Health Care Delivery in the U. S.
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HCS 235T Entire Course Link
HCS 235T Wk 1 - Health Care History Test
1. Question 1
What was the medical significance of the Flexner Report published in 1910?
the way medical education was delivered in the United States by establishing curriculums for medical education and standards for admission to medical school
the field of population health
the importance of public health
relationship between air quality and cardiovascular disease
Question 2 6.67/6.67
For children and adolescents, the 2 most important benefits of health insurance and access to a primary care provider are:
Vaccinations to protect from serious diseases, including mumps, tetanus, and chicken pox
Screening for cancer
checkups to ensure the child is keeping pace with normal development
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6.67/6.67
1. Transformed
2. Created
3. Defined
4. Established
2.
1.
2.
3. Routine
4.
Monitoring and managing weight, cholesterol, and blood pressure
3. Question 3 6.67/6.67
The Baylor Plan was:
1.
A service offering developed by Baylor University Hospital to pay for hospital care for $0.50 per month; first offered to public school teachers in Dallas, TX
2.
A service offering developed by Baylor University Hospital to pay for outpatient physician visits for 0.50 per month; first offered to public school teachers in Dallas TX
3.
A life insurance plan for employees and Baylor University Medical School students
4.
A curriculum for training physicians first used at Baylor University Medical School and later licensed to many other medical schools in the U.S.
4. Question 4 6.67/6.67
The largest purchaser of health care services in the U.S. is:
1. Medicare 2. Large corporations 3. Individual consumers 4. Insurance companies
5. Question 5 6.67/6.67
In the 1700s, new physicians learned how to practice medicine by:
1. Attending medical school 2. Reading the writings of Hippocrates
3. Apprenticing under an experienced physician 4. Apprenticing under a barber to learn surgery
6. Question 6 6.67/6.67
Medicare Part D was passed in 2003 and provided which benefit?
1.
Vision plans for older adults
2.
Chiropractic plans for older adults
3.
Dental plans for older adults
4. Prescription drug plans for the older adults
7. Question 7 3.33/6.67
Environmental quality influences a person’s health. The top 2 environmental factors influencing health are:
1. Annual average high temperature
2. Air quality index
3. Exposure to secondhand smoke as a child 4.Water quality
8. Question 8 6.67/6.67
People in which demographic category have the smallest proportion of members meeting the recommended guidelines for physical activity?
1. Those without a high school diploma
2.
Those with a college bachelor's degree 3.
Those with a postgraduate college degree
4.
Those who have attended college but did not obtain a degree
9. Question 9 6.67/6.67
Which 2 social factors influence the consumption of health care?
1. Zip code 2. Level of income
3.
Types of news media viewed
4. Level of education
10. Question 10 6.67/6.67
In 2020, the Centers for Medicare & Medicaid Services (CMS, 2020) reported that the proportion of the U.S. gross domestic product (GDP), which is the value of all goods and services produced, spent on health care was approximately:
1. 20% 2. 5% 3. 35% 4. 10%
11. Question 11 6.67/6.67
According to the National Institutes of Health National Institute of Dental and Craniofacial Research (NIH NIDCR, 2018), an indicator of oral health is tooth decay. What proportion of adolescents in the U.S. are affected by tooth decay?
Reference:
National Institutes of Health National Institute of Dental and Craniofacial Research. (2018, July). Dental caries (tooth decay) in adolescents (age 12 to 19).
1. Approximately 1 in 2 2.
Approximately 1 in 10 3. Approximately 1 in 4 4. Approximately 9 in 10
12. Question 12 6.67/6.67
What did the Affordable Care Act (ACA) of 2010 do?
