Healthcare Systems

Clinics-group of doctors who shares a facility and who provides specialty

care

Behavioral Health Facilities-specialized diagnostic and treatment centers

organized to serve the needs of patients with mental health and substance

use and abuse disorders

Healthcare System-organized, regulated entity providing healthcare

services to meet a specific need in a specific patient population

Health Information Portability and Accountability Act

(HIPAA)-legislation requiring healthcare entities to protect the privacy of

patient care information and medical records content and provide for easier

acquisition of health insurance

Health Maintenance Organizations-multiple providers and facilities

become aligned with a specific insurance carrier in order to encourage

preventive health care using healthcare cost incentives

Hospitals-organized and managed entities providing staff, training,

supplies, drugs, and support for the coordinated provision of services such

as direct patient care for acute and chronic illnesses and injuries,

emergency care for sudden severe illnesses or injuries, outpatient

diagnostic procedures and curative interventions, and rehabilitation

therapies

Insurance Companies/Plans-provide coverage of hospital/medical

expenses to subscribers who pay premiums for specific healthcare

expense coverage

Laboratories-facilities that perform diagnostic tests

Licensure-a process by which a government agency authorizes individuals

and care provision organizations to work in a given occupation or provide

healthcare services within a state or government entity

Long Term Care Facilities-provide extended care, nursing home, and

assisted living services for the elderly and disabled including bedside

nursing care, rehabilitation therapies, and homemaker activities as

dependency needs require

Medicare-insurance provided by federal funding for healthcare for those

older than 65 years old, administered by contracted insurance companies,

and managed by CMS (Center for Medicare/Medicaid)

Medicaid-Insurance provided by federal funding to the states for their

management in providing care for low income individuals.

Preferred Provider Organization-a network of providers and facilities

identified in an insurance plan that the insured must utilize to avoid a cost

penalty at the time of service