Exam (elaborations)
GBA 2 TEST BANK QUESTIONS WITH ALL CORRECT ANSWERS 2025 LATEST UPDATE
- Course
- Institution
GBA 2 TEST BANK QUESTIONS WITH ALL CORRECT ANSWERS 2025 LATEST UPDATE
[Show more]
Content preview
GBA 2 TEST BANK QUESTIONSWITH ALL CORRECT ANSWERS
2025 LATEST UPDATE
Why are patient engagement surveys important in PCMHS? - Answer-Patient
engagement surveys are important for assessing satisfaction and involvement, and they
play a role in evaluations by payers and public assessments. NCQA has standards for
documenting and reporting these measures.
What is the key difference between a PCMH and the traditional gatekeeper model in
terms of care coordination? - Answer-NAPCMH, care is coordinated by a diverse team
of professionals, including primary care, physicians, specialists, nurses, and non-clinical
staff, rather than systematically referring patients from a generalist to a specialist.
How do teams in a PCMH collaborate to manage patient care? - Answer-Teams in a
PCMH often hold daily huddles to review cases, lab results, and coordinate the care
efforts of various team members.
Does the PCMH model have a principal care provider, like the gatekeeper model? -
Answer-Yes, like the gatekeeper model, the PCMH has a principal physician or nurse
practitioner in charge of the patient's care. However, in a PCMH, this principal can be a
generalist, specialist, or nurse practitioner, who coordinates care.
What is the role of the principle in both PCMH and traditional gatekeeper models? -
Answer-In both models, the principle (a physician or nurse practitioner) is in charge of
the patient's care, but in a PCMH, the coordination of care is handled by the team rather
than solely by the principal.
What is the rationale behind the team approach in a PCMH? - Answer-The rationale is
that patients may need more resources per visit, but fewer visits in the long-term, and
using additional resources early prevents future emergencies.
How does the team approach in a PCMH reduce the total use of medical resources? -
Answer-By focusing on pre-visit preparation and post visit follow up, the model meets.
Patient needs while using fewer resources due to timely screening and preventive care.
,What role does clinical decision support play in the PCMH team approach? - Answer-
The team uses clinical decision support to review patient's health records, and compare
them with evidence based guidelines and alternatives, ensuring effective care
decisions.
What are the main elements typically blended in a PCMH reimbursement method? -
Answer-A blend of pay for performance, monthly per enrollee payments, and fee for
service is typically used in PCMH reimbursement methods.
What is the purpose of the monthly care coordination payment in a PCMH payment
model? - Answer-It provides predictable funding for practices to support the medical
home structure, and ensure continuous care coordination.
What role does the fee for service component play in a PCMH payment model? -
Answer-It rewards practice is based on the volume of visits and services provided,
incentivizing providers to deliver services.
How does the performance based component of the PCMH payment model function? -
Answer-It rewards practices for achieving quality and efficiency goals, encouraging
improvements in patient care and management of chronic conditions.
Why is the traditional fee for service reimbursement model not sufficient for a PCMH? -
Answer-It mainly compensate for office visits and does not reimburse for essential
activities outside, face-to-face encounters, such as answering patient questions via
email.
How do monthly per enrollee paymentpayments support the PCMH model? - Answer-
They help subsidize care, coordination, higher new staff, and encourage improved
access to care, patient education, and services for chronically ill patients outside face-
to-face visits.
How do performance based incentives benefit PCMHs? - Answer-They reward practices
for improving patient care measures, such as managing, chronic conditions like
diabetes and hypertension, promoting better quality of care.
What are common issues in US primary care that PCMHs aim to address? - Answer-
PCMH is aim to address issues of limited timely access to primary care and poor
communication between providers and patients.
How do PCMH's improve patient access to care? - Answer-PCMH is improve access
through open scheduling, post visit follow up, and 24 hour access to primary care
advice.
How do electronic health records help PCMH's improve care coordination? - Answer-
EHR's allow PCMH's to mine historical data and use advanced scheduling algorithms to
,reduce waste and increase operational efficiency, which improves access and
coordination.
How does the patient centered approach in PCMHS impact care coordination? -
Answer-The patient centered approach focuses on patient needs and outcomes, which
leads to improved quality of care and better coordination across services.
How does the information technology component of medical homes relate to meaningful
use standards? - Answer-The information technology component of medical homes
aligns with meaningful use standards, creating a virtuous cycle that helps practices
meet both sets of criteria.
What are the stages of meaningful use in relation to electronic health records? -
Answer-The stages require providers to first use a certified, EHR system, then meet
objectives like E prescriptions, medication, reconciliation, recording, demographic
information, exchanging health data, and reporting quality measures.
How does meeting medical home criteria help practices, meet meaningful use
standards? - Answer-Practice is transforming to meet medical home criteria are likely to
meet meaningful use standards, as both require robust use of electronic health records
and data exchange.
How do practices meeting meaningful use standards benefit medical home conversion?
- Answer-Practices that meet meaningful use standards are well equipped for the
challenges of converting to a medical home, as the standards overlap with many of the
medical home requirements.
What makes health care services different than other services? (5) - Answer-1. FEW
PROVIDERS
of a service in a given area.
2. DIFFICULTY TO JUDGE QUALITY AND COST
of competing services.
3. PHYSICIANS MAKE DECISIONS
on what services to purchase instead of consumers.)
4. INSURERS MAKE FULL PAYMENT
to the provider (instead of users.)
5. PATIENTS ARE INSULATED FROM THE COSTS OF HEALTH CARE
because health insurance is paid for in full or part by employers or government
agencies.
What are the 4 distinct characteristics of insurance? - Answer-1. Pooling of losses.
2. Payment only for random losses.
, 3. Risk transfer.
4. Indemnification.
What is meant by "pooling of losses" in insurance? - Answer-Losses are spread over
the group and average loss is incurred by each instead of the actual loss by one.
What is the law of large numbers? - Answer-As the size of a sample increases, it's
mean gets closer to the population mean.
What 2 concepts does the pooling of losses imply? - Answer-1. Sharing of losses.
2. Prediction of future losses.
What is the sole exception to the element of risk transfer? - Answer-Self-insurance.
What is risk transfer? - Answer-The transfer of risk from an insured to an insurer.
Why transfer risk to an insurer? - Answer-The insurer is in a better financial position to
bear risk due to the law of large numbers.
Why does adverse selection occur? - Answer-Individuals that are more likely to have
claims are more inclined to purchase insurance than those who are less likely to have
claims.
What is the effect of unchecked adverse selection on plans? - Answer-1. Individuals
who need insurance with purchase it at a higher rate than individuals who don't.
2. Claims will be higher than expected.
3. Premiums will increase to cover claims.
4. Healthy individuals will drop out of the plan to lower their own costs.
Why does the adverse selection problem exist? - Answer-Asymmetric information
Individuals know more about their own health status than insurers.
What is the moral hazard problem? - Answer-When individuals are more likely to use
unneeded health services when they are not paying the full cost of those services.
How do insurers combat the moral hazard problem? - Answer-Requiring individuals to
share in payment of their health care costs with HDHPs, coinsurance, or copays.
What 2 broad groupings can health insurers be categorized into? - Answer-Private
insurers
Public programs.
What are the 3 major private insurers? - Answer-1. Blue Cross Blue Shield
2. Commercial Insurers
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Scholarsstudyguide. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
70713 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 15 years now