NUR 166 FINAL REVIEW
accountable care organization (ACO) - ANS group of health care entities (e.g., hospitals,
primary care settings, and specialty care practices) organized via incentives to deliver the most
efficient and high-quality care for the population served
Advanced Practice Registered Nurse (APRN): - ANS registered nurse educated at the master's
or post-master's level in a specific role and for a specific population; examples include nurse
practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives
ambulatory care - ANS health care settings located in areas that are convenient for people to
walk into and receive care; may be provided in hospitals, clinics, or centers
capitation - ANS fixed amount per patient for a specified time period paid to a health care
service provider for the delivery of health care services
care coordination - ANS deliberate organization of patient care activities between two or more
participants (including the patient) to facilitate the appropriate delivery of quality health care
services in an efficient person-centered manner; mechanism to make sure that patients get the
right care at the right time in the most efficient and cost-effective manner, by the right person in
the right setting
community health center - ANS regionalized service for vulnerable geographic populations with
an emphasis on primary care and education, established to ensure that everyone who needs
care has access regardless of ability to pay
consumer - ANS the person who uses health care services (the patient)
diagnosis-related group (DRG) - ANS classification of patients by major medical diagnosis for
the purpose of standardizing health care costs
entitlement reform - ANS proposed legislation making changes in entitlement benefits, such as
Medicare and Medicaid, paid by the government to citizens, with the goal of improving the
nation's budget
extended-care services - ANS organizations, family members, and other caregivers that provide
medical and nonmedical care for people with chronic illnesses or disabilities who are physically
or mentally unable to care for themselves independently
fee for service - ANS system in which a bill is generated and a fee is paid every time a provider
does something for a patient
,health insurance marketplace - ANS federal and state system designed to help people more
easily find health insurance that fits their budget and needs with a plan offering comprehensive
coverage, from doctors to medications to hospital visits; insurance options can be compared
based on price, benefits, quality, and other features described in plain language
health maintenance organization (HMO) - ANS prepaid, group-managed care plan that allows
subscribers to receive all the medical services they require through a group of affiliated
providers; there may be no additional out-of-pocket costs, or subscribers may pay only a small
fee, called a copayment
high reliability organization - ANS organization that operates in a complex, high-hazard domain
for an extended period without serious accidents or catastrophic failures
hospice - ANS a type of end-of-life care for persons who are terminally ill, characterized by the
following: (1) patients are kept as free of pain as possible so that they may die comfortably and
with dignity; (2) patients receive continuity of care, are not abandoned, and do not lose personal
identity; (3) patients retain as much control as possible over decisions regarding their care and
are allowed to refuse further life-prolonging technologic interventions; and (4) patients are
viewed as individuals with personal fears, thoughts, feelings, values, and hopes
inpatient - ANS person who enters a health care setting for a stay ranging from 24 hours to
many years
managed care - ANS an organized, high-quality, cost-effective system of health care that
influences the selection and use of health care services of a population
Medicaid - ANS Title XIX (Social Security Act, 1965) to make health care available to those
people with less than the minimum income who do not qualify for Medicare
medical home - ANS an enhanced model of primary care that provides whole-person,
accessible, comprehensive, ongoing, and coordinated patient-centered care
medical neighborhood - ANS a patient-centered medical home and the constellation of other
clinicians providing health care services to patients within it, along with community and social
service organizations and state and local public health facilities
Medicare - ANS Title XVIII (Social Security Act, 1965) to provide a measure of health coverage
to all Social Security recipients
multipayer system - ANS a health care system in which care is paid for by both private
insurance companies and the government
, multispecialty group practice - ANS organization of physicians from different specialties joined to
share income, expenses, facilities, equipment, and support staff; the group practice can better
provide comprehensive care
outpatient - ANS person who requires health care services but does not need to stay in an
institution for those services
palliative care - ANS hospice care; taking care of the whole person—body, mind, spirit, heart,
and soul—with the goal of giving patients with life-threatening illnesses the best quality of life
they can have through the aggressive management of symptoms
Patient Protection and Affordable Care Act (PPACA) - ANS 2010 federal legislation designed for
comprehensive health reform, with an intent to expand coverage, control health care costs, and
improve the health care delivery system
pay for performance - ANS a strategy using financial incentives to reward providers for
achieving a range of payer objectives, including delivery efficiencies, submission of data and
measures to the payer, and improved quality and patient safety
preferred provider organization (PPO) - ANS a prepaid group practice that allows a third-party
payer (such as an insurance company) to contract with a group of health care providers to
administer services at a lower fee in return for prompt payment and a guaranteed volume of
patients and services
respite care - ANS a type of care provided for caregivers of homebound ill, disabled, or older
adult patients
single-payer system - ANS health care system in which the government collects all health care
fees via taxes and pays out all health care costs
value-based purchasing - ANS program that measures, reports, and rewards excellence in
health care delivery, taking into consideration access, price, quality, efficiency, and alignment of
incentives
advocacy - ANS protection and support of another's rights
care coordinator - ANS the care provider (nurse case manager, social worker, community health
worker, or lay person) who is responsible for identifying a person's health goals and coordinating
services and providers to meet those goals
care transition - ANS a continuous process in which a patient's care shifts from being provided
in one setting of care to another