1. Provided free health insurance to U.S. visitors, regardless of immigration status 2.
Made it illegal for insurance companies to deny or insurance for consumers with pre-existing health conditions
3. Required all people to have insurance with no exceptions 4.
Established protocol for deciding who is eligible for end-of-life care
13. Question 13 6.67/6.67
The first federal Patient Bill of Rights was passed in:
1. 1910 2. 1865 3. 2020 4. 1973 14. Question 14 3.33/6.67
Mental health, especially depression, is associated with which 2 physical conditions?
1. Arthritis 2. Gum disease 3. Heart disease 4. Hypertension
15. Question 15 6.67/6.67
Which 2 demographic factors influence the consumption of health care?
1. Gender 2. Height 3. Weight 4.
Race
16. Question 16 6.67/6.67
Which 2 of the following are the most important predictors of a child’s future health.
1.
Degree of exposure to exposure to lead-based paint hazards 2.
Longer work hours and part-time or temporary work
3.
Degree of exposure to health risk behaviors, such as smoking, alcohol, and drug use 4.
Availability of community-based resources and transportation options 17. Question 17 6.67/6.67
The 2 most important predictors of health related to access to care are:
1.
Having disability insurance
2.
Having a primary care provider 3.
Having health insurance 4.
Having dental insurance 18. Question 18 6.67/6.67
In 2020, how many Americans under age 65 did not have health insurance (Centers for Disease Control and Prevention [CDC], 2021)? Reference:
Centers for Disease Control and Prevention. (2021). Health insurance coverage.
1.
Approximately 30 million people
2.
More than 100 million people 3. Less than 10 million people 4.
Approximately 50 million people
19. Question 19 6.67/6.67
The Social Security Act of 1935:
1.
Provided hospitalization insurance for older people and disabled adults
2.
Provided reimbursement for physician visits to older adults
3.
Provided a social insurance program that paid monthly benefits to older adults
4.
Provided education benefits for the children of people with disabilities
20. Question 20 6.67/6.67 Medicaid is:
1.
A federal program introduced in the 1950s to provide ambulance transportation to people experiencing financial instability
2.
A federal program introduced in the 1990s that provides single-payer health insurance for people that are 65 and older and some younger people with certain disabilities
3.
A state and federal program introduced in the 1960s for the benefit of adults experiencing financial instability and children and adults with certain disabilities 4.
A family of health maintenance organization (HMO) programs first introduced in the 1970s
21. Question 21 6.67/6.67
When the American Medical Association was formed in 1847, its initial purpose was to:
1.
Establish standards for training physicians 2.
Ensure that patients have access to physicians 3.
Provide the advantages of a labor union to physicians 4.
Advocate for the interests of physicians
22. Question 22
6.67/6.67
Insurers began offering commercial insurance plans in the 1930s. The first insurance plans:
1.
Provided for neither hospital care nor physician care
2.
Provided for both hospital care and physician care
3.
Provided payment for hospital care, but not for physician care
4.
Provided payment for physician care, but not for hospital care
23. Question 23 6.67/6.67
The Health Maintenance Organization (HMO) Act of 1973:
1. Provided for federal government supported trials of HMO business models
2.
Mandated the use of HMOs instead of other types of insurance for persons eligible for Medicare or Medicaid
3.
Made interstate HMOs illegal
4.
Made HMOs legal for the first time in the U.S. 24. Question 24 6.57/6.57
The federal government’s Medicare program was first introduced in:
1. 1965 2. 1991 3. 1955 4. 2011
25. Question 25 6.67/6.67
Certificate of need laws are intended to:
1. Ensure that people applying for Medicare or Medicaid benefits are eligible to
receive them.
2.
Determine who is eligible for insurance under the Affordable Care Act (ACA).
3.
Ensure that states can decide the expansion of health care facilities and services to avoid excess capacity of facilities and services.
4.
Provide guidelines to transplant surgeons for deciding on eligible candidates for transplants.
26. Question 26 6.67/6.67
Food deserts are a predictor of poor health and refer to:
1.
The portion of the meal, often made up of sweets, often leading to obesity
2.
A region where food that thrives in hot dry climates is grown
3.
