To ensure that patients have the education, tools, and
support they need to make decisions and participate in
their own care is the goal of:
A) The Patient Protection and Affordable Care Act
(PPACA)
B) A patient-centered medical home (PCMH)
C) Accountable care organizations (ACO's)
D) Managed care organizations (MCO's) -
....ANSWER...B) A patient-centered medical home
(PCMH)
,Accountable Care Organizations are designed with the
following criteria:
A) To make providers independent of each other
B) To provide no financial incentives for provider
cooperation
C) To save money by avoiding unnecessary tests
D) To increase the use of emergency room services -
....ANSWER...C) To save money by avoiding unnecessary
tests
Prospective performance and Retrospective performances
are considered:
A) Private health plans
B) Contract performance models
C) Rating tiers
D) Consumer Directed Health Plans (CDHP) -
....ANSWER...B) Contract performance models
Reporting initiative including: Required Nation
Performance Measurement, Voluntary National
Performance Measurement, and Employer Coalition
Performance Measure, are all:
,A) Group advocacy goals intended to reduced consumer
spending
B) Consumer advocacy and healthcare value efforts
C) Healthcare report cards available to the public
D) Reports that contain public information regarding all
healthcare issues - ....ANSWER...C) Healthcare report
cards available to the public
Identify which option is NOT a payment type that
comprises a large percentage of Medicare expenditures.
A) Inpatient prospective Payment Systems
B) Outpatient Prospective Payment System
C) Medicare payments to physicians
D) MS-DRG payment - ....ANSWER...C) Medicare
payments to physicians
Which option is NOT a practice used to control the costs
of managed care?
A) Delivering services that are reasonable, and payers
agree on medical necessity and reimburse for services
, B) Combining services, bundling associated charges,
determining an appropriate charge the that set of services
C) Making advance payment to providers for all services
needed to care for a member
D) The payer and provider agreeing on a reasonable
payment for each service - ....ANSWER...C) Making
advance payment to providers for all services needed to
care for a member
Under Title XIX of the Social Security Act, Medicaid:
A) Mandates medical services for certain individuals and
low-income families
B) Advocates medical assistance for certain individuals
and low-come families
C) Pays for medical assistance for certain individuals and
low-income families
D) Provides medical referrals for certain individuals and
low-income families - ....ANSWER...C) Pays for medical
assistance for certain individuals and low-income families
Choice of providers and plans, which is a patient
protection for managed Medicare enrollees, involes:
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