Health-Care Delivery, Settings, and Economics

Vocabulary flashcards focusing on health-care team roles, care delivery principles, models of nursing, legislative provisions, public and private insurance systems, and payment models.

Medical Doctor (MD) & Doctor of Osteopathy (DO)

Healthcare providers who diagnose and treat disease, illness, and injury, order diets, diagnostic tests, medications, treatments, therapies, and medical procedures, and direct the overall medical care of patients.

Physician's Assistant (PA)

A healthcare provider employed directly by a physician or hospital facility who works closely with physicians to assist in directing patient care.

Nurse Practitioner (NP)

A Master's-prepared registered nurse certified in a specific clinical area of practice holding an advanced practice license to diagnose illnesses and prescribe medications and treatments.

Registered Nurse (RN)

A nurse who practices within a defined scope under the direction of a physician, providing direct patient care, managing clinical departments, and supervising other nurses and unlicensed personnel.

Licensed Practical / Vocational Nurse (LPN/LVN)

A nurse who practices within a defined scope under the supervision of a physician, dentist, or RN to deliver direct patient care and supervise assistive personnel.

Unlicensed Assistive Personnel (UAP)

Healthcare personnel who perform tasks of greater complexity than certified nursing assistants, including sterile procedures in select state jurisdictions.

Certified Nursing Assistant (CNA)

Staff who perform direct patient care duties and provide general assistance to the nursing staff.

Respiratory Therapist (RT) & Respiratory Therapy Technician (RTT)

Therapy staff who evaluate, treat, and care for patients experiencing respiratory impairment due to heart and lung disease, with the RTT generally operating under direct RT supervision.

Physical Therapist (PT) & Physical Therapy Assistant (PTA)

Therapy staff who provide interventions to restore physical function and mobility, alleviate pain, and prevent or limit permanent physical disabilities, with the PTA working under PT supervision.

Speech and Language Therapist (ST)

A specialist who assesses, diagnoses, treats, and works to prevent disorders linked to speech, language, voice, swallowing, and fluency.

Occupational Therapist (OT) & Certified Occupational Therapy Assistant (COTA)

Therapy staff who assist patients with disabilities to develop, recover, or maintain essential skills needed for daily living activities and employment.

Pathologist (MD)

A medical doctor specializing in the examination of tissue and blood samples to determine the origin, nature, or presence of disease.

Medical Laboratory Technologist (MLT) & Medical Technician (MT)

Laboratory staff who examine and analyze body fluids and tissue specimens, perform cross-matching of blood for transfusions, and analyze therapeutic blood levels of medications.

Phlebotomist

A laboratory staff member who draws blood specimens directly from patients for laboratory testing.

Radiologist (MD)

A medical doctor specializing in diagnostic and therapeutic procedures involving X-rays and radiation therapy who interprets radiographs and other radiological imaging modalities.

Radiologic Technologist (Rad Tech)

A technician who operates X-ray machinery and specialized imaging technology (CT, MRI, ultrasound) and assists the radiologist by performing ordered diagnostic tests.

Pharmacist

An ancillary staff member who distributes prescription medications and provides clinical guidance to patients and prescribers regarding drug selection, dosages, drug interactions, and side effects.

Pharmacy Technician

An ancillary staff member who assists the pharmacist by preparing prescribed medications, answering clinical phone inquiries, and maintaining drug inventory.

Registered Dietitian (RD)

A specialist who designs regular and therapeutic menus to meet specific patient dietary needs, collaborates with health-care providers, and educates patients on dietary modifications.

Dietary Technician

An ancillary worker who assists the Registered Dietitian by distributing and collecting selective patient menus and monitoring individual food intake.

Medical Social Worker & Public Health Social Worker

Professionals who provide comprehensive psychosocial support, advise caregivers, counsel patients, coordinate post-discharge needs, and arrange external support services.

Chaplain

An ancillary staff member who provides spiritual care to patients, addresses spiritual needs facing terminal diagnoses, and offers ongoing spiritual support to hospital personnel.

TeamSTEPPS

An evidence-based teamwork system distributed by the Agency for Healthcare Research and Quality (AHRQ) focusing on structured communication and teamwork skills to optimize patient safety.

Managed Care

Any method of financing and organizing healthcare delivery where operational costs are contained by managing and controlling the provision of services and benefits.

Medical Necessity

A determination established by evaluating a patient's clinical information against medical review criteria to confirm services are reasonable, appropriate, and essential for treatment.

Team Nursing

A nursing care delivery model utilizing a coordinated team of RNs, LPN/LVNs, and CNAs or UAPs where tasks and care are delegated based on skills, education, and legal licensure.

Client-Centered Care

A care delivery model that empowers patients to direct and manage their own care trajectory and promotes autonomy by incorporating patient choice into schedules, goals, and strategies.

Primary Care Nursing

A nursing care delivery model assigning a single nurse full accountability for all aspects of nursing care for specific assigned patients throughout their stay.

Case Management

A nursing care delivery model focusing on coordinating care for vulnerable, high-risk, or cost-intensive patient populations to eliminate redundant services and maintain cost-effectiveness.

Affordable Care Act (ACA)

Healthcare reform legislation addressing cost containment, pre-existing condition protections, elimination of lifetime benefit caps, no-cost preventive services, and young adult coverage up to age 26.

Medicare

A federal public health insurance program designated for individuals aged 65 years and older, as well as younger individuals with End-Stage Renal Disease (ESRD) or specified debilitating conditions.

Medicaid

A joint state and federal assistance program providing targeted healthcare coverage for individuals with household incomes falling below established poverty thresholds, including low-income pregnant women, children, and individuals with disabilities.

Indian Health Service (IHS)

A federal funding system providing health service delivery to qualified Native American individuals with documentation verifying a Certificate of Degree of Indian Blood (CDIB).

Health Maintenance Organization (HMO)

A private cost-containment insurance model where Primary Care Physicians receive capitated monthly set rates per member, requiring network-only care and specialist referrals.

Preferred Provider Organization (PPO)

A private coverage network providing greater flexibility for out-of-network care, typically without rigid referral structures.

Point-of-Service Plans (POS)

A hybrid private insurance model combining features of HMO networks and out-of-network coverage options.

TRICARE

A federal health insurance program catering to active-duty military members, military retirees, and their eligible dependents.

CHAMPVA

A Veterans Affairs health insurance program offering medical coverage for eligible family members of disabled or deceased veterans.

Worker's Compensation

A mandatory employer-funded insurance program providing financial and medical benefits to employees injured on the job.

Concierge Medicine

An alternative self-pay model where patients pay an annual baseline retainer fee to secure 24/7 direct physician availability.

Diagnosis-Related Groups (DRGs)

A prospective payment classification schedule used by Medicare to assign fixed reimbursement amounts based on specific patient medical classifications and diagnoses.