NHA CCMA Module 14

Three main goals of ACA

- Expand health insurance coverage - Shift the focus of health care delivery system from treatment to prevention - Reduce costs and improve the efficiency of health care

Psychiatrist

A medical doctor specializing in the diagnosis and treatment of mental illness.

Psychologist

A scientist who studies the mind and behavior of humans and animals

ACA

Affordable Care Act

Auditory learning

Learning by hearing and listening

Kinesthetic learning

Learning by performing a task or handling items

Coordinated Care

Patient care strategies that follow a management philosophy designed to improve patient care outcomes

PCMH

Patient-Centered Medical Home; A health care setting that organizes care around patients, working in teams and coordinating and tracking care over time.

Primary Care Provider (PCP)

Practitioners that coordinate preventative health care services

Practical Nurse (PN)

Triage phone calls, administer meds, and assist w/ other clinical duties

Social Workers

professionals with training in social welfare, human behavior, and the social environment who work with individuals, families, and groups

Patient-Centered

providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions

Accessible Services

providing tools (open-scheduling, extended hours, communication with providers) through patient information web portals

What does MACRA do?

replaces former medicare reimbursement schedule with a pay-for-performance program focusing on quality

Pharmacist

specialist in preparing and dispensing drugs

Dentist

specialist in teeth

Speech Therapist

treats and prevents speech and language disorders

Registered Dietitian Nutritionist (RDN)

A health professional who is a food and nutrition expert

ACOs

Accountable Care Organizations

Institute for Healthcare Improvement (IHI)

An independent organization devoted to improving patient safety and health care globally. Goals: 1. improve experience of care 2. improve health of populations 3. reducing cost of health care

Accountable Care Organization (ACO)

An organization of healthcare providers accountable for the quality, cost, and overall care of Medicare beneficiaries who are assigned and enrolled in the traditional fee-for-service program

Comprehensive Care

Cares for all pt needs--that is, the whole patient and not just medical and physical concerns. This involved the providers as well as the entire health care team

5 core functions of PCMH

Comprehensive Care Patient Centered Coordinated Care Accessible Services Quality and Safety

Continuity of care

Continuation of care smoothly from one provider to another, so that the patient receives the most benefit and no interruption in care.

Specialist

Diagnoses and treats conditions that require a specific area of expertise and knowledge.

Adv Practice Nurses

Usually perform same tasks as PA but are specialized nurses (ex. nurse anesthetists)

Occupational Therapist (OT)

assess a patient's pain, strength, and mobility to develop a treatment plan to improve areas of concern

Quality and Safety

commitments include delivering quality health care. This is met by delivering evidence-based medicine

compliance

meeting the standards and regulations of medical practice's establishing policies and procedures

Visual learning

Learning by seeing, reading, and watching

Registered Nurses (RN)

Licensed by individual states and oversee case management of pts w. complex chronic condition and coach pts abt overall health

MACRA

Medicare Access and CHIP Reauthorization Act

Physician Assistant (PA)

Similar training to physicians + licensed to practice medicine as long as they're supervised by an MD. They conduct physical exams, provide preventative care, prescribe diagnostic tests, assist w/ surgical procedures, diagnose illness, and prescribe meds