HCA 201 final Test Questions and Correct Solutions Rated A+

Ambulatory care - refers to outpatient services Who is the gatekeeper? - primary care physician Primary care focuses on services - such as prevention and therapeutic services In a gatekeeping system, patients can visit specialists without a referral from their primary care physicians. T or F - False Why is outpatient care considered an important key component of overall business strategy? - Outpatient services now constitute a key source of profits for hospitals The growth of non-hospital-based ambulatory services intensified competition for outpatient services between - hospitals and community-based providers Which service is not one of the five main hospital-based outpatient services? Clinical, surgery, emergency - None of the above Primary care is the point of entry into the health services system. T or F - True Outpatient care refers to health services - that does not require an overnight stay Which of the following is not one of the key changes that have been important in shifting the balance between inpatient and outpatient services? reimbursement, utilization control, technological factors - none of the above What are mobile health care services? - Health care services transported to patients Both private and public payers have a clear preference for outpatient treatment because it costs less than inpatient care. T or F - True home health care - is based on the philosophy of maintaining people in the least restrictive environment possible Hospice care is for - patients with terminally ill disease with a short life expectancy Development of new diagnostic and treatment procedures and less invasive surgical methods has made it possible to provide services in out-patient settings that previously required inpatient stays in hospitals. T or F - True Many hospital outpatient clinics, particularly those in inner-city areas - act as the communitys safety net Urgent Care Services - accept patients without appointments Alternative medicine refers to - nontraditional medicine and treatments Higher primary care physician supply has been associated with lower low-birth weight percentages and lower infant mortality. T or F - True A hospital's governing body is - legally responsible for the conduct of the hospital Pesthouses were - places for those with contagious diseases The first community hospitals were funded mainly through - private donations Hospitals began to attract well-to-do patients when - hospital services became technologically advanced A health system is mainly characterized by - a large array of health care services Prospective payment system based on DRGs. - Fixed rate per admission One effect of the PPS reimbursement method was - quicker discharge of patients managed care - curtailed inpatient utilization Implementation of the prospective payment system slowed down the growth of national spending on hospital care. T or F - True Average number of days per patient spent in the hospital. - Average length of stay Number of patients in a hospital on a given day. - census Which of the following is not a characteristic of a community hospital? - Federal Public hospitals are those that are open to the general public. T or F - True Voluntary hospitals - nonprofit A general hospital is distinguished from a specialty hospital in that the former does not provide specialized medical care. T or F - false Specialty hospitals provide only a narrow range of services for specific medical conditions. T or F - true What is the primary role of a teaching hospital? - Train Physicians Hospitals are licensed by state governments rather than the federal government. T or F - True Deemed status is conferred on a hospital that is - accredited Once premiums have been collected, an MCO functions like - an insurance company Capitation - fixed monthly payment per enrollee Under capitation, an MCO shares risk with the - provider Under discounted fee arrangements - providers agree to discount their regular fees in exchange for the volume of business an MCO brings The concept of managed care evolved out of earlier - prepaid plans During the 1980s, employers started switching from traditional health insurance to managed care plans because - health insurance had become less affordable Compared to publicly insured beneficiaries in the Medicare and Medicaid programs, a greater proportion of privately-insured individuals are enrolled in managed care plans. T or F - True In concurrent utilization review - decisions regarding appropriateness are made during the course of health care utilization Underutilization - medically needed care is not delivered HMOs were the first type of managed care plans to appear on the market. T or F - True Compared to other types of managed care plans, HMOs place considerable emphasis on preventive services. T or F - true require that services be obtained from in-network providers. - HMOs Physicians are salaried employees and deliver services to the enrollees. - staff model In the group model HMO, physicians are employed by - group practice An independent practice association (IPA) is - an intermediary between physicians and HMOs