Term
| Definition of ACA (contains 4 main points) |
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Definition
The Patient Protection and Affordable Care Act (ACA) is the landmark health reform legislation passed by the 111th Congress in 2010:
1) To provide more people with access to healthcare
2) Improve quality of healthcare and healthcare insurance
3) Regulate the healthcare insurance industry
4) Reduce healthcare spending |
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Term
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Definition
1) Integrate models of care
2) Expansion of Medicaid
3) Establish Health Information Exchange |
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Term
| Concepts associated with ACA : Accountable Care |
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Definition
| Organizations of healthcare providers for Medicare beneficiaries. Less structured than PCMH. Share in savings. |
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Term
| Concepts associated with ACA : Medicaid/Medicare |
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Definition
Medicare and Medicaid are two different government-run programs that were created in 1965 in response to the inability of older and low-income Americans to buy private health insurance. Medicare and Medicaid are social insurance programs that allow the financial burdens of illness to be shared among healthy and sick individuals, and affluent and low-income families.
*Medicaid is not the same as Medicare.
*Medicare is a federal program that provides health coverage if you are 65 or older or have a severe disability, no matter your income.
*Medicaid is a state and federal program that provides health coverage if you have a very low income.
*If you are eligible for both Medicare and Medicaid (dual eligible), you can have both. |
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Term
| Social Work Profession’s unique qualities that make it suited to ACA |
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Definition
1. Patient Navigation
a. Help with enrollment of uninsured and underinsured
b. Educate about plan selection
c. Understand referral system
d. Improve patient health literacy
2. Care Coordination
a. Inclusion and opportunities for SWs on multidisciplinary teams
3. Mental health/behavioral health parity
a. About 30 million people gain coverage for BH (an increase of 82% since ACA roll-out)
b. Medicaid is the main payer for BH services
c. Expansion of BH workforce presents opportunities for SW |
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Definition
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Term
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Definition
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Term
Concepts associated with ACA :
Health Information Exchange |
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Definition
Allows healthcare providers to access and securely share patient medical information electronically with other providers.
Avoid readmissions
Avoid medications errors
Improve diagnoses
Decrease duplicate tests etc. |
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Term
| Differences between the concepts of standards, values and ethics- Standards |
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Definition
Something put into place to improve practice and service delivery
establishes professional expectations
Provides a framework to assess responsible professional behavior.
Creates a context for values and Ethics
Forms the basis for making decisions. |
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Term
| Differences between the concepts of standards, values and ethics- Value |
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Definition
| A basic BELIEF we think to be true, through which we look at the world. |
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Term
| Differences between the concepts of standards, values and ethics- Ethic |
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Definition
| What we DO! Evolve into guidelines or rules. |
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Term
| Social Work Core Values (6) SSD(H)IIC |
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Definition
1. Service
2. Social Justice
3. Dignity and Worth of the Person
4. Importance of Human Relationships
5. Integrity
6. Competence |
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Term
| Medical Ethics (6) ABNJDF |
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Definition
1. Autonomy
2. Beneficence
3. Nonmaleficence
4. Justice
5. Dignity
6. Fidelity |
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Term
| Ethical Dilemmas A, D, CA, C, RA, I, M |
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Definition
| Assess situation, determine issues, consider alternatives, consult with professionals, review alternatives with patient, implement the best alternative, Monitor, evaluate and document the decision. |
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Term
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Definition
| Health Insurance Portability and Accountability Act- provided the first nationally recognizable regulations for the use/disclosure of an individual's health information. |
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Term
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Definition
| Preventable differences in incidence of disease, injury, violence experienced by socially disadvantaged populations. |
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Term
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Definition
| Absence of unfair and avoidable or remediable differences in health among social groups. |
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Term
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Definition
Living and working conditions that influence health directly and indirectly.
They play a more direct causal role and represent opportunities for improving health and reducing health disparities. |
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Term
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Definition
| Interventions after the fact. Medical care, fixes. |
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Term
| Pathways through which social factors shape health (6) NEIRSG |
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Definition
Neightnorhood conditions and health
Education and health
Income, wealth, and health
Race, Racism, and health
Role of stress
Health effects of social factors across generations |
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Term
ACE Concept (3) ANET
Adverse Childhood Events |
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Definition
| Childhood abuse, neglect, and exposure to other traumatic stressors are referred to as this. |
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Term
| Interdisciplinary vs. Multidisciplinary |
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Definition
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Term
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Definition
-Uses meaningful performance measures to gauge effectiveness
- Emphasize care coordination and interdisciplinary teams
- Integration of PC (Primary Care Physician) and BH (Behavioral Health) in one of three ways |
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Term
Social worker functions in team settings
CA, CM, HP, HE, TCH, LCS, AC |
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Definition
Comprehensive assessment and case management
Health promotion/health education
Therapy/clinical interventions
Linkages to community services
Advanced care planning |
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Term
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Definition
| The deliberate organization of patient care activities between two or more participants (including the patient) involved in a patient’s care to facilitate the appropriate delivery of health care services |
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Term
Key Services provided by PCMH
SEACM, BH, EOL |
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Definition
M• Preventive screening/health education
• Acute primary care
• Coordination of diagnostic services and specialty care
• Management of chronic health conditions
• Behavioral health care
• End of life care (source: Commonwealth Fund) |
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Term
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Definition
Decrease in hospitalizations for chronic illness.
>3 month complex |
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Term
| Integrated Care- Why is it important |
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Definition
| Mental health issues often first emerge in PC settings. SMI die 25 year earlier but 2/3 are treatable. S physical H issues more prone to depressions and anxiety. Hader for them to follow instructions and make lifestyle changes. |
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Term
| Integrated Care 3 Models, CCFI |
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Definition
| Coordinated, Co-located, Fully Integrated |
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Term
| Coordinated- a model of integrated care |
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Definition
- Info exchanged routinely
- need to bridge different cultures between medical and mental health
- Requires effort. Success is from personal commitment of providers. |
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Term
| Co-Located- a model of integrated care |
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Definition
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Term
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Definition
| A true team in a shared practice with a shared vision of treating the whole person |
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Definition
| Partnership created by schools and community health organizations to provide on-site medical and mental health services that promote the health and educational success of school-aged children and adolescents. |
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Term
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Definition
| The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. |
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Term
| Causes of mortality in adolescent population |
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Definition
| Largely preventable- accidents, homicide, suicide motor vehicle crashes, substance use, smoking, STI/STD, Pregnancy, Homelessness |
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Term
| Brain changes during adolescence |
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Definition
Connections- between different parts of the brain increase
Circuitry- involved in emotional responses is change during the teen years.
Hormonal- enormous changes
Sleep regulation- changes that contribute to teens' tendency to stay up late at night. |
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