Professional Documents
Culture Documents
Case Management- a type of nursing care system that sees each patient as an
individual and each situation as unique
Medicaid- federal government program that helps to pay healthcare for low income
individuals
Medicare- health insurance program for people older than 65 years of age.
Primary Care Physician(PCP)- managed healthcare physician that is paid per
month per member
Third Party Payer- party that pays bills of a beneficiary care for by a physician.
Preventive care
Young adults can stay on policy till age 28
Tax break for small businesses
No lifetime limits
Healthcare Exchanges
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these exchanges allow people to shop for insurance that offers the best
coverage for them
24-hour care
For patients with chronic illnesses or disability, particularly older people who
have mobility and eating problems who cannot be cared for at home
Assisted Living Facility- provide relatively independent seniors with assistance and
limited healthcare services in a home-like atmosphere.
Skilled Nursing Facility- a transitional care setting where patients stat for a few
days or as long as 100 days but eventually move to a rehabilitation or long-term
care ex: elderly man falls at home and suffers from a fractured hip, surgery for hip
successful but patient not eating and feeding tube placed. Eventually continues to
eat gradually for about 40 days and then is discharged to go home.
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Client-Centered Care- empowers the patient to take control of and manage his or
her care. It allows the patient to achieve independence within limits of their
disability.
Primary Care Nursing- one nurse is responsible for all aspects of nursing care for
their assigned patients. This type of care is mostly given in ICU
Case Management- handles the insurance, workers comp claims for the patient
Healthcare Economics
Medicare ProgramsPart A- insurance for hospitalization, hospice, home health and skilled nursing
facility services
Part B- supplemental health insurance to help pay for lab tests, x-rays, home health
nurses, medical equipment
Part C- Medicare advantage, health insurance plans administered by private
insurance
Part D- Medicare prescription drug coverage
Common Types of Health Insurance Programs
HMO- requires a primary care physician
PPO- provides services for a specific group of patients
POS- needs PCP but is not capitalized and patient can seek care in and out of
network.
Chapter
2: Health Care Delivery and Economics