Healthcare Quality Improvement and Risk Management - C430 Questions and Answers(A+ Solution guide)

___ ___ ___ is a payment model where services are unbundled and paid for separately. In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care. - ANS Fee-for-service (FFS) Payments agreed upon in a ______ contract by a health insurance company and a medical provider. It is a fixed, pre-arranged monthly payment received by a physician, clinic or hospital per patient enrolled in a health plan with a capitated contract. - ANS capitation The ___ ____ is an independent, not-for-profit group in the United States that administers voluntary accreditation programs for hospitals and other healthcare organizations. - ANS Joint Commission The National Committee for ____ ____ is an independent 501(c)(3) non-profit organization in the United States that works to improve health care quality through the administration of evidence-based standards, measures, programs, and accreditation. - ANS Quality Assurance (NCQA) Medicare accepts a JCAHO (aka ____ _____ or TJC) accreditation as evidence that a hospital meets Medicare conditions of participation - ANS Joint Commission Unbreakable Rules - ANS Red Rules ____ is a structured method for examining any system, process, or complex array of equipment for risk of failure before it fails. An expert team studies each step or component, evaluates its weaknesses or defects, and assigns it a risk score. - ANS FMEA _____ , an agency of the US government under the Department of Labor with the responsibility of ensuring safety at work and a healthful work environment. ____'s mission is to prevent work-related injuries, illnesses and deaths. - ANS OSHA (The Occupational Safety and Health Administration)a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid. Can deny reimbursement. - ANS Centers for Medicare and Medicaid