Exam (elaborations)
WGU C425 2023 – Questions With Complete Solutions
WGU C425 2023 – Questions With Complete Solutions
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WGU C425 2023 – Questions WithComplete Solutions
What is the dominant healthcare delivery system in the USA
✔️Ans -Managed care, employers and government are primary suppliers
What Population does the VA serve ✔️Ans -Veterans TRICARE is
insured for military personnel active and non-active
Describe the affordable care act and its role in healthcare reform
✔️Ans -Main goal was to expand coverage increase access to care Medicaid
expansion and take away pre-existing conditions
List for key characteristics of the US healthcare system ✔️Ans -
No central governing agency technology driven and focuses on acute care,
high cost, unequal access and average outcomes, imperfect market
conditions for healthcare delivery, fusion of market and social justice,
multiple players in balance of power access to healthcare is selectively base
on insurance.
Define health ✔️Ans -Overall well-being of mental and physical
well-being
Discuss disease classifications acute, subacute, chronic ✔️Ans -
Acute: Patient received short-term treatment for severe injury or episode
of illness and urgent medical condition or recovery from surgery examples,
heart attack lack of kidney function. Subacute: Comprehensive in patient
care someone who has an acute illness injury or disease trach tube feeding
tube wound care.
Chronic: Less severe but is continuous can be controlled but if uncontrolled
can lead the serious complications sometimes even if controlled. Examples,
diabetes, hypertension, asthma.
Define market justice ✔️Ans -Fair distribution of healthcare to
market forces in a free economy, medical services are based on peoples
willingness to pay individuals are responsible for their own achievements.
,Less involvement with government. People view this as if you can't pay you
shouldn't have health insurance
Social Justice ✔️Ans -More government involvement in medical
insurance, insurance for all
What is Healthy People 2020? ✔️Ans -10 your plans, focused on
medical care, prevention, and education. Creating environments that
promote good health for all. Healthy development behaviors across all life
stages
What is the Flexner Report? ✔️Ans -Report by Abraham Flexner
by the Carnegie Commission to evaluate medical schools
Outlined the inadequacies of medical schools that did not use the German
model that promoted medical education on the principles of scientific
discovery
Caused schools that did not use this scientific model to close from lack of
funding.
what is workers compensation? ✔️Ans -Insurance that aids
cash or medical insurance when you are hurt on the job.
Who is covered by Medicare? ✔️Ans -Elderly over the age of 65,
disabled, and those with high end renal failure" kidney disease"
Who is covered by Medicaid ✔️Ans -Low income adults,
children, elderly and disabled. Means test determines need for Medicaid.
Each state defines their own outline of need for people applying for
Medicaid
Describe cost sharing in the three main types of cost sharing in private
health insurance ✔️Ans -Premium cost sharing: Insured assume
some part of the risk purposes to reduce miss use of insurance benefits.
Deductible; amount insured pays before benefits are paid by the plan.
Copayments;'s money paid out of pocket each time services are rendered.
Coinsurance; amount Insured has to pay at a certain percentage after
deductible is met before insurance covers at 100%
, What is covered in Medicare a ✔️Ans -Medicare a covers
inpatient and hospital services nursing care, hospice care, and limited
home health services.
What is covered under Medicare B ✔️Ans -Ambulance services
clinical research, mental health, RX drugs, and DME, DME is a durable
medical equipment.
What is covered under Medicare C ✔️Ans -Routine dental,
vision, hearing aids and wellness programs
What is CHIP? ✔️Ans -Children's Health Insurance Program,
Provides insurance for children who do not qualify for Medicaid.
List three main sources of financing healthcare? ✔️Ans -Private
health insurance, public programs which include Medicaid and Medicare,
and uncompensated or charity care.
List two requirements for a hospital to be required a hospital?
✔️Ans -Hospitals must be licensed have organized physicians, provide
continue nursing services under RNs, have a governing body for hospital
conduct, have a CEO with responsibility for operations.
What is the Hill-Burton Act of 1946? ✔️Ans -A law passed in
1946 to give hospitals, nursing homes and other health facilities grants and
loans for construction and modernization. It had the biggest impact on
expansions of hospitals. The creation of Medicare and Medicaid in 1965
also fueled demand for hospital services .
What is informed consent? ✔️Ans -Informed consent to medical
treatment is fundamental in both ethics and law. Patients have the right to
receive information and ask questions about recommended treatment so
that they can make well considered decisions about their care. Successful
communication in the patient physician relationship fosters trust and
support shared decision making.
What is the Stark Law? ✔️Ans -Section 1877 of the Social
Security act also known as this physician self referral law. Prohibits
physicians from making referrals for certain designated health services
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