Sarbanes Oxley
- correct answer US federal law that set new or expanded requirements for all US public company
boards, management and public accounting firms. Cover responsibilities of a public corporation's board
of directors, adds criminal penalties and required SEC to create regulations
FMLA
- correct answer 1993: law requiring covered employers to provide employees with job-protected and
unpaid leave for qualified medical family reasons
Purpose of any HCO
- correct answer to provide care to individual patients and is usually stated in organization's "mission"
Population Health
- correct answer defining the population (by geography, sociodemographic factors, disease state, risk,
insurance coverage or in some other way), measuring the current state of health in the population,
setting goals for improvement and directing resources to making improvements. US HSS specifies
national goals and objectives for population health in the Healthy People 2020 program
Caregiving/Clinical/Logistic/Strategic Teams
- correct answer Caregiving Teams: Provide care to patients with similar needs (PCP, ACUTE, rehab)
Clinical Support Teams: provide specific clinical services to Caregiving Teams (clinical laboratory,
pharmacy, imaging, cardiopulmonary)
Logistic Support Teams - provide trained personnel, information, facilities, accounting, cash,
management and supplies
Strategic Support Teams: provide marketing, governance, internal consulting, finance, stakeholder
relations management and strategic positioning
Service Lines
- correct answer Patient care teams coordinated around a set of similar diseases or patient needs
, Premise of a Healthy Community
- correct answer Costs tend to rise and benefits to decline as care moves away from the healthy state.
Therefore, optimum care maximizes use of prevention, health maintenance, and health improvement
PCP, Acute inpatient or specialty outpatient care, rehab, continuing care in home or nursing home
setting, continuing care in home or nursing home setting, palliative care and death
Stakeholders
- correct answer Individuals or groups who have a direct interest in the organization's success and shape
its mission and strategies. Include buyers, workers, suppliers, regulators and owners. Patients are the
MOST important HCO stakeholders. They expect and deserve care that meets the goals summarized in
IOM's report: Crossing the Quality Chasm
Patient-centered care
- correct answer care that is respectful of and responsive to individual patient preferences, needs and
values and involving patients and families in care planning and decision making
Fiscal intermediaries
- correct answer Outside contractor that processes claims for US government programs such as
medicare and medicaid and provide most of the revenue to HCOs, making them essential stakeholders
Patient Protection and Affordable Care Act (ACA)
- correct answer A federal law providing for a fundamental reform of the US healthcare and health
insurance system, signed by President Obama in 2010. It includes: increase insurance coverage for many
patients, new approaches to support those with chronic disease, and a greater accountability for the
cost and quality of care. Part of the "Triple Aim" - improving the individual patient experience with
healthcare, improving the health of the population, and reducing per capita cost of care
Value-based purchasing
- correct answer Linking financial incentives to the quality of care provided - reward HCOs for quality and
sustained patient health
Certificate-of-need laws
- correct answer Certificate or approval of new services and construction and renovation of hospitals or
related facilities; issued in many states. Require that HCOs seek permission for construction or
expansion.