Exam (elaborations)

Advanced practice, role development and health policy Problem set study Exam Questions and Correct Answers Guaranteed Success 2023/2024

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APRN

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APRN

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Uploaded on October 27, 2024
Number of pages 31
Written in 2024/2025
Type Exam (elaborations)
Contains Questions & answers

3rd party payers
fee for service model
episodic model
managed care
methods of payment for aprn
capitation model ppo and hmo
advanced practice role development and health pol

Institution APRN
Course APRN

KieranKent55 Member since 1 year 29 documents sold

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Advanced practice, role development and
health policy Problem set study Exam
Questions and Correct Answers Guaranteed
Success 2023/2024

3rd party payers - correct answer
-private insurer reimbursement is contract specific per state
insurance commission
-Civilian Health and Medical Program of the US (military
personnel)
-Federal Employee health Benefit Program

Methods of payment for APRN - correct answer
1. Fee-for-service model
2. Episodic model
3. Capitation model, PPO, and HMO

Fee-for-service model - correct answer -unit of payment by visit
or procedure
-can occur with utilization review in which case payer has right
to authorize or deny payment of expensive medical interventions
(hospital admission, extra hospital days, surgery)

Episodic model - correct answer -one sum is paid for all services
delivered during a given illness
-DRG fee payment

,Professional Organization purpose and benefits - correct
answer -establish practice standards
-collective voice to promote nursing and quality of care
-monitor and influence policy and legislative initiatives
-position papers on practice issues
-disseminate information

Use or research in practice settings - correct answer -use EBP
-translate clinical evidence into practice settings and with
practice issues
-develop research-based clinical pathways
-track clinical outcomes and variances
-demonstrate quality and cost-effectiveness of care
-give structure to demonstration projections
-persuade lawmakers of NP value
-improve quality and patient outcomes

Barriers to research utilization - correct answer -time and cost
of studies
-resistance to change in work setting
-lack of rewards for using research findings
-lack of understanding or uncertainty regarding research
outcomes

Healthy People 2020 - correct answer 1. General health status
-life expectancy

,-healthy life expectancy
-physical and mental unhealthy days
-self-assessed health status
-limitation of activity
-chronic disease prevalence
-international comparisons
2. Disparities and inequality
-race/ethnicity
-gender
-SES
-LGBTQ
-geography
3. Social determinants of health
-social and economic factors
-natural and built environments
-policies and programs
4. HR-QOL and well being
-wellbeing/satisfaction
-physical, mental, and social health-related WOL
-participation in common activities

Primary health care - correct answer -PHC is the provision of
integrated, accessible healthcare services by clinicians who are
accountable for addressing a large majority of personal
healthcare needs, developing a sustained partnership with
patients, and practicing in the context of family and community

, -activities and/or functions define boundaries of primary care
-entry points to a system
-care that is accessible, comprehensive, coordinated, continuous
and accountable

Managed care - correct answer -a network that is integrated
and combines financing and delivery of healthcare services to
covered individuals
-connects consumers, sponsors, providers, and 3rd party payers

Objectives of managed care - correct answer -manage use and
price of healthcare delivery system
-control type, level, and frequency of treatment
-restrict level of reimbursement for services

Types of managed care plans - correct answer -HMO
-PPO
-POS
-integrated delivery systems
-accountable care organizations

Health maintenance organizations (HMO) - correct answer -
most common type
-offers preestablished benefit package: including preventive,
inpatient, and outpatient care
-HMO contracts with providers to provide care to enrollees

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Exam (elaborations) ·

Exam (elaborations)

Advanced practice, role development and health policy Problem set study Exam Questions and Correct Answers Guaranteed Success 2023/2024

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