WGU C425 Topic 1 - Healthcare Delivery Systems, Regulation, and Compliance Exam

Capitation A -ANSWER covers all services an enrollee may need during an entire year Market Justice -ANSWER most equitably distributed through the market forces of supply and demand, rather than government interventions. Distributed on the basis of willingness and ability to pay Social Justice ...

Supply-side rationing is used by universal healthcare, HMO's and ACO's to cut down on all of these except: A) Duplication of Effort B) Access to specialists C) Decrease provider communication D) Cost -ANSWER C An ACO (Accountable Care Organization) earns additional money by: A) Setting a ...

What is the dominant healthcare delivery system in the USA - ANSWERManaged care, employers and government are primary suppliers What Population does the VA serve - ANSWERVeterans TRICARE is insured for military personnel active and non-active Describe the affordable care act and its role in he...

Evidence-based care promotes cost-effective interventions.What is an unintended consequence of this methodology? a. Insurance plan members will see an increase in their premiums. b. The number of providers taking complicated cases will decrease. c. Providers will have fewer resources from which...

Supply-side rationing is used by universal healthcare, HMO's and ACO's to cut down on -ANSWER Decrease provider communication An ACO (Accountable Care Organization) earns additional money by: -ANSWER 1 Getting a share of money it saves Medicare 2 Producing better patient results All America...

Which important change in the U.S. healthcare system was made with the enactment of the Social Security Act? -ANSWER It funded payments through the federal government and the states. Why is the federally sponsored health insurance program known as Medicare important in the development of delivery...

A patient that stays overnight is an_____, a patient that receives care but does not stay overnight is an _______. - ANSWERInpatient, Outpatient Adjusting the utilization of care while active treating the patient is what type of review? - ANSWERConcurrent Utilization This organization leads th...

In a national health insurance system, healthcare is financed through -ANSWER Tax dollars in which the government guarantees health care services to all citizens The U.S. health care system is based on the -ANSWER Market justice principle Which of the following subsystems of healthcare deliver...

Universal Access -ANSWER Developed countries have national health insurance programs. It provides routine and basic health care. It is ran by the government and financed-through general taxes. All Americans are not "entitled" to routine and basic health care services. -ANSWER Access also ...

Outpatient care - ANSWERhealth services that don't require an overnight stay Private Practice - ANSWERLimited examination and testing Self-employment = more independence, short duration, Hospital outpatient clinics - ANSWERFunction as the community's safety net, providing primary care to th...

Which of the following is true in regards to health care today in the United States? There are more primary care physicians than specialty physicians. Primary care receives a higher reimbursement in professional fees. There are more specialty physicians than primary physicians. Outpatient care i...

The current model of U.S. healthcare focuses on - ANSWERidentifying symptoms or diseases in patients and eliminating them. The U.S. has a unique system of healthcare delivery, which did not emerge by mere accident, but as a result of - ANSWERmarket forces and an obligation to treat special popula...