WGUC425 OA Review Exam Questions and Answers with Verified
Solutions | Latest 2026 Update
Which of the following is true in regards to health care today in the United States?
There are more primary care physicians than specialty physicians.
Primary care receives a higher reimbursement in professional fees. There are more
specialty physicians than primary physicians.
Q: Outpatient care is slowly decreasing.
Answer:
There are more specialty physicians than primary physicians.
What triggered the downsizing phase in the U.S. hospital industry during the
1980s? Hill-Burton Act
Managed care
Prospective payment system
Q: Medicare and Medicaid
Answer:
Prospective payment system
Q: Designated Related Groups (DRG)
Answer:
based reimbursement necessitated hospitals to do what? Admit new patients at a
faster rate than before
Admit a greater number of Medicare patients than before Reduce the length of stay
for hospitalized patients
Q: Admit a smaller number of Medicare patients than before
Answer:
Reduce the length of stay for hospitalized patients
Q: In which type of utilization management is a primary care physician's opinion
necessary in referring or not referring a patient to a specialist?
Concurrent Retrospective Gatekeeping
Precertification
, Answer:
Gatekeeping
What is one aspect in which managed care differs from conventional insurance?
Collection of premiums
Assumption of risk
Responsibility for delivery of services
Q: Payments to providers
Answer:
Responsibility for delivery of services
What is the purpose of Skilled Nursing Facilities (SNF) certification? It enables a
facility to be operated as a skilled nursing facility.
It is required to legally operate a nursing home. It enables a facility to serve
Medicare clients.
Q: It enables a facility to serve both Medicare and Medicaid clients.
Answer:
It enables a facility to serve Medicare clients.
What is the main goal of long-term care as it relates to a patient's function? Restore
function
Provide assistance Promote independence
Q: Adapt to change
Answer:
Promote independence
The U.S. government plays a limited role in the health delivery system. The
government's role in the arena of health care delivery consists of:
developing private hospital organizations.
regulating public and private programs at the local levels.
being the responsible party for health care delivery through Medicare and
Medicaid programs.
Q: aiding in competition among managed care organizations.
Solutions | Latest 2026 Update
Which of the following is true in regards to health care today in the United States?
There are more primary care physicians than specialty physicians.
Primary care receives a higher reimbursement in professional fees. There are more
specialty physicians than primary physicians.
Q: Outpatient care is slowly decreasing.
Answer:
There are more specialty physicians than primary physicians.
What triggered the downsizing phase in the U.S. hospital industry during the
1980s? Hill-Burton Act
Managed care
Prospective payment system
Q: Medicare and Medicaid
Answer:
Prospective payment system
Q: Designated Related Groups (DRG)
Answer:
based reimbursement necessitated hospitals to do what? Admit new patients at a
faster rate than before
Admit a greater number of Medicare patients than before Reduce the length of stay
for hospitalized patients
Q: Admit a smaller number of Medicare patients than before
Answer:
Reduce the length of stay for hospitalized patients
Q: In which type of utilization management is a primary care physician's opinion
necessary in referring or not referring a patient to a specialist?
Concurrent Retrospective Gatekeeping
Precertification
, Answer:
Gatekeeping
What is one aspect in which managed care differs from conventional insurance?
Collection of premiums
Assumption of risk
Responsibility for delivery of services
Q: Payments to providers
Answer:
Responsibility for delivery of services
What is the purpose of Skilled Nursing Facilities (SNF) certification? It enables a
facility to be operated as a skilled nursing facility.
It is required to legally operate a nursing home. It enables a facility to serve
Medicare clients.
Q: It enables a facility to serve both Medicare and Medicaid clients.
Answer:
It enables a facility to serve Medicare clients.
What is the main goal of long-term care as it relates to a patient's function? Restore
function
Provide assistance Promote independence
Q: Adapt to change
Answer:
Promote independence
The U.S. government plays a limited role in the health delivery system. The
government's role in the arena of health care delivery consists of:
developing private hospital organizations.
regulating public and private programs at the local levels.
being the responsible party for health care delivery through Medicare and
Medicaid programs.
Q: aiding in competition among managed care organizations.
