Health Care ssv final

This set of flashcards covers key terms and concepts related to health care and social services as discussed in the lecture.

Health Care

Care provided to individuals to prevent or promote recovery from illness or disease.

Behavioral Health Care

An umbrella term referring to a continuum of services for persons at risk or suffering from mental, behavioral, or addictive disorders.

Managed Care

A system of health care delivery that limits the use and cost of services.

Gatekeeper

A person in a health plan organization who decides whether a prescribed medical service will be paid for.

Fee-for-Service

A pre-arranged amount of money that will be paid to a healthcare provider each time a specific service is delivered.

HMO

Health Maintenance Organization; consists of pre-paid medical group practices offering specific types of health care.

PPO

Preferred Provider Organization; a health plan that offers more flexibility in choosing healthcare providers.

POS Plan

Point of Service plan; a type of managed care plan that combines features of HMO and PPO.

Mental Health Parity Law (2008)

Requires coverage of mental health and substance use disorder services to be comparable to physical health coverage.

Medicaid

A medical assistance program for certain individuals and families with low incomes and resources.

Medicare

Health insurance for the aged and disabled; covers persons age 65 and older and some younger persons with disabilities.

Medicare Part A

Hospital insurance that helps cover inpatient care, skilled nursing facility care, hospice care, and some home health care.

Medicare Part B

Supplementary medical insurance covering outpatient care, doctor visits, and preventive services.

State Children’s Health Insurance Program (SCHIP)

Expands health insurance for low-income children up to age 19.

WIC

Women, Infants, and Children Program that provides grants for supplemental foods and health care referrals.

Affordable Care Act (ACA)

Federal statute aimed at increasing quality and affordability of health insurance while reducing uninsured rates.

Health Risk Factors

Factors influencing health that can be environmental, physiological, sociological, or psychological.

Increased Life Spans

Contributing factor to rising health care costs due to longer life expectancy.

Malpractice Suits

Legal actions taken against healthcare providers that contribute to increased healthcare costs.

Third Party Billing

A payment arrangement in healthcare where insurance pays for medical services rendered to insured individuals.

Health Disparities

Differences in health outcomes and access to care among different population groups.

Elderly Health Risks

The elderly population faces higher health risks and a chance of spending later years in poverty.

Disability Health Risks

Individuals with disabilities are at greater risk for health problems.

Rural Health Issues

People living in rural areas may have limited access to healthcare services.

Urban Health Issues

Densely populated urban areas can pose health care access challenges.

Quality of Care Concerns

Issues relating to the adequacy and appropriateness of healthcare services provided.

Pharmacological Approaches

Treatment strategies that emphasize the use of medications for mental health issues.

Resolution-Focused Helping

Development of strategies that emphasize solutions in social services.

Confidentiality in Healthcare

The ethical principle of keeping patient information private.

Ethical Issues in Mental Health

Concerns regarding treatment appropriateness, including monitoring and therapy.

Outpatient Treatment

Care provided without admission to a hospital; sometimes seen as inadequate for certain cases.

Health Insurance Coverage Requirements

Mandates for health insurers to cover certain medical services under specified conditions.

Performance Measurement

Evaluation of healthcare services to ensure quality and efficiency.

Continuum of Care

A managed care strategy that provides healthcare in varying intensities as needed.

Accountability in Healthcare

The responsibility of healthcare providers to manage cost and care effectively.