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WGU C425 Review Finals - 304 Questions And Answers
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WGU C425 Review Finals - 304Questions And Answers
Universal Access Correct 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.
Correct Answer - Access also requires an adequate health delivery
infrastructure.
There is a shortage of primary care physicians mostly in the southern and
mountains region.
Obesity, chronic disease and aging population will create a much greater
demand for medical services and the size of physician workforce will decline.
50 % of PCP accept Medicaid and Participation in Medicare by PCP
36% why PCP are reluctant to accept Medicaid insured patients because of
low reimbursement to providers and delays to receive payments after the
services.
Health Care Reform Correct Answer - Is the extension of health
insurance to the uninsured.
For system to remain solvent, it must be accompanied by control costs
measures.
To control costs:
· Manage utilization
· Limit reimbursement to providers
· Employ some sort of rationing for supply of health care services
,Only the government can control costs in a single payer system because they
finance the healthcare system for all citizens.
In a single payer system, Correct Answer - Medicare, Medicaid, CHIP
and VA are no longer needed.
The government will have the right to over the availability of services,
utilization and payments to providers.
This will be opposed by many Americans and it is not seen as an alternative
for the future.
ACA proposed interventions to control costs but few provisions on addressing
control of health care expenditures. Correct Answer - If the US does not
cut expenses in the bloated government, US may be left with no choice except
to take drastic "austerity measure" a term used to describe spending cuts,
including cuts in social program.
To save Medicare from bankruptcy, changes to reduce costs are proposed in
the ACA.
Medicare benefits and allow a government panel to make decisions about end
of life care.
Medicaid, the push to enroll beneficiaries to managed care and paying MCO
capitated monthly fees to cover all health care expenses for Medicaid
beneficiaries. Taxes will increase for Americans to pay for the health care
programs to be expanded.
If ACA fails:
Patient choice act, Health Care Freedom Plan, Empowering Patients First Act
were proposed by republican legislatures and the main features for these
plans are. Correct Answer - 1. Established state-based health care
exchanges to facilitate individuals to buy private health insurance and create a
market where private health plans compete for enrollees based on price and
quality.
,2. Create a national market for health insurance to allow individuals to
purchase health insurance plans across state lines which are currently
prohibited.
3. Allow automatic enrollment in employer plans and create tax incentives for
small business for auto enrollment.
4. Give tax credit or vouchers to individuals to purchase health insurance.
High risk pools that enable hard to insure people to purchase subsidized
covered.
• . Replace Medicaid with a program to provide grants to state for:
a) Acute Medical Care Assistance to the blind, foster care children, low income
women with breast cancer or cervical cancer, TB infected individuals;
b) long term care services and support disabled and elderly populations
6). Establish and implement a bidding mechanism to promise competition
among Medicare Advantage plans (Part C).
7) Prevent Medicare fraud and abuse.
8) Supplement the costs of Private health insurance for low income families
by distributing debit cards which may be used for costs and accessing health
care.
9). Repeal CHIP because options for this program may not be necessary.
10) Reform the Tort System by developing mechanism for the resolution of
disputes concerning injuries allegedly caused by health care providers.
Reduce frivolous lawsuits.
11) Assure consumers have access to price information prior to treatment so
that they can make their own decisions about the care.
What issues exists in this system which is driven by medical model of health
are unresolved? Correct Answer - 1) inadequate emphasis on wellness,
disease prevention and health promotion
2) a rise of chronic conditions and ensuing disabilities, the current health care
system focuses on acute illnesses.
3) Inadequate access to primary care resulting in patients overutilizing the ER
4) increases the costs of health care w/o any improvement in health care
5) The delivery of care is fragmented instead of continuous and coordinated.
3 emerging models of health care delivery Correct Answer - 1) Medical
Home Model
2) Community Oriented Primary Care Model
3) Accountable Care Organizations.
, Teamlet Model Correct Answer - 1) refers to two-person team
consisting of a PCP, nurse practitioners or physician assistant and an allied
health professional who will function as a health coach.
The main function of health coach:
· is to assist patient in gaining the knowledge and skills, confidence to self
manage their chronic conditions.
· Assist in coordinating appts
· Help patients adopt a healthy lifestyle
· Help patients understand and adhere to medication regimen
Connected Health Care Model Correct Answer - 1) uses communication
technology
2) patient self management and distant home monitoring
Main objective is to keep chronically ill patients connected to necessary
clinical expertise in between office visits
Future work force challenges Correct Answer - · Shortage of health care
professionals
· To have a successful model of health care delivery system to be highly
effective must have trained professionals.
· Nurses should practice to their full extent through education and training.
· Licensing requirements rules governing scope of practice should be allowed
across states for nurses who have masters or doctoral degrees
· Residency programs for nurses need to incorporate training in community
health, public health and geriatrics
Future workforce challenges Correct Answer - PCP need to be trained to
function as a comprehensivist to address the needs of growing number of
people with chronic conditions.
PCP must be prepared to manage complex pharmacology to address end of life
issues and medical ethics and lead health care teams
PCP need to be trained to function as a comprehensivist to address the needs
of growing number of people with chronic conditions.
PCP must be prepared to manage complex pharmacology to address end of life
issues and medical ethics and lead health care teams.
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