HCA 202
managed care - ANS seeks to achieve efficiency by integrating the basic functions of health
care delivery, and it employs mechanisms to control (manage) utilization and cost of medical
services. The dominant health care delivery system in the US today. Covers both private and
public health insurance programs through contracts with a MCO.
military - ANS medical care system available mostly free of charge to active duty military
personnel of the US army, navy, air force, and coast guard, as well as to members of certain
uniformed nonmilitary services. Provides both preventive and treatment oriented services
provided by salaried health care personnel.
TriCare - ANS a program that is financed by the US department of defense. This insurance plan
permits the beneficiaries to receive care from both private and military medical care facilities.
Veterans Administration - ANS a health care system available to retired veterans who have
previously served in the military, with priority given to those who are disabled.
It focuses on hospital care, mental health services, and long-term care. One of the largest and
oldest formally organized health care systems in the world, with a mission to provide medical
care for the US department of defense medical care system.
It is organized into 21 geographically distributed Veterans Integrated Service Networks.
Veterans Integrated Service Network - ANS organizes the VA system into 21 geographically
distributed networks. Responsible for coordinating the activities of the hospital and other
facilities located within its jurisdiction. Also responsible for improved efficiency and cost
containment.
special populations - ANS vulnerable groups with health needs but inadequate resources to
address those needs. Include poor and uninsured individuals, minorities, immigrants, or those in
disadvantaged communities. Typically receive insurance through the nation's safety nets,
Medicare and Medicaid, as well as community and migrant health centers, free clinics, and
hospital emergency departments.
Bureau of Primary Health Care - ANS located within the Health Resources and Services
Administration in the Department of Health and Human Services, provides support for
community based health centers that include programs for special populations
, medicare - ANS one of the largest sources of public health insurance in the US, serving the
elderly, disabled, and those with end stage renal disease. Offers coverage for hospital care,
post-discharge nursing care, hospice, outpatient services, and prescription drugs.
medicaid - ANS the third largest source of health insurance in the US; provides coverage for
low-income adults, children, the elderly, and individuals with disabilities
Children's Health Insurance Program - ANS aka CHIP; provides insurance to children in
uninsured families as well as children in families with modest incomes that do not qualify for
Medicare.
Integrated Delivery Systems - ANS a network of health care providers and organizations that
provides or arranges to provide a coordinated continuum of services to a defined population and
is willing to be held clinically and fiscally accountable for the clinical outcomes and health status
of the population served
most important principles specific to vulnerable populations:
1) emphasis on primary care
2) coordination of all care, including behavioral, social, and public health services
3) accountability for population health outcomes
Long term care - ANS consists of medical and nonmedical care that are provided to individuals
who have chronic health issues and disabilities that prevent them from doing regular daily tasks.
Delivered across various venues including patient's home, assisted living facilities, and nursing
homes.
public health system - ANS mission is to improve and protect community health
characteristics of the US healthcare system - ANS -no central or governing agency and little
integration or coordination
-technology driven delivery system focusing on acute care
-high in cost, unequal in access, and average in outcome
-delivery of health care under imperfect market conditions
-government as subsidiary to the private sector
-fusion of market injustice and social justice
-multiple players and balance of power
-quest for integration and accountability
-access to health care services selectively based on insurance coverage
-legal risks influence practice behaviors
system - ANS consists of a set of interrelated and interdependent components designed to
achieve some common goals. The components are strategically coordinated.
managed care - ANS seeks to achieve efficiency by integrating the basic functions of health
care delivery, and it employs mechanisms to control (manage) utilization and cost of medical
services. The dominant health care delivery system in the US today. Covers both private and
public health insurance programs through contracts with a MCO.
military - ANS medical care system available mostly free of charge to active duty military
personnel of the US army, navy, air force, and coast guard, as well as to members of certain
uniformed nonmilitary services. Provides both preventive and treatment oriented services
provided by salaried health care personnel.
TriCare - ANS a program that is financed by the US department of defense. This insurance plan
permits the beneficiaries to receive care from both private and military medical care facilities.
Veterans Administration - ANS a health care system available to retired veterans who have
previously served in the military, with priority given to those who are disabled.
It focuses on hospital care, mental health services, and long-term care. One of the largest and
oldest formally organized health care systems in the world, with a mission to provide medical
care for the US department of defense medical care system.
It is organized into 21 geographically distributed Veterans Integrated Service Networks.
Veterans Integrated Service Network - ANS organizes the VA system into 21 geographically
distributed networks. Responsible for coordinating the activities of the hospital and other
facilities located within its jurisdiction. Also responsible for improved efficiency and cost
containment.
special populations - ANS vulnerable groups with health needs but inadequate resources to
address those needs. Include poor and uninsured individuals, minorities, immigrants, or those in
disadvantaged communities. Typically receive insurance through the nation's safety nets,
Medicare and Medicaid, as well as community and migrant health centers, free clinics, and
hospital emergency departments.
Bureau of Primary Health Care - ANS located within the Health Resources and Services
Administration in the Department of Health and Human Services, provides support for
community based health centers that include programs for special populations
, medicare - ANS one of the largest sources of public health insurance in the US, serving the
elderly, disabled, and those with end stage renal disease. Offers coverage for hospital care,
post-discharge nursing care, hospice, outpatient services, and prescription drugs.
medicaid - ANS the third largest source of health insurance in the US; provides coverage for
low-income adults, children, the elderly, and individuals with disabilities
Children's Health Insurance Program - ANS aka CHIP; provides insurance to children in
uninsured families as well as children in families with modest incomes that do not qualify for
Medicare.
Integrated Delivery Systems - ANS a network of health care providers and organizations that
provides or arranges to provide a coordinated continuum of services to a defined population and
is willing to be held clinically and fiscally accountable for the clinical outcomes and health status
of the population served
most important principles specific to vulnerable populations:
1) emphasis on primary care
2) coordination of all care, including behavioral, social, and public health services
3) accountability for population health outcomes
Long term care - ANS consists of medical and nonmedical care that are provided to individuals
who have chronic health issues and disabilities that prevent them from doing regular daily tasks.
Delivered across various venues including patient's home, assisted living facilities, and nursing
homes.
public health system - ANS mission is to improve and protect community health
characteristics of the US healthcare system - ANS -no central or governing agency and little
integration or coordination
-technology driven delivery system focusing on acute care
-high in cost, unequal in access, and average in outcome
-delivery of health care under imperfect market conditions
-government as subsidiary to the private sector
-fusion of market injustice and social justice
-multiple players and balance of power
-quest for integration and accountability
-access to health care services selectively based on insurance coverage
-legal risks influence practice behaviors
system - ANS consists of a set of interrelated and interdependent components designed to
achieve some common goals. The components are strategically coordinated.
