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Terms in this set (414)
Providers Are people or organizations that provide health care,
including doctors, nurses, clinics, and agencies.
facilities are places where care is delivered or administered,
including, hospitals, long-term care facilities or
nursing homes, and treatment centers.
Payers people or organizations paying for healthcare
services
long term care (LTC) facilities, also called "nursing homes," "skilled nursing
facilities," and "extended care facilities" are for
people who need 24-hour skilled care.
Skilled care is medically necessary care given by a skilled nurse
or therapist. Lo0ng-term care assists those with on-
going conditions
Assisted living facilities are residences for people who need some
help with daily care, such as showers, meals, and
dressing
(HHA typically work here)
Adult day services are for people who need some help and supervision
during certain hours, but who do not live in the
facility where care is provided
,Acute care 24-hour skilled care given in hospitals and
ambulatory surgical centers for people who require
short-term, immediate care for illnesses or injuries
Subacute care Is care given in a hospital or in a long term care
facility. It is used for people who need less care than
acute (sudden onset short-term) illness, but more
care than for a chronic (long-term) illness.
Rehabilitation is care given by specialists. Physical, occupational,
and speech therapists help restore or improve
function after an illness or injury.
Hospice Care is given in facilities or homes for people who have
approximately six months or less to live
traditional insurance companies offer plans that pay for the heath care of plan
members. Most people covered by traditional
insurance are part of plan at their place of work. The
costs are paid for by the employer, the employee, or
shared by both.
Health Maintenance Organization Alternative means of health care in which people or
(HMO) their employers are charged a set amount and the
HMO provides health care and covers hospital costs.
You must use a particular doctor or group of doctors
except in the case of an emergency.
Preferred Provider Organization (PPO) a group of doctors and hospitals that agree to
provide health care at rates approved by the insurer
Managed care Cost-control strategies for health care (HMOs and
PPOs). They replace traditional insurance plans.
,Medicare A program added to the Social Security system in
1965 that provides hospitalization insurance for the
elderly and permits older Americans to purchase
inexpensive coverage for doctor fees and other
health expenses.
(4 Parts)
A: Helps pay for care in hospital or skilled nursing
facility or for care from a home health agency or
hospice.
B: Helps pay for doctor services and other medical
services and equipment
C: Allows private health insurance companies to
provide medicare benefits.
D: Helps pay for medications prescribed for
treatment.
-Covers more than 43 million people
-Pays for 37% of all home care
-Only pays for services if medically necessary
-Usually people that just got home from the hospital
Medicaid Is a medical assistance program for low income
people. It is funded by both the federal government
and each state. People must qualify for this program.
When were the first home health aides During The Great Depression in the 1930s, women
hired? were hired as "housekeeping aides." They were paid
by the government. Once the program discontinued,
some aides continued to work for local family and
children services, which provided services to families
in need.
In 1959... A national conference on homemaker services was
held. It was clear that there was a great need not
only for homemaker or housekeeping services, but
for personal, in-home care for sick people.
, In 1965... The Medicare program was created. Because many
Medicare recipients need home care, home health
services have been growing ever since. Medicare
first began referring to home makers as "home health
aides."
What are the basic methods of 1. Medicare
payment for home health services? 2. Medicaid
3. State and local governments
4. Insurance company
5. Individual client or family
Home Health Agencies businesses that provide health care and personal
services in the home.
What are some of the healthcare nursing care, specialized therapy, specific medical
services that are provided by home equipment, pharmacy, intravenous (IV) products, and
health agencies? personal care.
Home Health Aide (HHA) performs assigned tasks, such as taking vital signs,
and provides or assists with routine personal care,
such as bathing clients or preparing meals. Spend
the most time with clients than other members of the
health care team. They act as the "Eyes and ears" of
the team.
Case Manager/Supervisor Usually a registered nurse, a case manager, or
supervisor is assigned to each client by the home
health agency. They create the basic care plan for
each client. Monitors any changes that are observed
and reported by the HHA.
Registered Nurse In a home health agency, a RN coordinates,
manages, and provides care. RNs also supervise and
train home health aides. They develop the home
health aide plan of care, or assignments. Graduated
from two/four year nursing programs and passed a
licensing exam.