ATI Fundamentals for Nursing ATI 651 questions and answers

ATI Fundamentals for Nursing ATI Medicare - for clients over age 65 and/or with permanent disabilities. premiums applied as insurance program reimburses providers based on DRGs. Premiums applied as Managed Care Organizations (MCOs) provide enrolled clients with comprehensive care overseen by a primary care provider. Is federally funded. Medicaid - for clients with low income. is federally funded and individual states determine eligibility requirements. Traditional Insurance - reimburses for services on fee-for-service basis. Managed Care Organizations (MCOs) - comprehensive care is overseen by a primary care provider & focuses on prevention and health promotion Preferred Provider Organizations (PPOs) - client chooses from a list of contracted providers. using non-contracted providers increases the client's out of pocket costs Exclusive Provider Organizations (EPOs) - the client chooses from a list of providers within a contracted organization Long-Term Care Insurance - provides for long-term care expenses not covered by Medicare Preventive health care - focuses on educating and equipping clients to reduce and control risk factors of disease. Examples include immunizations, stress management programs, and seat belt use Primary health care - emphasizes health promotion, and includes prenatal and well-baby care, nutrition counseling, and disease control. is based on a sustained partnership between client and provider. examples include office or clinic visits and scheduled school/work centered screenings (vision, hearing, obesity) Secondary health care - includes the diagnosis and treatment of emergency, acute illness, or injury. examples include care given in hospital settings (inpatient and EDs), diagnostic centers, or emergent care centers Tertiary health care - involves the provision of specialized highly technical care. examples include oncology centers and burn centers Restorative health care - involves intermediate follow-up care for restoring health. examples include home health care, rehab centers, and skilled nursing facilities