Study.com Chapter 2,3, Health Care Delivery System

The U.S. Department of Health and Human Services

The Healthy People program sets nationwide health promotion and disease prevention goals for the *U.S.* Who administers the Healthy People program? The World Health Organization State governors The U.S. Department of Health and Human Services Watch correct answer Community health centers

High cost users

The top 5% of individual healthcare spenders in the U.S. account for more than half of all national healthcare spending. This figure most clearly demonstrates which of the following concepts from this lesson? Gross domestic product Inflation High cost users Prescription drug costs

2010s

When was the Patient Protection and Affordable Care Act signed into law by President Obama? 2010s 1980s 1920s 1940s

1980-today

When were safety net hospitals established? 1930-1965 1860s-1930s 1980-today 1965-1980

Between behaviors caused by medical conditions and those that are just outside social norms

Where is the line usually drawn in ethical debates on behavioral control? Between behaviors caused by medical conditions and those that are just outside social norms Between behaviors in adults and those in children Between conscious and unconscious behavior Between behaviors that are good and those that are bad

Germany

Which country established the world's first national health insurance system? Germany Denmark The United States Canada

POS

Which managed care delivery system allows members to select PPO or HMO options each time they seek services? HMO MCO POS PHP

ECMO machines

Which of the following is NOT an example of diagnosis medical technology? Blood pressure cuffs ECMO machines MRI scanners Heart monitors

computer

Which of the following is NOT an example of medical technology? Antibiotic drugs Band aid Computers MRI scanners

Morality as it is applied to advances in biological science and medicine

. What is bioethics? Ethical values that support the laws of nature over scientific advancements and technology Ethics that only apply to human beings Morality as it is applied to advances in biological science and medicine Universal, natural morals that apply to all living things

PPO

1. Sarah is 35 and wants to get a healthcare plan. She is not strapped for money, and she'd prefer a plan that offers her increased flexibility in terms of doctors she is able to see, even if it means a slightly higher cost to her. Which type of plan should Sarah get? Medicare HSA HMO PPO

Pharmaceuticals

10. Which term includes anything related to drugs or medications? Pharmaceuticals Medicinal purposes Conventional medicine Holistic care

Mental healthcare

11. Which segment of the healthcare system is grossly under-utilized? Pharmaceuticals Safety net services Mental healthcare Long-term care

They are subsidized by government funding.

12. How do safety net services receive funding? They receive donations. They do fundraisers. They are subsidized by government funding. They don't need funds.

The Beveridge Model-With this model, the government is responsible for financing and providing health care through taxes.

13. Under which health care model would you *never receive a doctor's bill*? The National Health Insurance Model The Beveridge Model The Out-of-Pocket Model The Bismarck Model

The Bismarck, Out-of-Pocket, National Health Insurance Models and Beveridge Models

14. The United States' health care system is a combination of models. Which models does it include? The Bismarck and Beveridge Models The Out-of-Pocket, National Health Insurance Models and Beveridge Models The Out-of-Pocket and National Health Insurance Models The Bismarck, Out-of-Pocket, National Health Insurance Models and Beveridge Models

The National Health Insurance Model-The national health insurance model is sometimes viewed as a combination of both the Bismark and the Beveridge models. Insurance companies are privately run, but payments come from a government program to which all citizens contribute

15. In *Taiwan*, insurance companies are privately owned but payments come from a *government program to which all citizens contribute*. What type of health care model is this? The Beveridge Model Out-of-Pocket Model The Bismarck Model The National Health Insurance Model

The Bismarck Model-The system uses private insurance agencies, also known as sickness funds. They are run as nonprofits and are required to accept all citizens without discrimination. As a result, even though both employees and employers are contributing to an insurance policy, the insurance company is not benefiting financially.

16. Toby recently moved to *Belgium* and works for a marketing company. He is required to contribute to his insurance policy along with his employer. Despite having several pre-existing conditions, Toby's insurance must cover him. What type of model would this be? The National Health Insurance Model The Out-of-Pocket Model The Bismarck Model The Beveridge Model

Provider

17. The _____ component is the component most concerned with quality of care. Employer Community Payer Provider

Zach, the 50 year old that spends his free time mountain climbing, hunting, and fishing with his brother and two nephews.

