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SUCCESS IN PRACTICAL/VOCATIONAL NURSING 9TH EDITION CH 16

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SUCCESS IN PRACTICAL/VOCATIONAL NURSING 9TH EDITION CH 16 Alliances - CORRECT ANSWER -New partnerships among hospitals, clinics, laboratories, health care systems, and physicians. They coordinate the delivery of care, contain costs, and attempt to provide seamless system. Capitation - CORRECT ANSWER -Set fee for health care, paid annually regardless of the number of health services provided. Coinsurance - CORRECT ANSWER -Percentage of total bill paid for by insurance company once deductible is paid. Continuous Quality Improvement (CQI) - CORRECT ANSWER -Search for new ways to improve patient care, prevent errors, and identify and fix problems. Copayment - CORRECT ANSWER -Percentage of the bill that is paid by a person (subscriber) who is enrolled in a health insurance plan. Cost Containment - CORRECT ANSWER -Holding costs within fixed limits. Deductibles - CORRECT ANSWER -Amount the subscriber must pay before health insurance begins to cover costs. Diagnosis Related Group (DRG) - CORRECT ANSWER -Prospective payment system. Specifies number of days for which Medicare will pay, based on illness category. Entitlement Program - CORRECT ANSWER -Those eligible because of age, disability, or economic status are entitled by law to benefits of certain programs, namely, Social Security, Medicare, and Medicaid. fee-for-service - CORRECT ANSWER -Patient pays the physician fee for each service provided.

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