NHA CCMA 3.0 Module #1: Foundational Knowledge and Basic Science

Capitation

Payment method based on patient characteristics and expected usage

Controlled Substances Act

Legislation that classifies regulated substances into schedules

Fee for Service

Insurance payment based on a fee schedule or service benefits

Health Maintenance Organization (HMO)

Health plan that contracts with medical centers for care

Managed Care

Health care plans with preset payments and provider networks

Patient-Centered Medical Home (PCMH)

Care approach focused on overall health, not just a single condition

Physician's Desk Reference (PDR)

Compendium of prescription medication information

Point of Service (POS)

Plan that allows patients to self-refer to specialists

Preferred Provider Organization (PPO)

Plan that offers flexibility to see providers in or out of network

Scope of Practice

Specific standards for medical professionals' responsibilities

Telehealth

Delivery of health care services virtually via video call

Value-based Plan

Insurance coverage based on health outcomes and quality of service

Medical Assistants (MA)

Professionals working alongside providers in outpatient or ambulatory care settings

State Medical Boards

Regulatory bodies that determine the scope of practice for medical assistants

MA Responsibilities

Administrative and clinical tasks performed by medical assistants in outpatient settings

Types of Providers

DO, MD, PA, and NP

Licensure

Mandatory regulation for physicians to practice medicine

Certification

optional; extra education and training to increase scope of practice

Primary Care Clinics

Outpatient care settings where patients are seen for routine visits

Specialty Care Clinics

Outpatient facilities where patients who have complex or severe diseases or conditions are seen for routine visits by doctors who specialize in a specific disease or condition

Home Health

Specific types of care provided to those who cannot leave their home easily

Mobile Health Units

Equipped with means of transportation that allow for the setup and use of specialized medical equipment

Hospice

End-of-life care focused on comfort rather than curative efforts

Patient-Centered Medical Home

Care delivery model focused on coordinated treatment by a PCP

Patient Portals

Online platforms providing access to test results, visit notes, and educational materials

General Health Care Services

Treatment of acute and chronic illnesses, and preventive care

Specialty Health Care Services

Diagnosis and treatment of specific diseases or conditions

Ancillary Services

Urgent care, laboratory services, and diagnostic imaging

Complementary Therapies

Alternative treatments such as acupuncture, chiropractic medicine, energy therapy, and dietary supplements

Schedule I of CSA

Substances with a high potential for abuse and currently no approved medical use in the US. They are illegal and cannot be prescribed. Ex: heroin, mescalin, LSD. Include cannabis despite it now being legal in some states in the US.

Schedule II of CSA

High potential for abuse, dangerous, can lead to psychological and physical dependence. Ex: morphine, methadone, oxycodone, fentanyl, amphetamine. Must be stored in a safe.

Schedule III of CSA

Moderate to low potential for physical or psychological dependence. Ex: ketamine, anabolic steroids, acetaminophen with codeine, buprenorphine

Schedule IV of CSA

Low potential for abuse and dependence. Ex: tramadol, diazepam, clonazepam

Schedule V of CSA

Contain limited quantities of some narcotics, usually for antidiarrheal, antitussive, and analgesic purposes. Ex: guaifenesin with codeine, pregabalin, diphenoxylate with atropine

Therapeutic effects

good effects - the ones for which providers prescribe them

Side effects

undesirable, unintended actions on the body

Adverse effects

unintended, harmful actions of a medication

Indications

problems for which the provider prescribes a particular medication

Contraindications

symptoms or conditions that make a specific treatment or medication inadvisable or even dangerous

Medication Precautions

problems that pose a lesser risk but require close observation and monitoring during medication therapy

How do you calculate dosages using ratios and proportions?

Desired/Have x Quantity = x

How many pounds are in 1 kg?

2.2 lbs

Basic Pharmacology

Classification and indications of common medications

Drug Classifications

Categorization of substances based on the Controlled Substances Act schedules

Pharmacokinetics

the study of how medications move through the body

Absorption

the body converts the medication into a form the body can use and moves it into the bloodstream

Distribution

the transportation of medication throughout the body

Metabolism

changes the active forms of the medication into harmless metabolites in the liver

Excretion

the removal of medication's metabolites from the body through urine, feces, saliva, bile, sweat, breast milk, or exhaled gas/vapors

Rights of Medication Administration

Patient, medication, dose, time, route, technique, and documentation

Physicians' Desk Reference (PDR)

free annual publication that contains current, detailed information about thousands of medications

Nutrition

Study of food and its impact on health

Water

human body is 50-80%; transporting nutrients and O2 throughout the body, helps remove waste, regulates body temperature

Nutrients

essential food substances; water, protein, carbs, fats, vitamins, and minerals

Proteins

large, complex molecules of amino acids; Functions: build and repair body tissues, source of energy

Carbohydrates

organic compounds that are simple (sugars) or complex (starches); Functions: source of energy

Fats/Lipids

contain fatty acids; Saturated (solid at room temperature) and unsaturated (liquid at room temperature) Functions: source of energy, solvent for fat-soluble vitamins, important in cell membranes, help with protein functions

Vitamins

organic substances the body needs for cellular functions

Minerals

inorganic substances the body needs in small quantities for building and maintaining body structures

Vitamins and Supplements

Essential nutrients and their dietary sources

Diabetes diet

calorie-controlled diet; best to eat several small, nutrient-dense meals consistently throughout the day to avoid spikes in blood glucose

Chronic Kidney Disease diet

Limit salt/sodium; be cautious with protein; eat heart-healthy foods low in cholesterol and fat; minimize phosphorous intake; control potassium levels

Celiac Disease diet

gluten-free (avoid foods made with wheat, barley, and rye)

Anorexia nervosa

starvation diet; warning signs: starvation, perfectionism, fear of weight gain, amenorrhea, excessive exercising

Bulimia nervosa

binging and purging; Warning signs/symptoms: consuming large amounts of food, then purging, using the bathroom immediately after eating, using laxatives and diuretics; mood swings

Binge eating

binging without purging; Warning signs/symptoms: weight gain, obesity, no dietary restrictions, eat when not hungry, eat alone due to shame/guilt of overeating

Micro-

0.000001

Milli-

0.001

Centi-

0.01

Kilo-

1,000

15 drops = ___ mL

1 mL

1 tsp = ___ mL

5 mL

1 tbsp = ___ mL

15 mL

1 fl oz = ___ mL

30 mL

1 cup = ___ mL

240 mL

2.2 lbs = ___ kg

1 kg

1 in = ___ cm

2.54 cm

Oral formulations

caplets, capsules, elixirs, emulsions, gels, lozenges, solid extracts, fluid extracts, solutions, suspensions, syrups, tablets, tinctures

Topical formulations

creams, gels, ointments, patches, sprays, tinctures

Inhalation formulations

aerosols, mist, steam

Vaginal formulations

creams, foams, solutions, suppositories, tablets

IV, IM, SubQ, and ID formulations

injectable liquids, powders for reconstitution

Otic and ophthalmic formulations

drops, ointments

Rectal formulations

creams, gels, solutions, ointments, suppositories

Sublingual formulations

sprays, tablets

Buccal formulations

tablets

Nasal formulations

drops, mist, sprays