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Fundamentals of Nursing Chapt 6
Berman
16
Nursing
Undergraduate 3
01/28/2012

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Cards

Term
Case Management
Definition
a method for delivering nursing care in which the nurse is responsible for a caseload of clients across the health care continuum
Term
Managed Care
Definition
a method of organizing care delivery that emphasizes communication and coordination of care among all health care team members
Term
Health Care System
Definition
the totality of services offered by all health disciplines
Term
Critical Pathways
Definition
multidisciplinary guidelines for client care based on specific medical diagnoses designed to achieve predetermined outcomes
Term
Patient Focused Care
Definition
delivery model that brings all services and care providers to the client
Term
Team Nursing
Definition
the delivery of individualized nursing care to clients by a team led by a professional nurse
Term
Medicare
Definition
a national and state health insurance program for U.S. residents older than 65 years of age
Term
Coinsurance
Definition
an insurance plan in which the client pays a percentage of the payment and some other group (e.g., employer, government) pays the remaining percentage
Term
Medicaid
Definition
a no cost federal & state insurance program for the poor
Term
Supplemental Security Income
Definition
special payments for people with disabilities, those who are blind, and people who are not eligible for Social Security; these payments are not restricted to health care costs
Term
Diagnosis Related Groups
Definition
a Medicare payments system to hospitals and physicians that establishes fees according to diagnosis
Term
Health Maintenance Organization
Definition
a group health care agency that provides basic and supplemental health maintenance and treatment services to voluntary enrollees
Term
Preferred Provider Organization
Definition
a group of physicians or a hospital that provides companies with health services at a discounted rate
Term
Preferred Provider Arrangement
Definition
similar to PPOs, but PPAs can contract with individual health care providers; the plan can be limited or unlimited
Term
Independent Practice Association
Definition
provide care in offices; clients pay a fixed prospective payment and IPA pays the provider; earnings or losses are assumed by the IPA
Term
Integrated Delivery System
Definition
a system that incorporates acute care services, home health care, extended and skilled care facilities, and outpatient services
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