Healthcare Administration Evolution, Systems, and Leadership

Healthcare Administration Evolution, Systems, and Leadership Leave the first rating Students also studied Terms in this set (348) Western Governors UniversityD 072 Save D545 crash course 26 terms Brownskinkaay Preview Healthcare Administration Evolution...414 terms carriephoto21 Preview Test Prep - WGU - Principles of Man...105 terms C_BondePreview

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Teacher mag health carean act or deed between the healthcare provider and the patient to maintain or improve the patient's healthcare status biomedical modela theoretical framework in healthcare that views illness and disease as primarily resulting from biological factors holistic healthan approach to wellness that simultaneously addresses the physical, mental, emotional, social, and spiritual components of health holistic medicinethe practice of healthcare professionals using a diverse range of disciplines, religious philosophies, and cultural practices to heal individuals, communities, and the environment functional organizational structureThe organization is split into departments based on the employees' expertise, such as the manager or chief executive officer, commercial and marketing, finance, accounting, managerial, facilities, etc.functional organizational structure advantages-Enhanced coordination & control -Centralized decision-making -Enhanced organizational-level perspective -More efficient use of managerial & technical talent -Facilitated career paths in specialized areas functional organizational structure disadvantages Specialization can lead to departments operating in silos Potential for decreased communication Narrow business perspectives

multi-divisional organizational structureThe chief corporation comprises several smaller business units or divisions based on geographic locations, products, or services so that the daily processes or functions occur at the unit or divisional level, allowing the separate units or divisions to operate independently multi-divisional organizational structure advantages Ability to hold corporate executives accountable for the results of local operations that are within their control multi-divisional organizational structure disadvantages Duplication of functions, such as products and services across divisions, which threatens the quality and costs of healthcare Increased operational costs due to the inability to achieve economies of scale Leads to a lack of standardization and inefficiencies Matrix organizational structurecomprises the functional structure and a temporary project structure, which requires using two managers simultaneously Matrix organizational structure advantagesClearly defined project objectives Seamless integration of project and functional objectives Efficient use of limited human resources Fluid streaming of information throughout the project Prompt diffusion of team members back into the functional organization upon project completion without organizational disruption Ability of functional management to handle conflicts arising at the project level Matrix organizational structure disadvantagesIncreases the complexity of the organization Problems derived from having employees answer to too many bosses and having conflicting managerial directives Difficulty in establishing priorities for functional and project management Delay in management reactions accountable care organization (ACO)a network of doctors, hospitals, and other healthcare providers that voluntarily come together to provide coordinated, high-quality care to their patients managed care organization (MCO)a type of healthcare delivery system that aims to manage the cost, quality, and accessibility of healthcare services; MCOs are commonly associated with HMOs, PPOs, and POS plans deliverythe provision of healthcare services by various providers in exchange for payment for services rendered health maintenance organizationa type of managed care organization that provides health insurance coverage through a network of healthcare providers who offer services to members for a fixed fee Integrated Delivery System (IDS)a network of organizations that provides or arranges to provide an organized variety of services to specific populations and is held accountable for the outcomes and health status of those populations consumer-driven health plan (CDHP)(also known as a high-deductible health plan) a type of health insurance plan that encourages individuals to manage their healthcare costs

Fee-for-service (FFS)a system wherein healthcare is provided as individual units of service, such as magnetic resonance imaging (MRI) or other X-ray, medical examination, flu shot, or other service preferred providera type of organization that provides services based on contracts with groups of physicians and hospitals that are referred to as preferred providers First contact as the gateway to the healthcare system. primary care Occur when needed after the patient has been seen at primary care.specialty care In integrated systems such as managed care, Primary care physicians (PCP) serve as gatekeepers to control cost, usage of services, and allocation of resources.Treats the person holisticallyprimary care physicians Trains in ambulatory care setting to learn how to treat many patient conditions and diseases.Primary care public health servicesservices provided by local health departments, including well-baby care, venereal disease clinics, family planning services, screening and treatment for tuberculosis, and ambulatory mental health services Which organizational structure used by healthcare facilities incorporates a temporary project structure using a project and a department manager?matrix

• multiple choice options

A rural clinic that provides services to families who lack access to adequate healthcare has improved the quality and health status of this population. A recent survey showed the patients are satisfied with the services.Which type of healthcare organization is described in this scenario?accountable care organization (ACO)

• multiple choice options

Which type of healthcare financing includes savings options such as a health savings account or a health reimbursement account?consumer-driven health plan

• multiple choice options

health insurance marketplacesystem established to facilitate the purchase of health insurance in organized markets (also referred to as health insurance exchanges) consumerismthe trend of patients increasingly acting as consumers who make informed choices about their healthcare services based on quality, cost, and other factors Radio Frequency Identification (RFID)a technology used in healthcare to track and manage medical equipment, pharmaceuticals, and sometimes patient information, using radio waves for automatic identification and tracking

Information Technology (IT)the use of digital technologies, like EHRs and telemedicine, for managing patient information, delivering healthcare services, and supporting decision-making processes Affordable Care Act (ACA)Enacted in 2010, the ACA aimed to increase the quality and affordability of health insurance. It expanded Medicaid, created health insurance marketplaces, and implemented regulations prohibiting insurers from denying coverage due to pre- existing conditions Food and Drug Administration Safety and Innovation Act (FDASIA) Enacted in 2012, FDASIA aimed to enhance the regulation of medical products by the FDA. It included provisions to expedite the review of new drugs and medical devices, improve drug safety monitoring, and strengthen the FDA's authority to regulate drug-compounding pharmacies.Health Information Technology for Economic and Clinical Health Act (HITECH Act) Enacted in 2009, the HITECH Act promotes the adoption and meaningful use of electronic health records (EHRs) and strengthens HIPAA privacy and security provisions related to electronic health information Consolidated Omnibus Budget Reconciliation Act

(COBRA)

enacted in 1985, requires employers with 20 or more employees to offer temporary continuation of health coverage to eligible employees and their dependents after certain qualifying events, such as job loss or reduced hours.Emergency Medical Treatment and Labor Act (EMTALA) enacted in 1986, requires hospitals that participate in Medicare to provide emergency medical treatment to individuals regardless of their ability to pay or insurance status False Claims Act (FCA)a federal law that prohibits knowingly submitting false or fraudulent claims for payment to the government, including claims submitted to Medicare, Medicaid, and other federal healthcare programs, whether directly or indirectly Federal Anti-Kickback Statute (AKS)a federal criminal law that prohibits exchanging anything of value in return for referrals or recommendations for items or services covered by federal healthcare programs, such as Medicare or Medicaid.Stark Lawalso known as the Physician Self-Referral Law, prohibits physicians from referring Medicare or Medicaid patients to entities with which they have a financial relationship for certain designated health services.The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) now known simply as The Joint Commission, is a nonprofit organization that accredits and certifies healthcare organizations and programs in the United States Centers for Medicare and Medicaid Services (CMS) a federal agency within the U.S. Department of Health and Human Services that administers Medicare and Medicaid programs Agency for Healthcare Research and Quality (AHRQ) a federal agency within the U.S. Department of Health and Human Services that conducts research and provides evidence-based information to improve healthcare quality, safety, efficiency, and effectiveness National Committee for Quality Assurance (NCQA) a private, nonprofit organization that accredits and certifies healthcare organizations and programs in the United States, focusing on quality measurement and improvement in healthcare delivery