HHP 4040 FINAL EXAM QUESTIONS WITH VERIFIED
ANSWERS
What are the trends seen in private medical office practice? - Answers - - ongoing
controversy regarding group practices and insurance payments
- in 1939, the AMA (among others) was indicted, found guilty, and fined for having
conspired to monopolize medical practice; due to expelling group practices from the
AMA
- 1950s, opposition to group practices subsided starting the trend to group practices
rather than private practice; medicare reimbursement, inflation (private practices more
expensive and administrative), medical specialization (more are specializing rather than
practicing general), most practicing physicians today are in group practices (68%)
Patient-Centered Medical Home - Answers - - voluntary -> group of providers working
together to provide care coordination for the patient - team-based model that was
originated by the American Academy of Pediatrics in 1967
comprehensive care: physical and mental health needs (team-based approach; holistic)
patient-centered: relationship-based health care (patients, families, and care givers are
core members)
coordinated: coordinates care across all aspects of the larger health care system (ex.
scheduling appointments all in one day for different services)
committed to quality and safety: using data and health information technology (ex.
electronic health records)
accessible: being able to reach a provider in a variety of ways
,Care Coordination - Answers - Central goal: Middle (3 primary perspectives -
patient/family perspective, health care professional perspective, and system
representative perspective
Colored circles: numerous services and settings: increase in complexity --> increase in
services needed
Blue ring: care coordination - making sure there's connection b/t providers, etc...how the
services may need to be connected
White spaces: gaps along the care pathway; ex.) miscommunication, lack of reports
, Accountable Care Organizations (ACO) - Answers - a network of doctors and hospitals
that shares financial and medical responsibility by providing coordinated care to
Medicare patients
- the patient-centered medical home is the primary component
- ACO is a legal constituted entity w/in its state with a governing board (group of
providers designated as an ACO)
- specific payment structure that combines fee-for-service payments with shared
savings and bonus payments linked to value (they're reimbursed for value-based care
and have to show trends in their patients over time)
ANSWERS
What are the trends seen in private medical office practice? - Answers - - ongoing
controversy regarding group practices and insurance payments
- in 1939, the AMA (among others) was indicted, found guilty, and fined for having
conspired to monopolize medical practice; due to expelling group practices from the
AMA
- 1950s, opposition to group practices subsided starting the trend to group practices
rather than private practice; medicare reimbursement, inflation (private practices more
expensive and administrative), medical specialization (more are specializing rather than
practicing general), most practicing physicians today are in group practices (68%)
Patient-Centered Medical Home - Answers - - voluntary -> group of providers working
together to provide care coordination for the patient - team-based model that was
originated by the American Academy of Pediatrics in 1967
comprehensive care: physical and mental health needs (team-based approach; holistic)
patient-centered: relationship-based health care (patients, families, and care givers are
core members)
coordinated: coordinates care across all aspects of the larger health care system (ex.
scheduling appointments all in one day for different services)
committed to quality and safety: using data and health information technology (ex.
electronic health records)
accessible: being able to reach a provider in a variety of ways
,Care Coordination - Answers - Central goal: Middle (3 primary perspectives -
patient/family perspective, health care professional perspective, and system
representative perspective
Colored circles: numerous services and settings: increase in complexity --> increase in
services needed
Blue ring: care coordination - making sure there's connection b/t providers, etc...how the
services may need to be connected
White spaces: gaps along the care pathway; ex.) miscommunication, lack of reports
, Accountable Care Organizations (ACO) - Answers - a network of doctors and hospitals
that shares financial and medical responsibility by providing coordinated care to
Medicare patients
- the patient-centered medical home is the primary component
- ACO is a legal constituted entity w/in its state with a governing board (group of
providers designated as an ACO)
- specific payment structure that combines fee-for-service payments with shared
savings and bonus payments linked to value (they're reimbursed for value-based care
and have to show trends in their patients over time)
