13389762
Description
Mind Map by Casey Jones, updated more than 1 year ago
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Created by Casey Jones
over 6 years ago
|
|
Allied Health
- United States Health Care System
- Purpose
- Improve health for
populations seeking care
through Health Care
professionals
- Improve health for
populations seeking care
through Health Care
professionals
- 9 Settings Professionals Work
- Ambulatory Care Centers
(Community Centers)
- Provide consultation, treatment, and
medication using advanced medical
technology. (Outpatient Care)
- - Minor Surgeries/ Procedures - Therapies
-Diagonostic Testing - Preventative Services
- - Minor Surgeries/ Procedures - Therapies
-Diagonostic Testing - Preventative Services
- Provide consultation, treatment, and
medication using advanced medical
technology. (Outpatient Care)
- Acute Care Hospitals (Hospitals)
- Provide care for individuals who have a disease
that comes on quickly or that lasts for a short
period of time.
- - Technical equipment - Phamaceuticals - Medical Supplies -
Medical staff and all neccessary personnel
- - Diagnosis Illness - Care/ Treat acute
conditions/ injuries
- - Proprietary (for profit) - Nonprofit (charity
based) - Government supported
- - Technical equipment - Phamaceuticals - Medical Supplies -
Medical staff and all neccessary personnel
- Provide care for individuals who have a disease
that comes on quickly or that lasts for a short
period of time.
- Long- Term Care Agencies
- Skilled nursing facilities
- Provide care that requires skills of a
licensed personnel, physical therapist or
occupational therapy aide.
- Regain skills such as feeding, dressing,
and bathing themselves.
- Regain skills such as feeding, dressing,
and bathing themselves.
- Provide care that requires skills of a
licensed personnel, physical therapist or
occupational therapy aide.
- Assisted Living facilities
- Bridge the gap between home
care and nursing homes, provide a
homelike enviornment
- Bridge the gap between home
care and nursing homes, provide a
homelike enviornment
- Hospice Care
- Caring for the physical and
emotional needs of
terminal illnesses
- Provides Care within
patients home
- Provides Care within
patients home
- Caring for the physical and
emotional needs of
terminal illnesses
- Skilled nursing facilities
- Home Care
- Supportive
care within
patients
home
- Supportive
care within
patients
home
- Doctor's Offices
- Medical facilities in
which medical doctor
receives and treats
patients
- Physicians-
Medical Doctors
(MD), Doctors of
Osteopathy
(Therapy)
- Chiropractors-
Back/
Musculoskeletal
(Limited to
prescribing and
diagnosing
- Nurse- Master's of
doctoral in nursing
(prescribe under
guidance of physician
- Physician's assistants
(PAs)- BA & 2 years of PA
School (prescribe under
guidance of physician
- Medical Administrative Assistants (MAAs)
- Medical Assistant (MAs)- clinical duties under a physician,
nurse practitioner, or PA (Vital signs, sterilize, assist in
procedures, take electrocardiograms (E KG).
- Medical Assistant (MAs)- clinical duties under a physician,
nurse practitioner, or PA (Vital signs, sterilize, assist in
procedures, take electrocardiograms (E KG).
- Medical Administrative Assistants (MAAs)
- Physician's assistants
(PAs)- BA & 2 years of PA
School (prescribe under
guidance of physician
- Nurse- Master's of
doctoral in nursing
(prescribe under
guidance of physician
- Chiropractors-
Back/
Musculoskeletal
(Limited to
prescribing and
diagnosing
- Physicians-
Medical Doctors
(MD), Doctors of
Osteopathy
(Therapy)
- Medical facilities in
which medical doctor
receives and treats
patients
- Specialty Hospitals
- specialized
care to
specific
patients,
populations,
or diseases
- Pediatrics-
(Children 1-18),
Geriatrics (Adults
65+), Oncology
(Cancer),
Cardiology (Heart)
- Pediatrics-
(Children 1-18),
Geriatrics (Adults
65+), Oncology
(Cancer),
Cardiology (Heart)
- specialized
care to
specific
patients,
populations,
or diseases
- Health Maintenance
Organizations (HMOs)
- Provide health care options
at reduced costs, arrange
for the provision of health
care through a prepaid plan
that provides through
networks of doctors and
hospitals.