A geographic location lacking national or regional supermarket chains
4.
Areas where a substantial portion of the population is impoverished and lacks access to affordable fresh food nearby
27. Question 27 6.67/6.67
Young adults, Blacks, and Latin@ Americans are more likely to be uninsured than other population groups because (Institute of Medicine, 2001):
1.
They are more able to pay for medical costs out-of-pocket.
2.
They have less of a need for health insurance.
3.
They are more likely to have pre-existing medical conditions.
4.
They are less likely to have jobs that provide employer-provided health insurance.
28. Question 28 6.67/6.67
The first hospitals in the U.S. were established in:
1. The mid-1800s
2.
The mid-1700s
3. The early 1800s
4. Before 1700
29. Question 29 6.67/6.67
The major elements of the Healthcare Insurance Portability and Accountability Act (HIPAA) of 1996 included regulations on which 2 elements?
1.
National licensing of nurses and medical technologists
2. Prescription drug pricing
3. Security of health care records
4. Privacy of health care records
30. Question 30 6.67/6.67
Which of these leads to the highest annual death rate in the U.S.?
1. Tobacco usage
2. Murder 3. Death by suicide 4. Use of illegal drugs
HCS 235T Wk 3 - Health Care Services and Providers Test
1. Question 1 6.67/6.67
Alternative health care workers represent a growing type of stakeholder in the health care system. Select 2 examples of alternative health practitioners:
1. Chiropractor
2. Prosthetist
3.
Hypnotherapist
4. Hospitalist
2. Question 2 6.67/6.67
The duties of this emerging role generally include investigation of incidents in which a breach of protected health information (PHI) may have occurred and reporting breaches, as necessary.
1. Privacy and compliance director
2. Chief information officer (CIO)
3. Chief population health officer
4. Data analyst
3. Question 3 6.67/6.67
Match the health care setting type with the appropriate level of care it provides.
1. Urgent care center
2. Radiology clinic
3. Skilled nursing facility
4. Trauma center
4. Question 4 6.67/6.67
Which organization is a type of integrated delivery system with a closed panel of patients and it employs its own providers exclusively?
1.
Staff model health maintenance organization (HMO)
2. Individual practice association (IPA)
3. Academic medical group
4. Group model health maintenance organization (HMO)
5. Question 5 6.67/6.67
The American College of Healthcare Executives (ACHE) and March of Dimes are examples of which type of stakeholder?
1.
Education and research or academia
2. Investors
3. Employee assistance programs
4. Community or professional organizations
6. Question 6 6.7/6.7
This emerging role focuses on the delivery of accessible acute care and diagnostic services within non-traditional consumer-oriented locations.
1. Medical home model
2. Ambulatory surgery center
3. Retail health management
4. Health maintenance organization (HMO)
7. Question 7 6.67/6.67
Which highly valued emerging role is responsible for managing and facilitating treatment plans for patients?
1. Clinical care coordinator
2. Health services administrator
3. Patient advocate
4. Licensed practical nurse (LPN)
8. Question 8 6.67/6.67
Effectively information sharing among everyone involved in a patient’s care in an organized manner is a good example of:
1. Fragmentation of care
2. Electronic health records (EHRs)
3. Coordination of care
4.
Medical home model
9. Question 9 6.67/6.67
Which type of health care organization cares for patients with acute or chronic conditions, while also developing cutting-edge new procedures and growing the next generation of health care providers?
1.
U.S. Centers for Disease Control and Prevention (CDC)
2. Private research foundation
3. Biotechnology corporation
4. Academic medical center
10. Question 10 6.67/6.67
The medical home model of care is an increasingly common example of which concept of health services management?
1. Integrated delivery system
2.