accountable care organization (ACO) - ANS group of health care entities (e.g., hospitals,
primary care settings, and specialty care practices) organized via incentives to deliver the most
efficient and high-quality care for the population served
Advanced Practice Registered Nurse (APRN): - ANS registered nurse educated at the master's
or post-master's level in a specific role and for a specific population; examples include nurse
practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives
ambulatory care - ANS health care settings located in areas that are convenient for people to
walk into and receive care; may be provided in hospitals, clinics, or centers
capitation - ANS fixed amount per patient for a specified time period paid to a health care
service provider for the delivery of health care services
care coordination - ANS deliberate organization of patient care activities between two or more
participants (including the patient) to facilitate the appropriate delivery of quality health care
services in an efficient person-centered manner; mechanism to make sure that patients get the
right care at the right time in the most efficient and cost-effective manner, by the right person in
the right setting
community health center - ANS regionalized service for vulnerable geographic populations with
an emphasis on primary care and education, established to ensure that everyone who needs
care has access regardless of ability to pay
consumer - ANS the person who uses health care services (the patient)
diagnosis-related group (DRG) - ANS classification of patients by major medical diagnosis for
the purpose of standardizing health care costs
entitlement reform - ANS proposed legislation making changes in entitlement benefits, such as
Medicare and Medicaid, paid by the government to citizens, with the goal of improving the
nation's budget
extended-care services - ANS organizations, family members, and other caregivers that provide
medical and nonmedical care for people with chronic illnesses or disabilities who are physically
or mentally unable to care for themselves independently
fee for service - ANS system in which a bill is generated and a fee is paid every time a provider
does something for a patient
,health insurance marketplace - ANS federal and state system designed to help people more
easily find health insurance that fits their budget and needs with a plan offering comprehensive
coverage, from doctors to medications to hospital visits; insurance options can be compared
based on price, benefits, quality, and other features described in plain language
health maintenance organization (HMO) - ANS prepaid, group-managed care plan that allows
subscribers to receive all the medical services they require through a group of affiliated
providers; there may be no additional out-of-pocket costs, or subscribers may pay only a small
fee, called a copayment
high reliability organization - ANS organization that operates in a complex, high-hazard domain
for an extended period without serious accidents or catastrophic failures
hospice - ANS a type of end-of-life care for persons who are terminally ill, characterized by the
following: (1) patients are kept as free of pain as possible so that they may die comfortably and
with dignity; (2) patients receive continuity of care, are not abandoned, and do not lose personal
identity; (3) patients retain as much control as possible over decisions regarding their care and
are allowed to refuse further life-prolonging technologic interventions; and (4) patients are
viewed as individuals with personal fears, thoughts, feelings, values, and hopes
inpatient - ANS person who enters a health care setting for a stay ranging from 24 hours to
many years
managed care - ANS an organized, high-quality, cost-effective system of health care that
influences the selection and use of health care services of a population
Medicaid - ANS Title XIX (Social Security Act, 1965) to make health care available to those
people with less than the minimum income who do not qualify for Medicare
medical home - ANS an enhanced model of primary care that provides whole-person,
accessible, comprehensive, ongoing, and coordinated patient-centered care
medical neighborhood - ANS a patient-centered medical home and the constellation of other
clinicians providing health care services to patients within it, along with community and social
service organizations and state and local public health facilities
Medicare - ANS Title XVIII (Social Security Act, 1965) to provide a measure of health coverage
to all Social Security recipients
multipayer system - ANS a health care system in which care is paid for by both private
insurance companies and the government
, multispecialty group practice - ANS organization of physicians from different specialties joined to
share income, expenses, facilities, equipment, and support staff; the group practice can better
provide comprehensive care
outpatient - ANS person who requires health care services but does not need to stay in an
institution for those services
palliative care - ANS hospice care; taking care of the whole person—body, mind, spirit, heart,
and soul—with the goal of giving patients with life-threatening illnesses the best quality of life
they can have through the aggressive management of symptoms
Patient Protection and Affordable Care Act (PPACA) - ANS 2010 federal legislation designed for
comprehensive health reform, with an intent to expand coverage, control health care costs, and
improve the health care delivery system
pay for performance - ANS a strategy using financial incentives to reward providers for
achieving a range of payer objectives, including delivery efficiencies, submission of data and
measures to the payer, and improved quality and patient safety
preferred provider organization (PPO) - ANS a prepaid group practice that allows a third-party
payer (such as an insurance company) to contract with a group of health care providers to
administer services at a lower fee in return for prompt payment and a guaranteed volume of
patients and services
respite care - ANS a type of care provided for caregivers of homebound ill, disabled, or older
adult patients
single-payer system - ANS health care system in which the government collects all health care
fees via taxes and pays out all health care costs
value-based purchasing - ANS program that measures, reports, and rewards excellence in
health care delivery, taking into consideration access, price, quality, efficiency, and alignment of
incentives
advocacy - ANS protection and support of another's rights
care coordinator - ANS the care provider (nurse case manager, social worker, community health
worker, or lay person) who is responsible for identifying a person's health goals and coordinating
services and providers to meet those goals
care transition - ANS a continuous process in which a patient's care shifts from being provided
in one setting of care to another