18. Susan is a 45 year old woman that lives in Baltimore, Maryland who enjoys outdoor activities and spending time with family and friends. Which of the following people below would be considered part of her community? Melanie, the 68 year old retiree from Minneapolis who enjoys spending winter indoors with her cats. Bill, the 22 year old programmer from Nashville, Tennessee with severe outdoor allergies. Zach, the 50 year old that spends his free time mountain climbing, hunting, and fishing with his brother and two nephews. Ally, who is 30 years old and in culinary school with hopes to own a restaurant one day.

Spouse

19. Which of the following options is not considered part of the health services administration process? Patient Insurance Company Doctor Spouse

HMOs, PPOs, and POS

2. Managed care plans include: Indemnity plans, HSA, PPO HMOs, PPOs, and POS HSA, POS, and indemnity plans HMOs, PPOs, and HSA

Researching your symptoms on a medical website.

20. Which option below would not be considered part of health services administration? Researching your symptoms on a medical website. A nurse coming to take your vitals. A doctor reviewing your signs and symptoms for diagnosis. The insurance company paying out to the hospital for your medical expenses.

Provides greater resources to more people

21. All of the following are benefits of integrated health systems EXCEPT: Greater diversity in care as well as better health outcomes Provides greater resources to more people Integration supports the continuation of care May provide savings for some

PPO

3. Which type of managed care plan lets you choose the doctor you want to go see without another doctor's referral? PPO Indemnity plan PPO HSA Fee for service plan

HMO

4. Which type of managed care plan needs your PCP's approval to go see another specialist? PPO HMO HMO Indemnity plan HSA

1910s

5. In which decade was *national health care legislation first proposed*, causing unions to believe that a plan offering compulsory health insurance would weaken the union systems? 1940s 1910s 1920s 1970s

1970s

6. When was the Health Maintenance Organization Act established? 1970s 1930s 2000s 1910s

1950s

7. When did the price of medical and hospital care begin to double? 1950s 1980s 1960s 1990s

1920s

8. In which decade was the organization that would be the precursor to Blue Cross Blue Shield established? 1920s 1900s 1960s 1980s

Long-term care

9. What industry involves *assisting people with personal care activities*? Daily care Assistive care Long-term care Home Care

Decreased family satisfaction

All of the following are benefits of magnet status EXCEPT? Improved patient outcomes Decrease length of stay High staff satisfaction ratings Decreased family satisfaction

The TAH has contributed to more equitable health care access

Diffusion of the total artificial heart (TAH) has impacted U.S. health care delivery in all of the following ways, EXCEPT: The TAH has carried significant cost implications. The TAH has improved patients' quality of life. The TAH has improved the quality of health care delivery. The TAH has contributed to more equitable health care access.

Government, professional associations, payors, and patients

Drivers of quality in healthcare may include: Clinical educators, nursing schools, medical schools, and public health Government, professional associations, payors, and patients Payors, vendors, suppliers, communities, and physicians Law enforcement, professional regulations, physician orders, and staff

This is an example of a participatory wellness program.

Emily receives a discount on her monthly insurance premium for walking 30 minutes every day. Which of the following statements about this wellness program is FALSE? This is an example of an activity-only program. This is an example of a participatory wellness program. The program is subject to federal standards. This is an example of a health-contingent wellness program.

Participatory

Emily's new health insurance plan includes a wellness program that reimburses employees for the cost of a gym membership. This is an example of a(n) _____ wellness program. Activity-only Health-contingent Participatory Watch correct answer Outcome-based

Actions formulated to meet challenges related to health issues

Health policies are defined as which of the following? Health policy is process of decentralization of care Rules and regulations passed by Congress A set of steps to move patients through the healthcare system Actions formulated to meet challenges related to health issues

By comparing a patient's vital signs against other people who have fallen ill.

How can big data help in diagnostics? Patients can be encouraged to take frequent blood tests and other check-ups for general information. Patients can immediately do their own research to self-diagnose their own ailments. By monitoring for changes in heart rate in a large population affected by a disease. By comparing a patient's vital signs against other people who have fallen ill.

Drug dosage

How is big data on the verge of changing pharmaceuticals? Drugs for specific diseases Drug dosage Monitoring vital signs It isn't

Five

How many steps are included in the Ace Star Model of Knowledge Transformation evidence-based practice model? Six Four Five Three

5

How many steps are there to create a policy? 3 4 6 5

18.1 million

If all states chose to expand Medicaid coverage under the ACA, how many people would that cover? 23.1 million 18.1 million 18.1 billion 1 million

Communication and education of the health policy

Which of the following defines the success of the implementation phase of health policy development? Communication and education of the health policy Oversight of the policy from Congress Comparing the past data to with present data How much money is made

Bundled payments are fixed amounts of money for a specific episode of care or visit

One method of reimbursement on stage now is the bundling of payments to providers. Which answer provides the best description? Bundled payments are fixed amounts of money for a specific episode of care or visit. Payments are sent to all providers as they render the care for a negotiable sum. All charges are bundled together for payment to all providers separately. Bundling of payments means the providers receive a payment for the entire year for that patient.

