What is the focus of a fee-for-service care model?
Focus is on quantity (volume) over quality. Fees drive the cost of care.
What is the focus of a
... [Show More] value-based care model?
Focus is on quality care. Rewards physicians for quality of care.
What are some of the goals of the Accountable Care Organizations (ACOs)?
Providing coordinated care services to patients/ reducing hospital readmissions/ improving patient compliance in community settings/ improving patients outcomes through coordination of care measures and services that improve a patient's quality of life
What is the Patient Protection and Affordable Care Act (ACA)?
The ACA is healthcare legislation enacted in 2009 that provides a system for obtaining government and privately funded health insurance through state exchange service.
What are Diagnostic Related Groups (DRGs)?
DRGs are code sets used to standardize types of care provided to patients in an inpatient setting
What is the purpose of a Diagnostic Related Group (DRG)?
DRGs categorize patients into groups based on their diagnoses what type of treatment (whether or not a procedure was surgical), any additional serious health complications or conditions the patient is also managing the patient's comorbidities, age and gender, and the patient's discharge status
What is utilization management?
UM ensures that a patient's length of hospital stay is appropriate, given their diagnoses, health issues, and types of treatments being administered.
What does SBIRT stand for?
S- Screening / B & I- Brief Intervention/ R & T- Referral to treatment
What does SBIRT involve?
An evidence-based practice that entails substance use/abuse screening, brief intervention, and referral to treatment when necessary.
What are SMART goals?
Specific, Measurable, Attainable, Realistic, Timely
What is motivational interviewing?
a collaborative conversation style for strengthening a person's own motivation and commitment to change
What is the focus of Motivational Interviewing?
Change Talk
What is task-centered care?
A care intervention that requires a number of tasks by various members of the care team.
What is Step One of the Care Coordination Process?
Client Identification and Selection: Focuses on identifying clients who would benefit from case management services.
What is Step Two of the Care Coordination Process?
Assessment and Problem/Opportunity Identification: Begins after the completion of the case selection and intake into case management and occurs intermittently, as needed, throughout the case.
What is Step Three of the Care Coordination Process?
Development of the Case Management Plan: Establishes goals of the intervention; prioritizes the needs of the client, support system, and family or caregiver; and determines the types of services and resources that are available to address the established goals or desired outcomes. [Show Less]