Assisted living facilities
3. Community-based health programs
4. Outpatient rehabilitation centers
11. Question 11 6.67/6.67
Health care administrators can function in a wide range of important capacities within a health care organization. Select 2 examples of such functions:
1. Hospitalist
2. Chief financial officer (CFO)
3. Health information technology specialist
4. Chief of medical officer (CMO)
12. Question 12 6.67/6.67
The priestly model and collegial model represent aspects of what changing dynamic facing health care stakeholders?
1.
The national health insurance model
2. The physician-patient relationship 3. The physician-payer relationship 4.
The staff HMO model
13. Question 13 6.67/6.67
Which stakeholder is involved in many roles within the health care organization, including planning, directing, and facilitating services, establishing policy, and managing employees?
1. Physician assistants 2. Hospitalist 3. Managed care nurse 4. Health care administrator
14. Question 14 6.67/6.67
In a health care setting, which 2 areas will a sustainability manager often be involved in?
1.
Analysis of diagnosis codes and hospital readmission rates 2. Waste handling within hospital food service operations 3.
Maximization of using physician extenders in the acute care setting 4.
Analysis of energy use patterns within operating rooms
15. Question 15 6.67/6.67
Select 2 crucial issues faced by U.S. health care that the integrated delivery system model seeks to address.
1.
Community- and school-based public health services
2.
Lack of coordination between different levels and settings within the health care system
3.
Lack of universal health care coverage for all citizens
4.
Duplication of testing, ancillary services, or health care
16. Question 16 6.67/6.67
Which emerging role focuses on community wellness and developing strategies to create efficiency and improve outcomes?
1. Sustainability manager
2. Clinical care coordinator
3. Chief population health officer
4. Wellness coach
17. Question 17 6.67/6.67
Lack of effective coordination of care may lead to increased cost to the health care system due to:
1. Inefficient or duplicated services
2. Increasing life expectancy rates
3. Providing care within the optimal setting 4. Enhancing communication among providers
18. Question 18 6.67/6.67
An emerging role within the health care system that brings in-depth knowledge of the latest diagnostic system developed by the World Health Organization (WHO) is called:
1. Clinical care coordinator
2. ICD-10 coder
3.
Diagnostic technologist
4.
Health information technologist
19. Question 19 6.67/6.67
Select 2 types of supplemental or ancillary services that may be standalone providers or located within an acute care setting.
1. Medical equipment suppliers
2. Radiological clinics
3. Outpatient surgery centers
4. Dental facilities
20. Question 20 6.67/6.67
What is a type of business model where a person isn’t responsible for assuming the debts, liabilities, or profits?
1. Solo practice
2. Medical group 3. Wellness center
4. Corporation
21. Question 21 6.67/6.67
Which stakeholder is responsible for licensing health care professionals and developing regulations to protect the health of the public?
1.
Occupational Health and Safety Administration (OSHA)
2. American Medical Association
3. Local public health offices
4. State departments of health
22. Question 22
6.67/6.67
Select 2 effects that can result from fragmentation of care within the U.S. health care system.
1.
Increased quality of care
2.
Increased access to clinical best practices
3.
Increased costs of care
4.
Higher rates of preventable hospitalization
23. Question 23 6.67/6.67
A health maintenance organization (HMO) is established to:
1.
Source and provide durable medical equipment for patients.
2.
Provide care and services to members within an established network of providers for a generally fixed annual fee.
3.Provide access to a wide range of medical professionals based solely on patient choice.
3.
Reduce costs by outsourcing coverage options.
24. Question 24 6.54/6.54
Emerging roles within the health care industry are driven by a desire to affect improvement in several areas that can include: (select 2)
1. Quality of care
2. Access to care
3.
Maximizing per capita spending
4. Quantity of care
25. Question 25 6.67/6.67
Among health care organizations, which of these is an example of business ownership that typically must report to its shareholders on a regular basis?
1.
Public-funded mental health facility
2.
Not-for-profit rural health clinic
3. Indian health service facility
4. For-profit hospital
26. Question 26 6.67/6.67
Select 2 types of organizations that have the role of suppliers within the U.S. health care system.