- Medical biller & medical
coder, Medical Assistant,
Medical Transcriptionist,
Pharmacy Technician,
Optician
- Medical biller & medical
coder, Medical Assistant,
Medical Transcriptionist,
Pharmacy Technician,
Optician
- Provide health care options
at reduced costs, arrange
for the provision of health
care through a prepaid plan
that provides through
networks of doctors and
hospitals.
- Rehabilitation Centers
- Aide patients to
return to their
highest state of
optimal health
after illness or
injury.
- Physical therapist aides- work with physical
therapists to provide care with ambulation
(moving from place to place), bend mobility
and transfer, exercises to promote physical
strength, pain relief techniques.
- Occupational therapy
aides- motion
exercises, splinting to
support an injury, and
wound care.
- Activities of Daily Living (ADL)
- Activities of Daily Living (ADL)
- Speech pathology
assistants- directly
under licensed
speech pahtologists.
- Physical therapist aides- work with physical
therapists to provide care with ambulation
(moving from place to place), bend mobility
and transfer, exercises to promote physical
strength, pain relief techniques.
- Aide patients to
return to their
highest state of
optimal health
after illness or
injury.
- Hospice Care (Palliative Care)
- Critically ill- supportive
treatment, alleviate their
pain, and provide comfort
when needed.
- Critically ill- supportive
treatment, alleviate their
pain, and provide comfort
when needed.
- Ambulatory Care Centers
(Community Centers)
- Health Maintenance Organizations (HMOs)
- Group of people, agencies, and/or
instutions that provide health care
services to individuals
- Private Sector Businesses
- Purpose
- Health Insurance (Health Benefits/ Health Coverage)
- Provides patients
with a means to
pay the costs
associated with
medical care and
services.
- Public Insurance
- Affordable Care Act
(ACA)- Act signed in
2010 to increase the
quality of affordability
of health insurance
- 7 Major
Changes
- Up to age 26 able to
stay on their
parents health
insurance
- Preexisting Condition
Insurance Plan (PCIP)- allows
people with preexisting
conditions to qualify
- Children can't be denied
- Children can't be denied
- Reimburse health care
providers to cover
eary retirees until
benefits of the ACA
(01/14), 55-65
- ACA addresses
shortage of health
care providers in
rural areas
- Insurance
companies are
required to explain
the costs of
insurance
premiums
- Medicaid
eligibility
numbers
have
increased
for each
state
- Additional funding
for building
community health
centers
- Up to age 26 able to
stay on their
parents health
insurance
- How does the
ACA protect
health
consumers?
- Insurance companies held
accountable. Not allowed to
deny paying claims, create
maximum annual payment
limits, create lifetime payment
limits
- Insurance companies held
accountable. Not allowed to
deny paying claims, create
maximum annual payment
limits, create lifetime payment
limits
- How does the ACA
benefit senior
citizens?
- Free preventative care such as
wellness checkups, Access to a
community transition program-
patient navigators assist seniors in
accessing services within their
communities
- Free preventative care such as
wellness checkups, Access to a
community transition program-
patient navigators assist seniors in
accessing services within their
communities
- What is the
Independent
Payment
Advisory
Boards (IPAB)?
- Reduce costs,
eliminate
waste, improve
health care for
seniors
- Reduce costs,
eliminate
waste, improve
health care for
seniors
- Accountable Care
Organization (ACOs)-
Providers volunteering to
give high quality care to
their Medicare patients;
Avoiding unnecessary
duplication of services and
preventing medical errors
- IPABs & ACOs monitor
health care
reimbursement. Process
follows: 1) Medical Billers
and coders submit claims
for Medicare patients. 2)
Boards make projections
about the amount spent on
reimbursement for
supplies and services for
Medicare patients.
- Methods to increase access to health care
through Medicaid: - Doctors receive higher
reimbursement rates, more individuals are also
eligible to receive Medicaid coverage. -
Individual states receiving incentives to expand
Medicaid coverage - Individuals receive tax
incentives enrolling in health care plans. -
Health Insurance Marketplace allow individuals
and businesses to apply for affordable health
insurance.
