homework 1.docx - HADM 205 CHAPTER 1 A Accountable Care...

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HADM 205 CHAPTER 1 A. Accountable Care Organizations – An ACO is a voluntary group of health care providers who come together to provide coordinated care to patient population in order to improve quality and reduce costs by keeping patients healthy and by reducing unnecessary service duplication. B. Capitation – A system that pays providers a specific amount in advance to care for the health care needs of a population of a specific time period. Providers are usually paid on a per member per month (PMPM) basis. The provider then assumes the risk that the cost of caring for the population may exceed the aggregate PMPM amount received. E. Electronic health record (EHR) – online version of patients medical records. It would include their demographics, insurance info, dictations and notes, medication and immunization history, ancillary test result. Under strict security permissions, the info can be accessed either in house or in private office settings. A. Group purchasing Organization (GPO) - A network of healthcare organizations and a third-party vendor who are able to acquire large volumes of supplies from manufacturers at negotiated discounted rates owing to economies of scale. I. Health Insurance Portability and Accountability Act (HIPAA) – A set of federal compliance regulations enacted in 1996 to ensure standardization of billing, privacy, and reporting practices as institutions convert to electronic systems. j. ICD-10 – It is the world health organization’s international statistical classification of diseases and related health problems coding system used in the US health system. This is a coding system that helps determine health insurance claim reimbursement. The tenth version, addresses issues and morbidity data reporting.

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