WGU C425 OA EXAM ACTUAL EXAM TEST BANK QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS)
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Course
WGU C425 OA
Institution
WGU C425 OA
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 car...
WGU C425 OA EXAM 2024-2025 ACTUAL EXAM TEST BANK QUESTION
AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIF
ANSWERS)
Study online at https://quizlet.com/_g0g862
1. Which of the following is true in regards to health care There are more
today in the United States? specialty physi-
There are more primary care physicians than special- cians than primary
ty physicians. physicians.
Primary care receives a higher reimbursement in pro-
fessional fees.
There are more specialty physicians than primary
physicians.
Outpatient care is slowly decreasing.
2. What triggered the downsizing phase in the U.S. hos- Prospective pay-
pital industry during the 1980s? ment system
Hill-Burton Act
Managed care
Prospective payment system
Medicare and Medicaid
3. Designated Related Groups (DRG) -based reimburse- Reduce the length
ment necessitated hospitals to do what? of stay for hospital-
Admit new patients at a faster rate than before ized patients
Admit a greater number of Medicare patients than
before
Reduce the length of stay for hospitalized patients
Admit a smaller number of Medicare patients than
before
4. In which type of utilization management is a primary Gatekeeping
care physician's opinion necessary in referring or not
referring a patient to a specialist?
Concurrent
Retrospective
Gatekeeping
Precertification
5. What is one aspect in which managed care differs Responsibility for
from conventional insurance? delivery of ser-
Collection of premiums vices
Assumption of risk
, WGU C425 OA EXAM 2024-2025 ACTUAL EXAM TEST BANK QUESTION
AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIF
ANSWERS)
Study online at https://quizlet.com/_g0g862
Responsibility for delivery of services
Payments to providers
6. What is the purpose of Skilled Nursing Facilities (SNF) It enables a facility
certification? to serve Medicare
It enables a facility to be operated as a skilled nursing clients.
facility.
It is required to legally operate a nursing home.
It enables a facility to serve Medicare clients.
It enables a facility to serve both Medicare and Med-
icaid clients.
7. What is the main goal of long-term care as it relates to Promote indepen-
a patient's function? dence
Restore function
Provide assistance
Promote independence
Adapt to change
8. The U.S. government plays a limited role in the health being the re-
delivery system. The government's role in the arena of sponsible party
health care delivery consists of: for health care
developing private hospital organizations. delivery through
regulating public and private programs at the local Medicare and
levels. Medicaid pro-
being the responsible party for health care delivery grams.
through Medicare and Medicaid programs.
aiding in competition among managed care organiza-
tions.
9. The ideology system that emphasizes the well-being social justice sys-
of the community over an individual is called the: tem.
social justice system.
market justice system.
money market system.
universal health care system.
10.
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