- 7 Major
Changes
- Government Health Insurance
- Medicaid- state-run
government program
that helps people with
lower incomes pay for
medical care
- Children's Health
Insurance Program
(CHIP)
- Families who don't have coverage
- Pays only $50 annually as well as co-pays
- Pays only $50 annually as well as co-pays
- Families who don't have coverage
- Largest source of
funding for health
insurance for low
income families
- Funded by both
federal and state
govemments,
managed at state
level
- Individual/ family salary
below poverty level
- Children's Health
Insurance Program
(CHIP)
- Medicare- federal program
for people 65+, younger
with disabilities, people
with end-stage renal
disease (E SRD)
- Previously worked
and paid taxes to
the government
- Medicare Part A-
inpatient hospital
coverage, skilled
nursing care, nursing
home care, and
hospice care
- Medicare Part B-
outpatient services, lab
tests, visits to doctor,
durable medical
equipment (DME),
ambulance and
preventative services
- Medicare Part C (Medicare
Advantage Plan)- includes
prescription drug coverage, ran by
private companies, combines
coverage provided with A & B
- Medicare Part D (Medicare
Prescription Drug Benefit)-
subsidizes the costs of
prescription drugs and
premiums
- Can be purchases in 1)
separately as only Medicare D
2) in addition to Medicare Part C
- Can be purchases in 1)
separately as only Medicare D
2) in addition to Medicare Part C
- Diagnosis- related Groups (DRGs)
- Use a formula to calculate reimbursement
for providers in acute care settings
- Principal Diagnosis-
Primary condition that led
to the patient being
admitted to the hospital
- Secondary
Diagnoses-
complications
that may affect
the patients
course of
treatment or
prolong stay
- Factors Used to Calculate DRGs
- Severity of Illness
- Risk of Mortality
- Prognosis
- Treatment Difficulty
- Need for Intervention
- Resource Intensity
- Severity of Illness
- Use a formula to calculate reimbursement
for providers in acute care settings
- Previously worked
and paid taxes to
the government
- Tricare
- Military
- Department of Defense
- Military
- Federal Employees Health
Benefits (FE HB)
- Indian Health Services (IHS)
- Veteran's Health Care
for military veterans
- Medicaid- state-run
government program
that helps people with
lower incomes pay for
medical care
- Affordable Care Act
(ACA)- Act signed in
2010 to increase the
quality of affordability
of health insurance
- Private Insurance
- Health Care
Maintenance
Organizations
(HMOs)
- Low or No Premiums, Lower Out of
Pocket Costs, Lower Copayments,
Smaller Network, Does not cover
Out of Network
- Provides or arranges managed care
for health insurance, self funded
health care benefit plans,
individuals, and other entities. Acts
as a liaison with health care
providers on a prepaid basis.
- Low or No Premiums, Lower Out of
Pocket Costs, Lower Copayments,
Smaller Network, Does not cover
Out of Network
- Preferred Provider
Organizations (PPOs)
- Out of Network Coverage, State or
Nationwide, Provider Network, No
Referrals to See Specialists, Easy to
Use
- Agreement between
entities such as hospitals,
doctors, surgery centers,
and insurance agencies to
provide health care at a
reduced amount.
- Out of Network Coverage, State or
Nationwide, Provider Network, No
Referrals to See Specialists, Easy to
Use
- Point of Service-
choose between
an HMO or PPO
each time they
receive.
- Provided by
employers and
other
organizations
- Health Care
Maintenance
Organizations
(HMOs)
- Costs of Insurance
- Deductible- minimum
amount payed out of
pocket before a health
isurer will pay any
expenses to health
care provider
- Copayment (Copay)-
predetermined amount
defined by health insurer
paid each time a health
service is accessed.
- Coinsurance- refers
to splitting the cost
between
individuals and
their insurance
carrier
- Deductible- minimum
amount payed out of
pocket before a health
isurer will pay any
expenses to health
care provider
- Provides patients
with a means to
pay the costs
associated with
medical care and
services.
- Cultural Differences
- Communication Methods
- Health
Care
Careers
- Health Care Worker
- Community Settings
- Hospital Environment
- Health Care Worker
- Health
Care
Careers
- Communication Methods
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