Student Answer: : Managed care’s way of classifying » 4 : Diagnosis
patients by diagnosis, average length Related Group (DRG)
of hospital stay, and therapy received
: Summarizes what the insurance » 11 : Explanation of
company paid the provider, how much Benefits (EOB)
the patient owes, and provides an up-
to-date status of the patient’s annual
deductible and out of pocket expenses
: Employees become part of their » 1 : Cost sharing
employer’s group insurance plan and
the employer subsidizes the monthly
premiums
: Emphasized environmental » 10 : Public Health
sanitation to stop the spread of
epidemic diseases
: Each individual service or treatment » 3 : Fee-for-Service
is paid and billed separately (FFS)
: A derogatory term for a medicine, » 12 : Nostrum
especially an ineffective one, prepared
by an unqualified person
: Involves bundled payments when » 6 : Capitation
physicians are paid for a series of
treatments that are not billable
individually
: Preventing unnecessary specialized » 13 : Gatekeeping
care
: Global mission of health protection, » 9 : Centers for
prevention, and preparedness Disease Control (CDC)
: Practice of recognizing that » 5 : Cultural
different groups have unique health Competency
experiences and needs
: Enter into contracts with hospitals » 2 : Managed Care
and healthcare professionals to Organizations (MCO)
provide healthcare to the beneficiaries
in exchange for a negotiated rate per
patient
: Amount of payment is determined » 7 : Prospective
prospectively, before the service is Payment System (PPS)
rendered
: Reimbursement models aimed at » 8 : Pay-for-
improving the quality, efficiency, and performance
overall value of health care
Points Received: 9 of 13
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