NU-126 Test 2 Study Guide with
Complete Solutions
Nursing plays an important role in - Ans:-Care quality and safety as well as cost contaimenent, care
coordination, and service delivery
National Quality Forum - Ans:-(2010) identified 34 health care practices, organized in seven
functional area...
- use some form of review for medical necessity of the services under consideration
Table 7.2 c&j
Managed care plans - Ans:✔✔-Plans that restrict your choices usually cost less. If you want a flexible
plan, it will probably cost more. There are three types of managed care plans:
- Health maintenance organizations
- preferred provider organizations
- point of service
Health maintenance organizations - Ans:✔✔-Usually only pay for care within the network. You choose a
primary care doctor who coordinates most of your care
Preferred provider organizations - Ans:✔✔-Usually pay less if you get care within the network (list of
providers and hospitals). They still pay part of the cost if you go outside the network. May or may not
pay for preventative care.
Point of service - Ans:✔✔-Plans that let you choose between an HMO or a PPO each time you need care.
How health care is paid - Ans:✔✔--Private insurance- blue cross blue shield
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