1. Public health agencies
2. Pharmaceutical companies
3. Biotechnology companies
4. Government-sponsored plans
27. Question 27 6.67/6.67
This type of care provider focuses on provision of health care and housing services over a long period of time to those patients who may have temporary or chronic illness, injury, or disability.
1. Ambulatory care
2. Rehabilitative services
3. Auxiliary services 4. Subacute or long-term care
28. Question 28 6.67/6.67
Within the U.S. health care industry, hospice care generally focuses its efforts on:
1. Controlling severe pain, while addressing the patient’s social, spiritual, and physical needs
2.
Rehabilitative services to address significant injury or illness aimed at restoring
normal capability
3.
Supplementing or supporting acute ambulatory care
4. Emergency services for individuals in need of immediate life-saving care 29. Question 29 6.67/6.67
A type of health care organization which allows patients to choose any physician within or outside an existing network is called a:
1. Health maintenance organization (HMO)
2. Preferred provider organization (PPO)
3. Medical home 4. Community-based health center 30. Question 30 6.67/6.67
Physician extenders are an important type of stakeholder which provide medical services but are not physicians. Select 2 examples of physician extenders:
1. Certified nurse midwife
2. Certified respiratory therapist
3. Family practitioner 4. Nurse practitioner
HCS 235T Wk 5 - Health Care Costs, Insurance, and Trends
Test
1. Question 1 6/6
Which 4 factors contribute to quality of care?
1. Highly reliable organizations
2.
Process improvement
3.
Fee for service
4.
Outcomes linked to payment (
5. Patient-centered care
6. Preauthorization
2. Question 2
5/5
Which 3 statements are characteristics of patient-centered care?
1.Patient-centered care happens if the care provider does all the treatment, tests, and prescriptions the patient wants done.
1.
Evidence-based medicine shows that an outcome is patient-centered is if care is meaningful and valuable to the patient.
2.
Making the health care facility look like an upscale hotel or spa makes it patient-centric under the Patient-Centered Medical Home (PCMH) standards.
3.
Access and continuity, care management, and coordination are key functions of patient-centered medical homes.
4. Patient-centered care is a key element of high-quality care.
3. Question 3
5/5
Which 3 are accurate statements about health care ethics?
1.
If something is illegal, it is prima facie ethical.
2. Rationing of health care resources is avoidable.
3.
Ethical decision-making is based on the right thing to do.
4.
Ethical standards are right and wrong choices as determined by society and individuals.
5.
Ethical issues can arise when there are 2 sets of values or obligations or courses of action in conflict and a decision must be made between them.
4. Question 4 5/5
Choose the correct descriptions for the following abbreviations: HIX and HIE.
1.HIX: The technical process of how information will be exchanged between stakeholders to ensure that all information is exchanged for privacy and security in accordance with standards by the Department of Health and Human Services (HHS)
1.
HIE: The technical process of how information is exchanged between stakeholders to ensure that all information is exchanged for privacy and security in accordance with standards by the Department of Health and Human Services (HHS)
2.
HIE: Entities established under the Affordable Care Act (ACA) that offer patients the ability to choose a health plan based on price
3.
HIX: Entities established under the Affordable Care Act (ACA) that offer patients the ability to choose a health plan based on price
5. Question 5 5/5
Which 2 statements are accurate about eligibility for Medicare coverage?
1.
People with disabilities are eligible without an age requirement or ESRD.
2. Anyone 65 years of age or older is eligible.
3.
To be eligible for premium-free Part A, an individual must be entitled to receive Medicare based solely on their own earnings.
4.
A patient can receive all 4 Parts (A, B, C, and D) at the same time.
6. Question 6 6/6
Which 3 statements accurately describe the Patient Protection and Affordable Care Act of 2010 (PPACA)?
1.
It allowed states to choose to expand Medicaid with federal funding assistance.
2.
