Health Care Final Exam- regulations Questions And Already Passed Answers.
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Course
Healthcare Regulation
Institution
Healthcare Regulation
What are the drives of health care regulation? - Answer cost, quality, access
What is the most important driver of health care regulation? - Answer cost
Why do markets fail? - Answer unseen externalities and inadequate information
What are some ways to regulate? - Answer costs,...
Health Care Final Exam- regulations
Questions And Already Passed Answers.
What are the drives of health care regulation? - Answer cost, quality, access
What is the most important driver of health care regulation? - Answer cost
Why do markets fail? - Answer unseen externalities and inadequate information
What are some ways to regulate? - Answer costs, taxes, fines, suspension of license, etc.
What is regulation? - Answer Controlling human or societal behaviors by rules or restrictions
What is quality assurance? - Answer inspection or culling, throw out defective products or "bad apples"
Focus on the "tail" of distribution
Find the source of the mistake
What is quality assurance's main focus? - Answer the performance of the medical provider
What is quality improvement? - Answer Analyze and fix the production system; prevention
What is quality improvement's main focus? - Answer patient care
Who created quality improvement? - Answer Walter Shewart study, showed that any system has
predictable errors that can be improved upon
What is TQM? - Answer Total Quality Management
What is CQI? - Answer Continuous Quality Improvement
,Who applies quality improvement? - Answer PRO and QIO and JCAHO analyzing root causes
What is JACHO? - Answer what hospitals hate regulatory agency that comes in and checks hospitals
every three years, biggest regulatory agency
80% of hospitals choose to get license through JACHO
What si the National Practitioner Database? - Answer maintained by HRSA
workforce management
What is QIO? - Answer Quality Improvement Organization
works to improve quality
What is regulated by the state? - Answer Physicians: Licensing boards for licenses
Hospitals: licensure JCAHO
Managed Care: ERISA
What do states typically regulate? - Answer licensure
What does the federal government typically regulate? - Answer health care is national so it needs
national oversight
Who benefits when you repeal community rating? - Answer Healthy people
Who benefits when you repeal health benefits? - Answer Healthy People
What are the typical measures of process? - Answer claims database
medical records
, What are the most accepted quality measures? - Answer measures of technical processes
What is technical care? - Answer did you go through all the proper procedures
When premiums fall for other people, they go __for others in the pool. - Answer up
What is regulated by the federal government? - Answer Physician: Coordination of discipline (NPDB)
Hospitals: Medicare and EMTALA
Hill-Burton funding
Managed Care: HMO Act of 1973 (stimulated growth of HMO's)
What is regulated privately? - Answer Physician: Private entities
Hospitals: Private JCAHO commissions
NCQA
What is ERISA? - Answer Employee Retirement Income Security Act
exempts self insured employers from state regulation
What is the NCQA? - Answer National Committee on Quality Assurance
reviews measurement tools
What is the NQF - Answer National quality foundation
review measurement tools
What is NQMC? - Answer quality measures
What are the market forces used to drive quality improvement? - Answer public reporting and pay for
performance
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