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dynamics of healthcare > Midterm > Flashcards

Midterm Flashcards

1
Q

Affordable Care Act

A

Legislation passed in 2010 requiring US citizens and permanent residents to have minimum essential health insurance coverage
the most significant change in the past 10 years

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2
Q

Healthcare costs

A

Expenses related to medical treatment and services

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3
Q

Medicaid

A

Government program providing health coverage to low-income individuals and families

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4
Q

Medicare

A

Government program providing health coverage to individuals aged 65 and older, and certain younger individuals with disabilities

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5
Q

Private insurance

A

Health coverage provided by private companies

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6
Q

Reasons for rising healthcare costs

A

Factors contributing to the increase in expenses related to medical treatment and services-technology medication aging increased prevalence of chronic diseases

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7
Q

Decline in mortality

A

Reduction in the number of deaths due to improvements in hygiene in the 20th century

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8
Q

Highest cause of deaths in the U.S.

A

heart disease

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9
Q

Health professionals needed for opioid addiction

A

Medical practitioners required to treat individuals suffering from opioid addiction will need more behavioral health and social workers

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10
Q

Projected population by 2050

A

⅓ Hispanic, ⅓ White, ⅓ African American

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11
Q

Downside of improved healthcare and longevity

A

People will live longer with more chronic disease

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12
Q

Preventive services included in ACA

A

Mammography colonoscopy and immunizations

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13
Q

chronic diseases are associated with

A

personal lifestyle

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14
Q

Telehealth

A

Delivery of healthcare services remotely using technology-became common during pandemic

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15
Q

Virulent antibiotic resistant bacteria strain

A

MRSA (methicillin resistant staph aureus)

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16
Q

Health IT

A

Use of computers to store and exchange health information

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17
Q

Social determinants of health

A

Factors that influence health outcomes, including birthplace, living conditions, education, and employment

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18
Q

Blue Cross/Blue Shield

A

Health insurance company offering coverage to individuals and families(private insurance

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19
Q

direct health services provided by the federal government

A

Tricare, ACA, Indian Health Service, Medicaid, Medicare

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20
Q

US DOES NOT HAVE

A

CENTRALIZED healthcare delivery systems

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20
Q

Health Promotion Service

A

Services aimed at promoting and maintaining good health(prenatal nutrition)

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21
Q

Disease Prevention Service

A

Services focused on preventing the occurrence of diseases (smoking cessation)

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22
Q

Diagnosis and Treatment

A

Services involved in identifying and addressing medical conditions (x-ray and lab) most used

