Healthcare Flashcards

Flashcards on Healthcare Delivery & Insurance in the United States

Public Health Practice

Interventions aimed at disease prevention and health promotion, specific protection, and case findings.

Primary Medical Care

Clinical preventive services; first-contact treatment; ongoing care for common conditions.

Secondary Medical Care

Specialized attention and ongoing management (e.g., cardiologist, dermatologist, urologist).

Tertiary Medical Care

Highly specialized and technologically sophisticated medical and surgical care for unusual and complex conditions.

Long-Term Practice

Provided after surgery or other treatment - rehab care, therapy, home care.

Long-Term Care

Help with chronic illnesses and disabilities, time-intensive skilled care to basic daily tasks.

End-of-Life Practice

Services provided shortly before death.

Doctors of Medicine (MD)

Focus on diagnosis and treatment of disease; allopathic providers.

Doctors of Osteopathic Medicine (DO)

Focus on relationship between body structure & function.

Non-allopathic providers (CAM)

Nontraditional means of health care like acupuncture, homeopathy, chiropractic care.

Limited (or Restricted) Care Providers

Advanced training in a health care specialty; provide care for a specific part of the body.

Non-Physician Practitioners (NPPs)

Practice in many areas like physicians, but do not have MD or DO degrees; training beyond RN but less than a physician.

Allied Healthcare Professionals

Assist, facilitate, and complement work of physicians and other health care specialists.

Public Health Professionals

Work in public health organizations, financed by tax dollars, and available to everyone.

Private Hospitals

Profit making; specialty hospitals.

Public Hospitals

Supported and managed by government jurisdictions.

Voluntary Hospitals

Not-for-profit and receive tax benefits; About half of all U.S. hospitals.

Outpatient Care

Patient receives ambulatory care without being admitted.

Rehabilitation Centers

Restorative care is provided following injury, disease, or surgery.

Premiums

Regular periodic payments for insurance coverage.

Deductible

Amount of money that the beneficiary must pay before the insurance company pays.

Co-insurance

Portion of an insurance company’s approved amounts that the beneficiary pays.

Co-payment

A negotiated set fee.

Fixed indemnity

Maximum amount an insurer will pay for a certain service.

Exclusion

Specific health condition excluded from coverage.

Pre-existing condition

Condition diagnosed or treated 6 months before a policy began.

Managed Care

Control costs through efficiency & coordination, reduce unnecessary utilization, increase access to preventive care.

Preferred Provider Organizations (PPO)

An organization that buys fixed-rate health services and sells them to consumers; can go in or out-of-network.

Exclusive Provider Organizations (EPO)

Like PPO but with fewer providers and stronger financial incentives; must use in-network providers.

Health Maintenance Organizations (HMO)

Groups that supply prepaid comprehensive health care with an emphasis on prevention and primary care; must stay in-network.

Point-of-Service plan (POS)

Allows you to go out-of-network for covered services but for a higher cost; hybrid of HMO and PPO.

National Health Insurance

A system in which the federal government assumes responsibility for health care costs of the entire population; primarily paid for with tax dollars.

Health Savings Account (HSA)

Functions like 401(k) plans, high deductibles/lower premiums, pay for medical needs tax-free.

Health Reimbursement Arrangements (HRA)

Established by employers to pay employees’ medical expenses.

Flexible Spending Account (FSA)

Functions on an annual basis; estimate annual health care costs; pay for health care tax-free; lose unused money at the end of the cycle.

Affordable Care Act (ACA)

Increase the number of U.S. citizens who have health insurance.