Health Ecosystem D391 WGU

Health
Ecosystem
D391
WGU
A
group
of
people
with
a
common
interest,
especially
in
a
buisness
-
ANS-Stakeholders
Adverse
Selection
-
ANS-is
where
a
consumer
does
not
purchase
health
insurance
until
they
need
coverage.
Affordable
Care
Act
of
2010
(ACA)
-
ANS-To
move
the
US
system
to
a
universal
coverage.
Expanded
Medicaid
and
CHIP.
Established
requirements
for
Indviduals
and
businesses
to
buy
and
provide
coverage.
Provided
government
subsidies
to
assist
with
those
requirements.
Introduced
health
insurance
exchanges
to
help
consumers
compare
and
purchase
insurance
plans.
Supported
healthcare
deliver
and
payment.
An
Approach
to
delivering
high
quality,
cost-effective
primary
care
(Keiser
Permanente)
-
ANS-Patient
Centered
Medical
Home
(PCMH)
An
important
law
that
established
a
new
reimbursement
and
incentive
structure
for
doctors
treating
medicare
patients:
-
ANS-Medicare
Access
and
CHIP
Reauthorization
Act
of
2015
(MACRA)
An
organization
of
individuals,
institutions
and
resources
that
deliver
services
to
clients
-
ANS-Healthcare
System
Clinical
Social
Workers
-
ANS-Provides
assessments,
diagnose
and
counseling
DECIDE
decision
making
model
-
ANS-D.
=
Define
the
Problem
(Think)
E.
=
Explore
the
Alternatives
(Understand)
C.
=
Consider
the
Consequences
(Wonder)
I
=
Identify
Your
Values
(Look
into
Yourself)
D.
=
Decide
and
Take
Action
(Act
as
Necessary)
E.
=
Evaluate
Your
Decision
(Design)
Efficiency
-
ANS-Obtaining
the
most
significant
health
benefit
in
a
way
that
minimizes
costs
and
resource
use Electronic
Medical
Record
(EMR)
-
ANS-A
collection
of
medical
information
on
a
patient
providing
a
360-degree
view
for
the
medical
team
Ensures
the
privacy
of
people's
protected
information
(PHI)
-
ANS-The
Health
Insurance
Portability
and
Accountability
Act
of
1996
Examples
of
mental
health
providers
-
ANS-Psychiatrist
(specialize
in
mental
health-can
prescribe
meds),
Psychologist
(study
of
the
human
mind
and
behavior,
provides
counseling,
cannot
prescribe
meds)
Federal
Trade
Commission
(FTC)
-
ANS-Responsible
for
enforcing
antitrust
laws
Federally
funded
nonprofit
health
centers
or
clinics
that
serve
medically
underserved
areas
and
populations.
Federally
qualified
health
centers
provide
primary
care
services
to
undeserved
populations
-
ANS-Federally
Qualified
Health
Center
(FQHC)
Five
institutional
providers
-
ANS-1.Primary
Care
(a
core
component
of
healthcare
delivery)
2.Post
acute
short-term
care
(provide
nursing
and
physical
therapy
services
so
clients
can
become
more
independent
after
medical
services)
3.Hospitals
(In-Patient-
offer
medical,
surgical,
and
nursing
care
to
those
who
are
ill
or
injured)
4.Long-term
care
(include
nursing
homes,
assisted
living
facilities,
and
retirement
communities,
is
to
provide
clients
with
a
superior
quality
of
life)
5.Institutional
providers
(Hospital,
Critical
Care,
Skilled
nursing
facility,
Home
Health
Agency,
Hospice)
Five
Main
Funding
Models
-
ANS-1.Self-Funded
2.Bismark
3.Beveridge
4.National
Health
Insurance
5.Bis-Bev
Focuses
on
physical
health,
enables
clients
to
perform
daily
activities
such
as
bathing
or
dressing
-
ANS-Therapists;
Occupational
Therapy
Health
Information
Exchange
(HIE)
-
ANS-Distributing
patient
information
among
the
healthcare
team
to
deliver
quality
care.
Allows
health
professionals
to
access
and
share
a
client's
medical
information.
It
has
contributed
to
the
faster
delivery
of
services
to
clients
in
the
community .