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23
Q

Chronic Care

A

Services for managing long-term medical conditions (diabetes care

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24
Rehabilitation
Services aimed at restoring physical or mental abilities ( head injury and stroke
25
National Association of Free clinics
Organization providing free healthcare services to underserved population
26
Federally Qualified Health Centers
Largest comprehensive safety net of primary and preventative care. Healthcare facilities offering comprehensive primary care services to underserved populations
27
free medical clinics
privately funded non for profit community organizations that provide healthcare at little or no costs to low income individual
28
Federally funded health centers
Healthcare facilities receiving financial support from the federal government-established for those in financial need. Offer comprehensive prenatal, dental, pharmacy, and behavioral health. The ACA provides funds to expand the health centers.60% receiving these services are members of a minority population
29
Free clinics receive little or no state funds
Free clinics do not receive significant financial support from state governments
29
Free clinics are necessary
after establishing ACA
30
The majority of people who are uninsured and would use Free medical clinics
Individuals who do not have health insurance through their employer and have incomes below the federal poverty level
31
Community Hospitals
Medical facilities providing long-term care and specialized services non for profit -include OB GYN majority of hospitals
31
Public hospitals
Medical institutions owned by local, state, or federal agencies
32
Community Hospitals
Medical facilities providing long-term care and specialized services
32
CHIP
Government insurance program for children from low-income families
33
Tricare
Government healthcare program providing services to veterans and active duty military personnel
34
Major breakthroughs in the treatment of mental illness
Development of Pharmaceuticals and National Institute of Mental Health.medications and research institution focused on mental health
35
created through social security act
Medicaid and Medicare
36
Hospitals
2nd largest business in the US
36
Certified Community Behavioral Health Clinics (CCBHCs)
mental health and substance abuse
36
Major Forces Affecting the Development of Hospitals
Transformation of nursing into a profession requiring training Development of specialized technology Patients needing acute care advances in Medical education
36
Proprietary hospitals
For-profit medical institutions operated for the financial benefit of corporations
36
Medications for the treatment of opioid abuse
Naloxone, methadone, suboxone
36
ACA requires all health insurances to include
mental health
37
Private Hospitals
Medical institutions owned and operated by churches, businesses, corporations, and physicians
37
Informed consent
patients most important legal rights
37
Patient Care Partnership
Replacing the AHA's Patients' Bill of Rights, this plain language brochure informs patients about what they should expect during their hospital stay with regard to their rights and responsibilities. High quality care help with billing autonomy(make your own decisions) privacy
38
1 in 8 ER visits are due to
mental health disorder
38
more than 1/2 patients with mental and behavioral health disorders do not get treatment because
they do not know where to get help
38
NIH
abbreviation for National Institutes of Health; the federal agency that funds and conducts biomedical research
39
Capitation
fixed amount for each service
39
HHS (Health and Human Services) is responsible for
Medicare, Medicaid, public health, biomedical research, food and drug safety, disease control and prevention, Indian health, and mental health services.
39
nations largest public health insurance
Medicaid
39
Public health focus
on community
40
Mandatory Medicaid Services
home health, hospitals, ambulatory care, mental health services
40
Example of capitation
HMO
41
HMO
cheaper, fixed rate, only in network providers, need a referral for a specialist
41
Premium
Amount you pay monthly, quarterly, semiannually or annually to purchase different types of insurance
42
PPO
more expensive premium, can see out of network providers, do not need a referral
43
ADL
activities of daily living (bathing toileting eating)
43
elderly population growth
50% by 2030
43
EPO
like an HMO but do not need referrals to see a specialist
43
Chronic conditions
any disease or condition that lasts a long time (usually longer than six months or a year). It usually can't be cured and therefore requires ongoing treatment and management. Examples include arthritis and asthma
44
IADLs
instrumental activities of daily living preparing meals, housekeeping, managing finances
44
Medicare B
Covers outpatient hospital stays and diabetic supplies, DME (durable medical equipment), patients on long term disabilities, X-rays, dialysis, vaccines, and respiratory nebulizers
44
Medicare D
Prescription drug coverage
44
Alzheimer's disease
most common form of dementia progressive and irreversible brain disorder characterized by gradual deterioration of memory, reasoning, language, and, finally, physical functioning
44
Medicare C
Medicare Advantage Plan pay a premium -private medical insurance
44
health literacy
the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions lack of literacy causes medical errors
44
Adult day care
care given at a facility during day time hours; generally for individuals who need some assistance and/or supervision but are not seriously ill or disabled; usually reside outside of the facility
44
Dementia
a slowly progressive decline in mental abilities, including memory, thinking, and judgment, that is often accompanied by personality changes
44
Hospital Readmission Reduction Program
A program under the affordable care act to improve quality and reduce cost of care for patients readmitted to the hospital for pneumonia, congestive heart failure, or accurate myocardial infarction. Medicare reduce his perspective payments to hospitals that failed to meet the criteria for readmission for these three diagnosis
44
The Tax and Jobs Act of 2017 impacts the Affordable Care Act by...
took away the individual mandate
44
Medicare A
hospital insurance
44
most common ADL in long term care
Bathing
44
NHE
National Health Expenditures slowed between 2010-2014
44
Medicaid expansion
An expansion of the Medicaid program under the ACA gives states the ability to expand Medicaid to cover all adults living up to 138 percent of the federal poverty level. Not all states
44
ACA disparity
in states that did not expand Medicaid
44
Master Patient Index (MPI)
A list or database created and maintained by a healthcare facility to record the name and identification number of every patient who has ever been admitted or treated in the facility
44
medical technology
refers to the procedures, equipment, and processes by which medical care is delivered
44
Hospice
providing end of life care
44
assisted living facility
a facility that generally provides housing, group meals, personal care, support services, and social activities in a community setting
44
ACA young adults
can stay on parents coverage until 26
44
ACO (Accountable Care Organization)
create incentives for hospitals and healthcare providers to coordinate patient care
44
primary payer of long term services
Medicaid
44
Coverage gap
people who do not qualify for Medicaid but do not make enough money to buy insurance
44
HIPAA (Health Insurance Portability and Accountability Act)
confidentiality
44
Essential Health Benefits
A list of health care services mandated to be covered in insurance plans offered by American Health Benefit Exchanges Ambulatory care prescription maternity care rehabilitation lab service
44
Bar coding technology
scanner technology and machine-readable bar codes such as UPC
44
Interoperability
mechanism of electronic communication among organizations so data can be incorporated from one system to another

dynamics of healthcare (5 decks)

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