Hormone therapy

Over the past few years, less people have been using antibiotics. _____ is another type of medication that has seen a decrease in use over the past few years Antidepressants Statins Pain medications Hormone therapy

Model for Improvement

Quality models can be more effective by asking the right questions beforehand. What model adds questions before PDSA Model to bring clarity? Customer Satisfaction Review Quality Care Improvement Quality Review Model Model for Improvement

Do

Quality teams may use the PDSA model for quality improvement projects. What does the 'D' stand for? Deliberate Differentiate Decision Do

Performing kidney dialysis

Which of the following is NOT within the scope of primary care when a patient is complaining of kidney trouble? Counseling patients on smoking cessation to improve blood pressure and thereby improve kidney health Managing chronic illnesses like high blood pressure, high cholesterol, early kidney disease Performing kidney dialysis Ordering tests to check for a broad range of diseases when a patient complains of kidney pain

Service lines

What are integrated departments within a hospital that offer different aspects of a single service. Service lines Silos Integrated medicine Service cells

Use value-stream mapping and data to support cost and waste reduction, errors, and increase patient satisfaction

What are some key components of Six Sigma? A data-driven plan to improve nursing satisfaction Create a quality program based on data and investments Increase number of patients, increase revenue, and reduce budgets Use value-stream mapping and data to support cost and waste reduction, errors, and increase patient satisfaction

Screening services, lifestyle management services, and disease management services

What are the three core services that wellness programs typically provide? mergency preparedness services, lifestyle management services, and disease management services Screening services, lifestyle management services, and disease management services Lifestyle management services, financial management services, and disease management services Screening services, lifestyle management services, and networking services

A not-for-profit organization that provides accreditation of healthcare organizations

What is TJC? A governmental body regulating surgeons who implant artificial joints A for-profit organization started by a group of surgeons A not-for-profit organization that provides accreditation of healthcare organizations A nurses' union that fights for better working conditions in hospitals

a statistical review of several similar experiments or studies

What is a meta-analysis? an experiment in which researchers try and determine specific risk factors. a review of different cases to examine possible causes. a compilation of multiple studies to show consensus. a statistical review of several similar experiments or studies

To bridge the gap between staff physicians and the hospital board

What is a responsibility of medical leaders? To bridge the gap between staff physicians and the hospital board To serve as expert witnesses To serve as the spoke persons for medical staff To build esteem of medical colleagues

A healthcare system that provides every citizen with a basic level of health insurance coverage

What is a universal healthcare system? A healthcare system that provides every citizen with a basic level of health insurance coverage Watch correct answer A healthcare system that is solely funded through government taxes on individuals A healthcare system that is solely funded through government taxes on employers A healthcare system that provides most citizens with a basic level of health insurance coverage

The impact of research on humanity and human life

What is generally the ultimate focus of bioethics? The impact of research on humanity and human life The importance of technology in answering questions of the universe The natural laws of universal morality The morality of actions in daily life

Efficient way to communicate

What is the benefit of using electronic medical records for the interdisciplinary team? Access to patient health information Efficient way to communicate Easier to document in the computer vs on paper HIPAA doesn't apply to EMR

The Western Clinic in Washington

What is the first example of managed care in the United States? Tricare, nationwide The Western Clinic in Washington Medicaid in Massachusetts The Eastern Care Clinic in Virginia

The Prescription Drug and User Fee Act (1992)

Which federal law allowed the FDA to collect application fees from companies applying for new drug approval? The Food and Drugs Act (1906) The FDA Modernization Act (1997) The Food, Drug, and Cosmetic Act (1938) The Prescription Drug and User Fee Act (1992)

The Food, Drug, and Cosmetic Act (1938)

Which federal law first gave the FDA the power to regulate medical devices? The Food and Drugs Act (1906) The Food, Drug, and Cosmetic Act (1938) The FDA Modernization Act (1997) The Medical Device Amendments of 1976

Centers for Medicare and Medicaid

Which government agency must provide nursing home certification? Center for Disease Control and Prevention Department of Health and Welfare Centers for Medicare and Medicaid Joint Commission

Dental floss

Which medical device is classified under Class I of the Medical Device Amendments of 1976? Replacement heart valves Dental floss Breast implants Powered wheelchairs

Hospitals, physicians, and government representatives

Which of the following are the major stakeholders in establishing health policy? Local concerned citizens and lobbyists Commercial healthcare vendors and sales representatives Department of Homeland Security and Department of Justice Hospitals, physicians, and government representatives

Members of racial and ethnic minorities are less likely to have health insurance than whites.

