Health Care Workforce, Care Continuum, Post-Acute Care, and System Gaps

Vocabulary flashcards covering healthcare scope of practice, state practice regulations, care delivery models, continuum facilities (FQHC, RHC), post-acute settings, end-of-life care, and healthcare delivery gaps.

Physician (MD/DO)

A doctor who evaluates, diagnoses, treats, monitors, advises, prescribes, delegates, and supervises care within their specialty and breadth of knowledge.

Nurse Practitioner (NP)

An advanced nurse who evaluates, diagnoses, treats, monitors, advises, and prescribes (with some restrictions) within their specialty and breadth of knowledge under a practice agreement with a participating physician.

Physician Assistant (PA)

A medical provider who evaluates, diagnoses, treats, monitors, advises, and prescribes (with some restrictions) within their specialty and breadth of knowledge under a practice agreement with a participating physician.

Registered Nurse (RN)

A healthcare professional who assesses patients, plans care, and manages overall nursing care.

Licensed Practical Nurse (LPN)

A nurse who provides routine nursing care and implements the care plan under direction.

Certified Nursing Assistant (CNA)

A care provider who helps patients with daily activities and everyday needs, such as bathing, dressing, and eating.

Pharmacist

A healthcare professional who serves as a medication expert.

Collaborative Practice Agreement (Michigan NP Rule)

An agreement for nurse practitioners that must be renewed annually and requires direct physician delegation for prescribing controlled substances.

Participating Practice Agreement (Michigan PA Rule)

An agreement for physician assistants that continues until terminated and allows them to prescribe controlled substances under their own authority.

Independent Panels Model

A care delivery model where each provider independently manages their own group of patients.

Collaborative Model

A care delivery model where providers work together while managing their own patient panels.

Shared Panels Model

A care delivery model where multiple providers share responsibility for the same group of patients.

Team-Based Model

A care delivery model where different healthcare professionals collaborate to meet patients' needs.

Delegated Model

A care delivery model where a physician delegates appropriate clinical tasks to a PA or NP within applicable practice requirements.

Broader Care Team

A team of professionals that assists patients with needs such as mobility, nutrition, mental health, and access to resources.

Federally Qualified Health Center (FQHC)

A non-profit or publicly owned clinic located in a federally designated medically underserved population that provides comprehensive primary care and enabling services regardless of ability to pay, using a sliding fee scale.

FQHC Board Requirement

A governance rule mandating that patients must make up at least $51\%$ of an FQHC's governing board.

Section 330 Federal Grants

Federal grants provided along with special Medicare/Medicaid payment rates to fund Federally Qualified Health Centers (FQHCs).

Rural Health Clinic (RHC)

A non-profit, for-profit, or publicly owned clinic in a qualifying rural area with a federal shortage or medically underserved designation that provides basic laboratory services under special Medicare/Medicaid payment rates without being required to serve everyone.

RHC Staffing Requirement

A regulatory rule requiring a Rural Health Clinic to have an NP, PA, or certified nurse-midwife on staff for at least half the time the clinic is open.

Swing Bed

A bed in a small rural hospital that can be used interchangeably for either acute hospital care or skilled nursing-level care, depending on the patient's clinical need.

Long Term Care Hospital (LTCH)

An institutional post-acute care setting for very sick patients who require hospital-level care for weeks but no longer need an intensive care unit (ICU).

Inpatient Rehabilitation Facility (IRF)

A post-acute care setting for medically stable patients who are strong enough to tolerate intensive therapy for approximately $3\text{ hours}$ per day.

Skilled Nursing Facility (SNF)

A post-acute care facility for patients who require daily nursing care or less intensive rehabilitation to recover but cannot tolerate intensive therapy.

Palliative Care

Care aimed at managing pain, symptoms, and stress at any stage of illness, which can occur alongside curative or disease-controlling treatments.

Hospice Care

Comfort- and quality-of-life-focused care near the end of life for patients with a life expectancy of $6\text{ months}$ or less, typically initiated after curative treatments have stopped.

Coverage Gap

A systemic gap in the care continuum where healthcare services exist, but insurance does not pay for them.

Workforce Gap

A systemic gap characterized by an insufficient number of healthcare providers to meet patient needs.

Access Gap

A systemic barrier where the patient is unable to physically or practically reach care.

Fragmentation Gap

A systemic breakdown where healthcare is split into disconnected systems that lack effective communication.

Coverage-Workforce Interaction

A dynamic where lack of coverage leads to fewer providers practicing in an area because patients cannot cover the cost of care.

Workforce-Access Interaction

A dynamic where provider shortages force patients to experience longer wait times and drive longer distances.

Fragmentation-Access Interaction

A dynamic where poor communication between disconnected providers results in lost referrals and delayed care.

Coverage-Access Interaction

A dynamic where lack of insurance coverage causes patients to delay or skip receiving necessary care.

Dental Care (Systemic Separation)

A sector of care that developed distinct insurance models and extra benefits sold independently, which is not covered by Medicaid.

Vision Care (Systemic Separation)

A sector developed around separate training and licensing with glasses sold as retail products and separate vision insurance, not covered by Medicaid.

Hearing Care (Systemic Separation)

A health service domain historically sold directly to consumers without insurance coverage, leaving hearing aids uncovered.

Mental Health Care (Systemic Evolution)

A sector that grew out of the public, government-funded system, later designated as an essential health benefit under the ACA.