C425 WGU (HEALTH SYSTEM) COMPREHENSIVE
QUESTIONS AND RELEVANT VERIFIED SOLUTIONS FOR
SUCCESS 2024 LATEST UPDATE
What is the dominant healthcare delivery system in the USA - (correct answer)
Managed care, employers and government are primary suppliers
What Population does the VA serve - (correct answer) Veterans TRICARE is
insured for military personnel active and non-active
Describe the affordable care act and its role in healthcare reform - (correct answer)
Main goal was to expand coverage increase access to care Medicaid expansion and
take away pre-existing conditions
List for key characteristics of the US healthcare system - (correct answer) No central
governing agency technology driven and focuses on acute care, high cost, unequal
access and average outcomes, imperfect market conditions for healthcare delivery,
fusion of market and social justice, multiple players in balance of power access to
healthcare is selectively base on insurance.
Define health - (correct answer) Overall well-being of mental and physical well-being
Discuss disease classifications acute, subacute, chronic - (correct answer) Acute:
Patient received short-term treatment for severe injury or episode of illness and urgent
medical condition or recovery from surgery examples, heart attack lack of kidney
function. Subacute: Comprehensive in patient care someone who has an acute illness
injury or disease trach tube feeding tube wound care.
Chronic: Less severe but is continuous can be controlled but if uncontrolled can lead the
serious complications sometimes even if controlled. Examples, diabetes, hypertension,
asthma.
Define market justice - (correct answer) Fair distribution of healthcare to market
forces in a free economy, medical services are based on peoples willingness to pay
individuals are responsible for their own achievements. Less involvement with
government. People view this as if you can't pay you shouldn't have health insurance
Social Justice - (correct answer) More government involvement in medical
insurance, insurance for all
What is Healthy People 2020? - (correct answer) 10 your plans, focused on medical
care, prevention, and education. Creating environments that promote good health for
all. Healthy development behaviors across all life stages
What is the Flexner Report? - (correct answer) Report by Abraham Flexner by the
Carnegie Commission to evaluate medical schools
, Outlined the inadequacies of medical schools that did not use the German model that
promoted medical education on the principles of scientific discovery
Caused schools that did not use this scientific model to close from lack of funding.
what is workers compensation? - (correct answer) Insurance that aids cash or
medical insurance when you are hurt on the job.
Who is covered by Medicare? - (correct answer) Elderly over the age of 65,
disabled, and those with high end renal failure" kidney disease"
Who is covered by Medicaid - (correct answer) Low income adults, children, elderly
and disabled. Means test determines need for Medicaid. Each state defines their own
outline of need for people applying for Medicaid
Describe cost sharing in the three main types of cost sharing in private health insurance
- (correct answer) Premium cost sharing: Insured assume some part of the risk
purposes to reduce miss use of insurance benefits. Deductible; amount insured pays
before benefits are paid by the plan. Copayments;'s money paid out of pocket each time
services are rendered. Coinsurance; amount Insured has to pay at a certain percentage
after deductible is met before insurance covers at 100%
What is covered in Medicare a - (correct answer) Medicare a covers inpatient and
hospital services nursing care, hospice care, and limited home health services.
What is covered under Medicare B - (correct answer) Ambulance services clinical
research, mental health, RX drugs, and DME, DME is a durable medical equipment.
What is covered under Medicare C - (correct answer) Routine dental, vision, hearing
aids and wellness programs
What is CHIP? - (correct answer) Children's Health Insurance Program, Provides
insurance for children who do not qualify for Medicaid.
List three main sources of financing healthcare? - (correct answer) Private health
insurance, public programs which include Medicaid and Medicare, and uncompensated
or charity care.
List two requirements for a hospital to be required a hospital? - (correct answer)
Hospitals must be licensed have organized physicians, provide continue nursing
services under RNs, have a governing body for hospital conduct, have a CEO with
responsibility for operations.
What is the Hill-Burton Act of 1946? - (correct answer) A law passed in 1946 to give
hospitals, nursing homes and other health facilities grants and loans for construction
and modernization. It had the biggest impact on expansions of hospitals. The creation of
Medicare and Medicaid in 1965 also fueled demand for hospital services .
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