Healthcare Management Terms for High School Students
- Know their healthcare options
- Avoid misunderstandings and understand the care they’re receiving
- Understand healthcare insurance terminology, which can make the process of working with their insurance companies a bit easier
- Overcome barriers to healthcare access
- Health Insurance Portability and Accountability Act (HIPAA)
- Pre-existing conditions
- Acute illness
- Anti-inflammatory medication
What Does HIPAA Stand for, and Why Is It Important?
HIPAA resources and additional information
- The American Academy of Pediatrics (AAP) addresses decades-long misperceptions about the HIPAA Privacy Rule and provides answers to frequently asked questions.
- In its Data Insider blog, Digital Guardian provides insights into the role information security plays in HIPAA compliance.
- For information on the HIPAA Privacy Rule and Security Rule, the U.S. Department of Health and Human Services (HHS) provides a summary, which includes descriptions of key definitions used in the regulation. HHS.gov also offers a resource that provides answers to commonly asked questions about facility directories as they pertain to HIPAA rules.
What Is a Pre-existing Condition?
- Deductible. A deductible is the flat fee that patients are responsible for before insurance companies pay for healthcare services. For example, if a deductible is $1,000 a year, the insurance will only pay for medical services after a patient has paid $1,000 in healthcare service costs.
- Copayment. A copayment is a fixed fee that patients pay for a medical service covered by an insurance company. It’s typically paid in advance at a medical appointment. The healthcare provider charges the patient’s insurance company for the remaining cost of the medical services provided.
Additional information about pre-existing conditions
- HealthCare.gov provides information on 10 essential health benefits covered by marketplace health insurance plans under ACA rules.
- HHS.gov and Investopedia explain what pre-existing conditions are and offer additional insights.
- Policygenius provides a list of common pre-existing conditions that were typically denied coverage before ACA.
Acute and Chronic Illnesses: Differences and Examples
- Chronic illnesses:
- Diabetes describes a condition in which a patient’s body is unable to regulate the amount of sugar in the bloodstream. It’s typically caused by the lack of insulin, a hormone produced in the pancreas for blood sugar control. Diabetes can also be caused when a patient’s body is resistant to insulin.
- Coronary heart disease, also called coronary artery disease, describes when small blood vessels that supply blood and oxygen to the heart become narrowed. This narrowing can be caused by a buildup of plaque in the arteries.
- Asthma is a disease that limits the amount of air passing through the airways, causing patients to experience shortness of breath, chest tightness, and coughing. It’s caused by inflammation of the airways.
- Cancer is a disease in which abnormal or malignant cells go through uncontrolled growth in the body. The cause of many cancers is unknown, but according to MedlinePlus, it “appears to occur when the genetic material of a cell becomes changed.” Risk factors for cancer include environmental toxins, genetic problems, chemical exposure, and radiation.
- Arthritis comes in hundreds of forms. It generally describes when inflammation or degeneration occurs in one or more joints in the body.
- Acute illnesses:
- Acute bronchitis, also known as a chest cold, describes when the lungs of patients swell and produce excess mucus. It’s caused when the airways of the lungs are infected with a virus or bacterial infection.
- Influenza, or the flu, is a contagious respiratory infection that can range from mild to severe. It’s a seasonal illness caused by a virus that’s spread from person to person.
- Pneumonia describes inflammation of the alveoli, which are the air sacs of a patient’s lungs. It can be caused by bacteria, viruses, and fungi, infecting one or both lungs.
- COVID-19 is an acute respiratory condition with common symptoms that include fever, cough, and tiredness, according to the Mayo Clinic. Other symptoms include loss of taste or smell, headache, and chest pain, to name a few. The virus can spread through person-to-person transmission of respiratory droplets or contact with surfaces where the virus is present.
Anti-Inflammatory: Definition and Examples of a Key Medical Term
- Celecoxib. Celecoxib also goes by the brand name Celebrex. It relieves pain and swelling for conditions such as arthritis, acute pain, and menstrual pain.
- Fenoprofen. Fenoprofen also goes by the brand name Nalfon. It’s used to treat pain, swelling, and stiffness derived from conditions such as osteoarthritis and rheumatoid arthritis.
- Ketorolac tromethamine. Ketorolac tromethamine also goes by the brand name Toradol. It’s used to manage moderate to severe acute pain over the short term (up to five days).
- Meloxicam. Meloxicam also goes by the brand name Mobic. It’s used to reduce pain caused by osteoarthritis and rheumatoid arthritis, including juvenile rheumatoid arthritis.
- Naproxen. Naproxen also goes by the brand name Voltaren. It’s used to reduce arthritis-related pain, inflammation, and joint stiffness.
Using Standard Clinical Terminology in Care
- A recent study published by StatPearls reports that 7,000 to 9,000 people in the U.S. die each year due to medication errors; the misuse of abbreviations constitutes a significant cause.
- Lack of comprehension is one reason patients passively share decision-making with their physicians. This often leads to low patient satisfaction, according to a Harvard Public Health Review study. The study also notes that while low health literacy is an issue among the entire patient population, it’s “most prominent among low-income, ethnic minorities, and elderly populations.”
- Communication between healthcare providers was found to be “the root cause in more than 70% of serious medical errors,” as reported in a Safety in Health
Additional information about clinical terminology
- “Standards in Healthcare Data” examines how data standards, quality, and implementation can improve clinical data interoperability and drive continuous improvement.
- “Terminology Services: Standard Terminologies to Control Health Vocabulary” describes the usefulness of a terminology server to facilitate the management of health information and improve system interoperability.
- The Healthcare Information and Management Systems Society describes common terminology standards in health information and technology. It explains that they’re essential for ensuring the effectiveness of information exchange and interoperability.
- Articles from Forbes and WebMD inform readers on the basics of insurance policy, explicitly describing key insurance and healthcare terms, such as coinsurance, out-of-pocket maximum, COBRA, and flexible spending accounts.
- The “Glossary of Health Coverage and Medical Terms” from the U.S. Department of Labor is a handy resource that provides definitions of commonly used healthcare terms.