It is also known to the public as Obamacare.
3.
It offers bronze, silver, gold, platinum, and catastrophic plans.
4.
It covers all those who do not have health insurance coverage.
7. Question 7 5/5
Which 2 are accurate when planning for future health care in the U.S.?
1.
Supply chains for PPE are now all manufactured in the U.S. to ensure they are available when and where needed for the care of patients.
2.
FEMA operates before, during, and after natural disasters, such as floods, forest fires, and hurricanes.
3.
All states now require certificate of need approval for new hospitals and expensive equipment, such as new PET scanners and robotics.
4.
Analysis of big data is useful to both government for health care planning and individual hospitals as part of current operations and identifying future trends and solutions.
8. Question 8 5/5
Which 2 types of insurance plans are known for being gatekeeper models?
1. Preferred provider organization (PPO)
2. High deductible health plan (HDHP)
3. Health maintenance organization (HMO)
4. Provider-sponsored organization (PSO)
9. Question 9 5/5
Which 3 health care services are funded by the government?
1. Veterans Health Administration
2. Indian Health Services (IHS)
3. Military Health System (MHS)
4. Workers’ Compensation Programs
5. Medicare Supplemental Insurance
10. Question 10 6/6
Which 3 populations do not have health care coverage, even after the implementation of the Affordable Care Act (ACA)?
1. Tribal citizens
2.
People who do not file income taxes and do not qualify for Medicaid
3. Undocumented immigrants
4.
Younger, healthier individuals who do not have disabilities and choose not to purchase coverage
5. Non-exempt individuals under the ACA
11. Question 11 10/10
Match each model of physician/patient interaction to its description. Answers
1. Paternalistic
The physician decides on the best treatment and talks to patient to obtain consent only.
2. Informative
The physician provides information about treatment options and patient decides on their own treatment.
3. Interpretive
The physician assists patient in determining which treatment is most in line with the patient’s values.
4. Deliberative
The physician dialogs with patient to help choose the best health-related values and achieve the best outcome for the patient’s specific situation.
12. Question 12 5/5
Which 2 are terms used when referring to functions only related to electronic health records (EHRs)?
1. Computerized provider order entry (CPOE)
2. Meaningful use
3. Photocopy
4. Microfilm
13. Question 13 5/5
Select 3 ways health care costs are paid for in the United States:
1.
Publicly funded insurance coverage
2. Individuals
3.
Universal health care coverage
4.
Privately funded insurance coverage
14. Question 14 5/5
Which 3 statements are current developments in health care that will continue to be future challenges?
1.
Blockchain is a trend in protecting unauthorized access to patient electronic health records (EHRs).
2.
The 21st Century Cures Act will require providers to have interoperability.
3.
Identifying and matching the correct patient with the correct medical record will continue to have unacceptably high error rates.
4.
Information blocking will be required under the 21st Century Cures Act.
15. Question 15 5/5
Which statement is correct for source of payment?
1.
Medicare and Medicaid costs are jointly paid for by the federal government and the states.
2.
Medicare and Medicaid costs are paid for only by the federal government.
3.
The state governments are the only payer for Medicaid costs.
4.
The state governments are the only payer for Medicare costs.
16. Question 16 10/10
Match each health care technology term to its correct description. 5 of 5 pairs matched correctly Prompts Answers
1. Health Information Technology for Economic and Clinical Health (HITECH) Act
Part of the 2009 American Recovery and Reinvestment Act to stimulate the adoption of health information technology (HIT)
2. Meaningful use
Standards to encourage the adoption of an electronic health record (EHR) to increase patient quality and safety
3. Population health Health outcomes of a group of individuals, including the distribution of such outcomes within the group which includes health outcomes, patterns of health determinants, and policies and interventions that link them.
4. Big data
Characterized by the Four Vs, which are volume, variety, velocity, and veracity.