All of the following statements are examples of disparities. Which of these disparities is a healthcare disparity? Members of racial and ethnic minorities have higher infant mortality rates than whites. Members of racial and ethnic minorities have a higher prevalence of diabetes than whites. Members of racial and ethnic minorities are less likely to have health insurance than whites. Members of racial and ethnic minorities have lower life expectancies than whites.

Medicare

Jalisa is 37 years old and has end-stage kidney failure. Which program BEST fits her health insurance needs? Medicare Both Medicare and Medicaid Medicaid An HMO

health insurance that is designed to reduce the costs of services to its members by contracting with specific providers

Managed care can be best described as _____. federal and private health insurance that offers both reduced costs to its members and unlimited providers to choose from health insurance that is designed to reduce the costs of services to its members by contracting with specific providers federal and private health insurance that offers reduced costs to its members health insurance that was developed twenty years ago

The FDA was initially formed under the Food and Drugs Act.

Which of the following statement about the Food and Drugs Act (1906) is TRUE? The FDA was initially formed under the Food and Drugs Act. The Food and Drugs Act allowed the FDA to permit fast track approvals for life-saving drugs. The Food and Drugs Act gave the FDA the authority to review medical devices. The Food and Drugs Act gave the FDA the authority to collect application fees.

In 2016, per capita spending on U.S. healthcare was approximately $8,000 per person.

Which of the following statements about U.S. healthcare spending is NOT true? Healthcare spending as a percentage of GDP is higher in the U.S. than any other country. Healthcare spending is projected to account for 20% of U.S. gross domestic product by 2025. Healthcare spending currently accounts for 18% of all U.S. gross domestic product. In 2016, per capita spending on U.S. healthcare was approximately $8,000 per person.

Lowering self-esteem

Which of these is NOT a good target for prevention programs? Eating disorders Addiction Domestic violence Lowering self-esteem

Teachers

Which of these is NOT a key player when trying to implement health policies? Health professionals Doctors Nonprofits Teachers

Risk of malpractice

Which of these is NOT an ethical concern of big data in healthcare? Preferential treatment Risk of malpractice Patient privacy Discrimination for others

Stem cell research can be used to manipulate people's behaviors.

Which of these is not one of the major debates about stem cell research? Stem cell research often involves destroying human embryos. All of these are major debates about stem cell research. Stem cell research could be used to cure degenerative diseases. Stem cell research can be used to manipulate people's behaviors.

A letter from a member's primary doctor

Which one of the following best defines a ''referral''? A letter from a member's HMO A letter from a member's MCO A letter from a member's specialist A letter from a member's primary doctor

POS

Which type of managed care plan is a combination of a PPO and HMO? PPO POS Indemnity plan HSA POS

Systematic review

Which type of study is the most valid and reliable based on the evidence-based practice hierarchy? Systematic review Randomized control trial Cohort study Case-controlled study

138%

With the implementation of the Affordable Care Act (ACA), how much coverage can Medicaid expand to people under the Federal Poverty Line? 75% 100% 138% 90%

the benefit of communal health information exchange

You log onto a newly formulated centralized EHR. Within minutes, you have access to Omar's visits with his cardiologist. You also can see the prescription medications he is taking. This is an example of: the benefit of a good bedside manner the benefit of communal health information exchange the danger of familial support the benefit of individualized EHR systems

A benefit

You work for a company that provides an insurance option that is quite affordable because they subsidize the cost as part of _____ to their employees. A benefit None of these A directive A message

'The Medicare program' is prohibited by U.S. law from negotiating the price of prescription drugs.

_____ is prohibited by U.S. law from negotiating the price of prescription drugs. 'The Medicaid program' is prohibited by U.S. law from negotiating the price of prescription drugs. 'The Medicare program' is prohibited by U.S. law from negotiating the price of prescription drugs. 'The private insurance industry' is prohibited by U.S. law from negotiating the price of prescription drugs. 'The U.S. Department of Veterans Affairs' is prohibited by U.S. law from negotiating the price of prescription drugs.