C425 Healthcare Delivery, Regulation, and Compliance (WGU) Final Exam Solved Correctly.
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Module
C425
Institution
C425
Capitation A - Answer covers all services an enrollee may need during an entire year
Market Justice - Answer most equitably distributed through the market forces of supply and demand, rather than government interventions. Distributed on the basis of willingness and ability to pay
Social...
C425 Healthcare Delivery, Regulation,
and Compliance (WGU) Final Exam
Solved Correctly.
Capitation A - Answer covers all services an enrollee may need during an entire year
Market Justice - Answer most equitably distributed through the market forces of supply and demand,
rather than government interventions. Distributed on the basis of willingness and ability to pay
Social Justice - Answer An ideal that embraces all aspects of civilized life and that is linked to
fundamental notions of fairness and to cultural beliefs about right and wrong.
defensive medicine - Answer Ordering more tests and procedures than are necessary in order to
protect physicians from a lawsuit.
medical model - Answer emphasizes clinical diagnosis and medical intervention in the treatment of
diseases or symptoms. Health is defined as lack of illness
National Health Insurance - Answer course of care delivered by providers (Canada)
National Health System - Answer Great Britain taxes support the system, but government also manages
the infrastructure for healthcare delivery
Socialized Health Insurance - Answer government mandated contributions by employers and
employees finance health care (Germany)
Acute Care - Answer relatively severe, short duration, often treatable. Ex. stroke
Chronic Care - Answer continuing for a long time
, Planned Rationing - Answer The government making deliberate attempts to limit the supply of health
care services
Medicare - Answer Benefit period = 60 days after admitted
Pt B: cover physicians bill, small premiums for elderly
Premiums are income based
Part D: Prescription Drug coverage
Voluntary, w monthly premium
1973- expanded to non elderly disabled, end stage renal disease patients. Financed by pay roll taxes
American Medical Association - Answer protect the interests of physicians, organized medicine.
Supported licensing discouraged employment by hospitals and insurance companies
Globalization - Answer various forms of cross border economic activities
Medicaid - Answer Eligible poor, financed through federal matching funds to the states
Each state has its own criteria for eligibility based on income, bank account, property and assets
Federal law covers: low income elderly, blind, disabled, children in low income families. Means tested
program
provider-induced demand - Answer Artificial creation of demand by providers that enables them to
deliver unneeded services to boost their incomes.
Deductible - Answer Amount you must pay before you begin receiving any benefits from your
insurance company
Centers for Medicare and Medicaid Services (CMS) - Answer provide clarification and interpretation of
complex provisions of the law. Promotes consistency in
interpretation between states
individual private insurance - Answer price based on how risky your life is
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