D391 NEWL Y UPDATED QUESTIONS WITH
CORRECT ANSWERS GRADED A+
a system composed of elements that create a community ...ANS: healthcare ecosystem
an organization of individuals, institutions, and resources that deliver services to clients ...ANS: healthcare system
a group of people with a common interest, especially in a business ...ANS: stakeholders
a person or institution that performs a service; for example, a healthcare worker performs health services. ...ANS: provider
diverse individuals with various skills and knowledge who provide services to patients ...ANS: healthcare producers
multiple client services and treatment in the healthcare system ...ANS: product
education and qualifications for healthcare providers ...ANS: licensure ASCORERS STUVIA
individuals or organizations who cover the costs of healthcare services, either through self-pay or insurance companies ...ANS: payers
an individual or organization that purchases healthcare coverage on behalf of their employees ...ANS: purchasers
individuals or organizations who invest in healthcare services ...ANS: investors
monitors payer organizations ...ANS: National Committee for
Quality Assurance (NCQA)
helps improve and monitor providers' quality of care ...ANS: Joint Commission on Accreditation of Healthcare Organizations
(JCAHO)
government organization that protects consumers from harm ...ANS: U.S. Department of Health and Human Services
helps reduce harm to healthcare patients and employees ...ANS: government regulations
payment for health services ...ANS: health insurance ASCORERS STUVIA
providers receive payment for services performed ...ANS: fee-for-service
a model in which providers are paid capitation payments, restricting patients to a preferred list of providers and controlling access to care ...ANS: health maintenance organizations
an event covered by insurance; the risk of payment is borne by the insurer, so insurance companies work hard to manage risk for both individuals and groups ...ANS: insurance risk
payments such as deductibles, premiums, and co-pays ...ANS: insurance expenses
situation in which individual incurs no consequence for a decision, allowing for extravagant choices such as using more medical services than are necessary ...ANS: Moral hazards
in insurance terms, a situation in which the insured person has information that the insurer does not have, gaining coverage at a cost below the true level of risk ...ANS: adverse selection
provider of service awards for quality patient care ...ANS: value-based care ASCORERS STUVIA
reduce cost and improve patient outcomes ...ANS: wellness and prevention
standardizes care and protects patients ...ANS: legislation
a law that states everyone in the United States can receive affordable, accessible, quality care ...ANS: Affordable Care Act
health insurance for people over age 65 and people on social security disability ...ANS: Medicare
funds paid to providers for services rendered ...ANS: reimbursement
approves food, drugs, biological products, and medical devices ...ANS: Food and Drug Administration (FDA)
federal agency responsible for enforcing antitrust laws and preventing monopolies from developing ...ANS: Federal Trade Commission (FTC)
insurance for the low socioeconomic population ...ANS: Medicaid