Healthcare System and Contemporary Pharmacy Practice (PHR 915) - Vocabulary Flashcards

Vocabulary flashcards covering health concepts, health equity, care delivery, health professions, Medicare/Medicaid, care models, and policy/practice topics from the notes.

Health

State of complete physical, mental, and social well-being, not merely the absence of disease or infirmity (WHO, 1946).

Health Equity

Everyone has the opportunity to attain their full health potential and no one is disadvantaged because of social position or other socially determined circumstances.

Social Determinants of Health (SDOH)

Conditions in the environments where people are born, live, learn, work, play, worship, and age that affect health outcomes and risks.

Health Equity Framework - Programs

Programs that implement successful health equity strategies.

Health Equity Framework - Measurement

Data practices to support the advancement of health equity.

Health Equity Framework - Infrastructure

Organizational structures and functions that support health equity.

Health Equity Framework - Policy

Laws, regulations, and rules to improve population health.

Care

Efforts to maintain or restore physical, mental, or emotional wellbeing by trained and licensed professionals; includes preventive measures and medical interventions.

Ambulatory Care

Care provided on an outpatient basis in settings such as clinics, pharmacies, outpatient surgery centers, and hospital outpatient departments.

Health Care Professionals

Licensed professionals who provide care across settings, including nurses, physicians, pharmacists, dentists, PAs, and others.

Registered Nurse

Licensed nurse who provides patient care across settings.

Nurse Practitioner

Advanced practice registered nurse who provides clinical care, diagnosis, and treatment.

Physician

Medical doctor who diagnoses and treats illnesses.

Pharmacist

Licensed professional who dispenses medications and may provide clinical services.

Dentist

Licensed professional who treats teeth and mouth health.

Physician Assistant

Licensed clinician who collaborates with physicians to provide medical care.

Physical Therapist

Healthcare professional who helps patients improve movement and manage pain.

Psychologist

Professional who studies behavior and mental processes and may provide therapy.

Chiropractor

Healthcare professional who treats musculoskeletal issues through manual adjustment and other methods.

Optometrist

Eye care professional who provides vision tests and prescriptions for glasses or contacts.

Podiatrist

Foot and ankle care specialist.

Primary Care

Care for common health problems and preventive services; accounts for the majority of visits.

Secondary Care

Hospital-based care requiring more specialized clinical expertise.

Tertiary Care

Management of rare and complex disorders.

Healthcare System

Network of institutions and actors that provide care; includes input suppliers, financial intermediaries, regulators, and preventive services; and financing flows.

Providers, Payors, Patients

Three main system components: Providers deliver care, Payors finance/reimburse, Patients receive care.

Medicare

Federal health insurance program for people aged 65+ or certain younger individuals with disabilities; includes Parts A–D.

Medicaid

State-administered, federally guided program funding health care for low-income individuals and other groups.

Part A (Medicare)

Hospital Insurance: inpatient hospital care, skilled nursing facility, hospice, some home health services.

Part B (Medicare)

Medical Insurance: physician services, outpatient care, DME, labs, preventive services.

Part C (Medicare)

Medicare Advantage; private plans that cover Parts A and B and may include extra benefits and drug coverage.

Part D (Medicare)

Prescription Drug Benefit; outpatient drug coverage provided by private plans.

Capitated Care

A payment model where providers are paid a set amount per enrollee per month to cover expected care.

Traditional Medicare (Fee-for-Service)

Payment model where services are paid separately rather than bundled.

Bundled Payment for Rx

Payor arrangement where drug costs and related services are paid within a single bundle.

Future of Pharmacy Care Coalition

Advocates for federal policy solutions recognizing and advancing pharmacists’ essential role in patient care.

Scope of Practice (Kentucky context)

Legal authorization (e.g., KRS 315.010, 201 KAR Chapter 2) for immunizations, medications, and protocol-driven care, enabling pharmacist collaboration and MTM.