5. Health information system (HIS)
Data generation, compilation, analysis and synthesis, and communication
17. Question 17
5/5
Which 3 statements about future health care trends in the U.S. are true?
1.
Inflation in wages and supplies will not be a factor in planning for costs.
2. Universal coverage and single payer coverage are the same.
3. Private health care insurance is now and for the next 5–10 years the largest source of health care coverage in the U.S.
4.
National debt, gross domestic product (GDP), and economic indicators, such as interest rates and taxation, will impact health care planning and operations.
5.
Prescriptions as a percent of health care expenditure in the U.S. will be greater than expenditures for physician and clinical services based on current trends.
6.
Outpatient care will continue to be on average at least 50% or more of hospital revenue.
18. Question 18
10/10
Match how the provider of care is financially impacted by each insurance plan type/model.
5 of 5 pairs matched correctly
Prompts Answers
1. Health maintenance organization (HMO)
If the provider can take care of the patient for less than the fixed payment, the provider makes money; if it costs the provider more than the fixed payment, the provider loses money.
2. Preferred provider organization (PPO)
If the provider can make more money from the additional patient volume to exceed the cost of the discount on the provider’s fees, then the provider makes money; if the provider cannot do so, the provider loses money.
3. Point of service (POS)
This hybrid model can have a combination of benefits and challenges of the 2 models it combines, depending on the contract structure between the provider and the payer/plan.
4. Provider-sponsored organization (PSO)
Provider assumes all risk and can lose money if costs exceed revenue.
5. High deductible health plan (HDHP)/health savings account (HAS) Provider typically gets paid full fees at the time of service, unless the patient exceeds the available funds in their account. In that case, the provider must collect payment directly from the policyholder and the provider often has volume/usage by patients that reduces revenue to the provider compared to other plans.
19. Question 19 5/5
Which 2 statements apply to infectious disease in the U.S.?
1.
Travel guidelines and recommendations from the Centers for Disease Control and Prevention (CDC), the Department of Homeland Security (DHHS), and World Health Organization (WHO) should be monitored by health care providers to screen patients who have traveled to countries affected by infectious diseases that are transmissible.
2.
Heightened infection surveillance and prevention must be a permanent part of planning and operations and a significant consideration in any setting, even if not directly related to health care.
3. The Joint Commission requires a 90% or better compliance with flu vaccines for staff in hospitals that it accredits.
4.
Once the current COVID-19 pandemic has run its course, all health care organizations can resume their previous processes for infection surveillance, prevention, and control because it will be at least a century before another pandemic will happen.
20. Question 20 10/10
Match each Medicare part with its correct description.
4 of 4 pairs matched correctly
Prompts Answers
1. Part A
Covers hospital care, skilled nursing facility care, hospice, and home health services
2. Part B
Covers physician services, clinical research, ambulance services, durable medical equipment, mental health, inpatient, outpatient, and partial hospitalization
3. Part C
An alternative coverage which is a managed care model known as Medicare Advantage Plans
4. Part D
Prescription drug benefit created by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003
21. Question 21 10/10
Match the name of each health care law to its correct description.
4 of 4 pairs matched correctly
Prompts Answers
1. False Claims Act (FCA)
Health care services that are not rendered, upcoded, and/or not supported by documentation in the medical record or part of a previously submitted claim
2. Physician Self-Referral
Commonly referred to as the “Stark law”; prohibits certain physician relationships with other entities with whom the physician or a family member has a financial interest unless an exception applies
3. Emergency Medical Treatment and Labor Act (EMTALA)
Federal law that requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay
4. Title VII
Prohibits discrimination based on race, sex, color, religion, and national origin
22. Question 22 5/5
Which 2 of the following are barriers to electronic health records (EHRs)?
1.
It’s important to secure patient information from unauthorized access.
2.
Patient access to their own medical records kept in portals is not permitted by regulation.
3.
It’s difficult to maintain privacy of patient information.
4.
