nursing home |
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State Children's Health Insurance Program |
Federally funded state operated program to provide health it coverage for uninsured children. Individual states determined participation eligibility and |
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Preferred provider organization PPO |
Type of managed care plan that lemons and enrollees choice to a list of preferred hospitals to physicians the end providers. In enrollee pays more out of pocket expenses for using a provider not on the list |
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Managed care organization MCO |
Provides comprehensive prevented this and treatment services to a specific group of voluntary enrolled people. Structures include a variety of models, staff model group model network model |
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LTC insurance |
Supplemental insurance for coverage of services. Policies provide a set amount of dollars for an unlimited time for as little as two years |
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Primary care |
Prenatal and well baby care Nutrition counseling Family planning Exercise classes |
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Preventive care |
Blood pressure and cancer screening enter immunisations enter mental health counseling and crisis prevention enter Community legislation |
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Secondary acute care |
Emergency care Acute medical care Radiological procedures for a cute problem for example xrays and CT scans |
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Tertiary care |
Intensive care Subacute care |
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Restorative care |
Cardiovascular and pulmonary rehabilitation Sports Medicine Spinal cord injury programs Home care |
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Continuing care |
Assisted living Psychiatric and other adult day care |
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Respite care |
Is this service that provide short term only for time off for people providing home care to an L, disabled, or free older adult |
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Adult day care centers |
Provide a variety of healthy and social services to a specific patient population who live alone or with family in the community |
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Hospice |
Is a system of family centered care that allows patience to live and remain at home withIs a system of family centered care that allows patience to live and remain at home with comfort independence and dignity will easing the pain of terminal illness |
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Pay for performance |
Programs in public reporting of hospital quality data are designed to promote quality, effective, and safe patient care by physicians in healthcare organizations. These programs are quality improvement strategies that reward excellence through financial incentives to motivate change to achieve measurable improvements |
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Centered care |
The most affect patients experiences with healthcare the eight dimensions cover most of the scope of nursing practice |
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The 8 dimensions of patient centred care |
Respect values, preferences, expressed in needs Coordination and integration of care Information communication and education Physical comfort Emotional support and release of fear and anxiety Involvement of family and friends Transition and continuity Access to care |
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Nursing informatics |
Uses information and technology to communicate, manage knowledge, mitigate error, and support decision making |
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Vulnerable populations |
Children women and older adults most threatened in urbanization |
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Globalization |
Health care providers have to make their services more accessible because of advances in communication, and nurses and other healthcare providers practice across state national boundaries |
