WGU C425 Chapter 6 - Chapter 8 Questions with correct Answers

Who finances a health reimbursement arrangement (HRA)? - ANSWER-Employers Medicare Part A is primarily financed through which of the following? - ANSWER-Payroll deductions What is referred to as the amount that the insured has to pay out of pocket each time health services are received? - ANSWER-Copayment Who assumes the bulk of the risk in managed care plans? - ANSWER-MCO What does Medicare part A pay for? - ANSWER-Hospitalization, short term skilled nursing care, home health, and hospice. Which of the following healthcare services would NOT be covered under Medicare Part A or B? - ANSWER-Vision care Under Medicare Part A, a benefit period begins during what period? - ANSWER-The beneficiary is hospitalized Part A deductible must be paid at what point of care? - ANSWER-For each benefit period How many days of hospitalization is required before Medicare pays for services in a skilled nursing facility? - ANSWER-3 What is Medicare B primarily financed through? - ANSWER-Taxes and premiums Requires payroll taxes to be paid equally by employers and employees - ANSWER-Medicare Part A Does not include any specific medical benefits mandated under Medicare - ANSWER-Part C What is the Medicaid program financed by? - ANSWER-State and federal government CHIP is available to families with incomes up to: - ANSWER-200% of the federal poverty level What type of physician reimbursement is based on individually distinct services that are separately billed? - ANSWER-Fee for service Which of the following is based on the time, skill, and intensity it takes to provide a service? - ANSWER-Resource-based relative value scale With which of the following is PMPM associated? - ANSWER-Capitation As a method of reimbursement, PPOs use: - ANSWER-Discounted fee-for-service In which of the following is the amount of reimbursement established in advance? - ANSWER-Prospective reimbursement In order to make a profit under the DRG method of reimbursement a hospital must do which of the following? - ANSWER-Control its costs DRG codes are an extension of which Medicare reimbursement payment system? - ANSWER-PPS Which of the following is used to compare health care expenditures to total economic consumption? - ANSWER-Gross domestic product True or false? Enrollment in Part D of Medicare is based on a person's income - ANSWER-FALSE True or false? Each state administers its own Medicaid program. - ANSWER-TRUE True or false? Risk is predictable for providers. - ANSWER-FALSE Which of the following is NOT a domain of primary care? - ANSWER-Patient confidentiality Lower hospitalization rates are strongly associated with receiving increased: - ANSWER-Primary Care Unique attributes of primary care? - ANSWER-First-contact access, Ongoing care, Comprehensiveness of services What is the key difference between primary care and specialty care? - ANSWER-Primary care focuses on patients as persons and specialty care focuses on patients as diseases True or false? Continuity of care refers to care over time by a single provider or team of healthcare professionals. - ANSWER-TRUE True or false? An example of tertiary care would be immunizations. - ANSWER-FALSE True or false? Community health centers, church health centers, primarily serve as safety net providers. - ANSWER-TRUE What is the term for the number of patients in a hospital on a given day? - ANSWER-Census Which of the following is not considered a community hospital? - ANSWER-Department of Veterans Affairs (VA) hospitals In a short-stay hospital the average length of stay is how many days? - ANSWER-25 days or less Which of the following would be classified as a public hospital? - ANSWER-Federal hospital What is a proprietary hospital? - ANSWER-A for-profit hospital What is the main focus of a rehabilitation hospital? - ANSWER-Improve physical function What is the main distinguishing characteristic of a teaching hospital? - ANSWER-It must train physicians The Magnet Recognition Program is sponsored by what body? - ANSWER-The American Nurses Association Issues related to medical ethics in hospitals are generally resolved by which of the following? - ANSWER-Ethics committees Who is responsible for managing a hospital? - ANSWER-CEO What is the primary mission for nonprofit hospitals? - ANSWER-To benefit the communities in which they are located by providing some public good True or false? The average number of days a patient stays in the hospital is called days of care. - ANSWER-FALSE True or false? Most physicians in the U.S. are employees of hospitals. - ANSWER-FALSE