Patients requesting to change EHR information they believe to be in error is not permitted by law.
23. Question 23 10/10
Match how the patient/policyholder can be impacted by each insurance plan type.
3 of 3 pairs matched correctly Prompts Answers
1. Health maintenance organization (HMO)
Patient must get a referral from PCP to see a specialist.
2. Preferred provider organization (PPO)
Patient can choose to go out of network to see providers of choice, but may have to pay more to
do so.
3. High deductible health plan (HDHP)
Patient is allowed to choose any provider. They may also have a high deductible to pay out of pocket, unless there is an HSA component to the plan.
24. Question 24 5/5
Select 3 health care insurances that are publicly funded.
1. TRICARE
2. Medicaid
3. Blue Cross Blue Shield
4.
Medicare Parts A, B, C, and D
25. Question 25 6/6
Which 3 of the following are accurate statements about the Health Insurance Portability and Accountability Act?
1.
It gives access to health information exchanges (HIEs).
2.
It is abbreviated HIPPA.
3.
It helps remove the barriers to employees who change employment without losing insurance coverage.
4.
It enacted more health information privacy protections for patients.
26. Question 26 5/5
Which 3 have been cited as long-term advantages of electronic health records (EHRs)?
1.
Physicians/providers experience burnout due to more time spent on documentation.
2.
Societal outcomes improve, such as improved ability to conduct research and improved population health.
3.
Privacy and security issues do not occur in electronic records, but instead only in paper medical records. EHR involves low upfront cost of acquisition and implementation.
4.
EHR involves low upfront cost of acquisition and implementation.
5. Patients experience improved quality of care.
6. Organizational outcomes include financial and operational benefits, such as workflow.
27. Question 27
5/5
Which 2 types of insurance plans are most well known for being open access models?
1. Provider-sponsored organization (PSO)
2. High deductible health plan (HDHP)
3. Health maintenance organization (HMO)
4. Preferred provider organization (PPO)
28. Question 28 10/10
Match each ethical decision-making principle in health care with its correct description.
4 of 4 pairs matched correctly Prompts Answers
1. Autonomy
This refers to the right of patients to make decisions about their health care.
2. Beneficence
The patient’s own interests must be considered foremost in any decisions that need to be made involving care and treatment or that affect the patient in some way.
3. Non-malfeasance
This refers to the “First of all, do no harm” approach from the Hippocratic Oath.
4. Justice
This refers to equity and fairness for patients, institutions, and society.
29. Question 29 10/10
Match each term to its correct examples.
Prompts Answers
1. Provider
Physician, advanced practice nurse, psychologist, and physical therapist
2. Payer
Medicare, Medicaid, Blue Cross Blue Shield®, United Healthcare, TRICARE, and Veterans Health Administration
3. Plan type
Health maintenance organization (HMO), preferred provider organization (PPO), point of service
(POS), provider-sponsored organization (PSO), and high deductible health plan (HDHP)/health savings plan (HSA)
4. Place of service
Inpatient facility, outpatient clinic, assisted living, skilled nursing facility, tribal health, emergency department, and prison
30. Question 30
6/6
Which 3 trends contribute to higher cost of health care in the U.S.?
1.
Chronic conditions occurring at a younger age
2. Retail health
3. Administrative complexity
4. Implementation of the Affordable Care Act (ACA)
5. Pharmaceutical medication cost
31. Question 31
5/5
Which 4 are current trends in health care?
1.Universal access to health care enacted as the result of the Affordable Care Act (ACA)
1. Technology cost and benefit for diagnosis, treatment, and information
2.
Short-term impacts of the COVID-19 pandemic on patient access and willingness to seek health care without herd immunity
3.
Challenges in access to health care for vulnerable populations, including people who are chronically ill, older adults, socially disparate people, rural health communities, mental health patients, and women
4.
Ethical issues in patient treatment, informed decision-making, and technology
5.
Replacing managed care for reimbursement with fee for service