Case Management
Range of models for intergrating health care services for individuals or groups
Coinsurance
The percentage share of a government approved charge that is paid by the client
Critical Pathways
An interdisciplinary plan or tool that specifies interdisciplinary assessments interventions, treatments outcome for healthrelated conditions across a time line
Diagnosis-Related Groups (DRG)
A classification system that establishes pretreatment diagnosis billing categories
Differentiated Practice
Health care plan that contracts with individual health care providers
Health Care System
System in which the best use of nursing personnel is based on their educational preparation and skill use
Health Maintenance Organization (HMO)
A group health care agency that provides health maintenance and treatment services to voluntary enrollees
Independent practice associations (IPAs)
Similar to HMOs, care is provided in offices where the client pays a fixed amount to the IPA
Integrated Delivery System (IDS)
One that incorporates acute care services, home health care, extended and skilled care facilities and outpatient services
Licensed Vocational (practical) Nurse
Provides direct client care under the direction of a registered nurse, physician or other licensed practitioner
Managed Care
A health care system whose goals are to provide cost effective quality care
Medicaid
Federal public assitance program that provides health care coverage to people who require financial assistance
Medicare
National and health insurance program for older adults
Patient-focused care
A delivery model that brings services, providers to the clients
Preferred Provider Arrangements
Similar to PPOs but PPAs can contract with individual health care providers, the plan can be limited or unlimited
Preferred Provider Organization
Health care plan that contracts with a group of providers or agency that provides services at a discounted rate
Supplemental Security Income
the totality of services offered by all health disciplines