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Chp 6. Health Care Delivery Systems
Vocabulary
15
Nursing
Not Applicable
01/11/2010

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Cards

Term
Case Managment
Definition
a method for delivering nursing care in which the nurse is responsible for a case load of clients across the health care continuum
Term
Coinsurance
Definition
an insurance plan where the client pays a percentage of the payment and some other group (eg, employer, government) pays the additional percentage
Term
Diagnosis-related groups (DRGs)
Definition
a Medicare payments system to hospitals and physicians which establishes fees according to diagnosis
Term
Health Care System
Definition
the totality of services offered by all health disciplines
Term
Health maintenance organization (HMO)
Definition
a group health care agency that provides basic and supplemental health maintenance and treatment services to voluntary enrollees
Term
Independent practice association (IPA)
Definition
provide care in offices, clients pay a fixed prospective payment and IPA pays the provider. Earnings or losses are assumed by the IPA
Term
Integrated delivery systems (IDS)
Definition
systems that incorporates acute care services, home health care, extended and skilled care facilities, and outpatient services
Term
Licensed vocational (practical) nurse (LVN/LPN)
Definition
a nurse who practices under the supervision of a registered nurse, providing basic direct technical care to clients
Term
Managed Care
Definition
a method of organizing care delivery that emphasizes communication and coordination of care among all health care team members
Term
Medicaid
Definition
a United States federal public assistance program paid out of general taxes and administered through the individual states to provide health care for those who require financial assistance
Term
Medicare
Definition
a national and state health insurance program for United States residents over 65 years of age
Term
Patient-focused care
Definition
delivery model that brings all services and care providers to the client
Term
Preferred provider arrangements (PPA)
Definition
similar to PPOs but PPAs can contract with individual health care providers; the plan can be limited or unlimited
Term
Preferred provider organization (PPO)
Definition
a group of physicians or a hospital that provides companies with health services at a discounted rate
Term
Supplemental Security Income (SSI)
Definition
special payments for people with disabilities, those who are blind, people who are not eligible for Social Security; these payments are not restricted to health care costs
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