There are two types of healthcare services: public and private.

Public Health:

1. Objective: Protect and improve population health
2. Scope: Government agencies (e.g., CDC), health education, and policy development
3. Funding: Government-funded, accessible to all

Private Healthcare Services:

1. Objective: Diagnose and treat individual patients
2. Scope: Primary care providers, specialists, hospitals, and clinics
3. Funding: Private sources, depends on ability to pay or insurance coverage

Providers are individuals (doctors, nurses, etc.) or groups (hospitals) that provide care to patients. There are a variety of types of care that providers can give to patients. Here are just a few.

• Inpatient care is when the patient stays at the hospital overnight.
• Ambulatory care or outpatient care is the kind of care where the patient has no plan to stay beyond the duration of the visit.
• Primary care is the most general kind of care usually conducted by a primary care physician (PCP). A PCP will direct the patient to more specialized forms of care if necessary.

Corporate Practice of Medicine (CPOM) is a legal principle that varies in each state but is used to prevent non-clinicians from interfering with or influencing physician judgment. Corporations cannot directly employ physicians to practice medicine.

• Friendly PC - a legal entity where the owners/shareholders are licensed physicians only. The entity contracts with a management service organization (MSO) to provide management and administrative services to the PC.

EMR/EHRs are record-keeping systems for providers.

• As I mentioned earlier, Obamacare drove the adoption of EHRs. The government decides what EMRs look like - they are mostly built around submitting claims and not for ease of use.
• The EMR industry is fragmented for ambulatory practices and patients' data lives in a variety of places, making it very difficult to integrate different EHRs.

Licensing, credentialing, and enrollment, or the process of provider network management, must happen for a clinician to provide care to patients.

• Payer enrollment is the process of contracting with the health plans in each state where they provide care.