FOUNDATIONS CHAPTER 8 QUESTIONS
AND ANSWERS WITH SOLUTIONS 2024
consumer - ANSWER the person who uses health care services (the patient)
diagnosis-related group (DRG) - ANSWER classification of patients by major medical diagnosis for the
purpose of standardizing health care costs
entitlement reform - ANSWER proposed legislation making changes in entitlement benefits, such as
Medicare and Medicaid, paid by the government to citizens, with the goal of improving the nation's
budget
extended-care services - ANSWER includes residential care and intermediate or skilled long-term care
facility
fee-for-service - ANSWER system in which a bill is generated and a fee is paid every time a provider does
something for a patient
Health Insurance Marketplace - ANSWER federal and state system designed to help people more easily
find health insurance that fits their budget and needs with a plan offering comprehensive coverage, from
doctors to medications to hospital visits; insurance options can be compared based on price, benefits,
quality, and other features described in plain language
health maintenance organization (HMO) - ANSWER Prepaid, group-managed care plan that allows
subscribers to receive all the medical services they require through a group of affiliated providers; there
may be no additional out-of-pocket costs, or subscribers may pay only a small fee, called a copayment
hospice - ANSWER a type of end-of-life care for persons who are terminally ill, characterized by the
following: (1) patients are kept as free of pain as possible so that they may die comfortably and with
dignity; (2) patients receive continuity of care, are not abandoned, and do not lose personal identity; (3)
patients retain as much control as possible over decisions regarding their care and are allowed to refuse
further life-prolonging technologic interventions; and (4) patients are viewed as individuals with personal
fears, thoughts, feelings, values, and hopes
, inpatient - ANSWER person who enters a health care setting for a stay ranging from 24 hours to many
years
managed care - ANSWER an organized, high-quality, cost-effective system of health care that influences
the selection and use of health care services of a population
Medicaid - ANSWER Title XIX (Social Security Act, 1965) to make health care available to those people
with less than the minimum income who do not qualify for Medicare
medical home - ANSWER an enhanced model of primary care that provides whole-person, accessible,
comprehensive, ongoing, and coordinated patient-centered care
medical neighborhood - ANSWER a patient-centered medical home and the constellation of other
clinicians providing health care services to patients within it, along with community and social service
organizations and state and local public health agencies
Medicare - ANSWER Title XVIII (Social Security Act, 1965) to provide a measure of health coverage to all
Social Security recipients
multipayer system - ANSWER a health care system in which care is paid for by both private insurance
companies and the government
ambulatory care - ANSWER health care settings located in areas that are convenient for people to walk
into and receive care; may be provided in hospitals, clinics, or centers
multispecialty group practice - ANSWER organization of physicians from different specialties joined to
share income, expenses, facilities, equipment, and support staff; the group practice can better provide
comprehensive care
outpatient - ANSWER person who requires health care services but does not need to stay in an
institution for those services
AND ANSWERS WITH SOLUTIONS 2024
consumer - ANSWER the person who uses health care services (the patient)
diagnosis-related group (DRG) - ANSWER classification of patients by major medical diagnosis for the
purpose of standardizing health care costs
entitlement reform - ANSWER proposed legislation making changes in entitlement benefits, such as
Medicare and Medicaid, paid by the government to citizens, with the goal of improving the nation's
budget
extended-care services - ANSWER includes residential care and intermediate or skilled long-term care
facility
fee-for-service - ANSWER system in which a bill is generated and a fee is paid every time a provider does
something for a patient
Health Insurance Marketplace - ANSWER federal and state system designed to help people more easily
find health insurance that fits their budget and needs with a plan offering comprehensive coverage, from
doctors to medications to hospital visits; insurance options can be compared based on price, benefits,
quality, and other features described in plain language
health maintenance organization (HMO) - ANSWER Prepaid, group-managed care plan that allows
subscribers to receive all the medical services they require through a group of affiliated providers; there
may be no additional out-of-pocket costs, or subscribers may pay only a small fee, called a copayment
hospice - ANSWER a type of end-of-life care for persons who are terminally ill, characterized by the
following: (1) patients are kept as free of pain as possible so that they may die comfortably and with
dignity; (2) patients receive continuity of care, are not abandoned, and do not lose personal identity; (3)
patients retain as much control as possible over decisions regarding their care and are allowed to refuse
further life-prolonging technologic interventions; and (4) patients are viewed as individuals with personal
fears, thoughts, feelings, values, and hopes
, inpatient - ANSWER person who enters a health care setting for a stay ranging from 24 hours to many
years
managed care - ANSWER an organized, high-quality, cost-effective system of health care that influences
the selection and use of health care services of a population
Medicaid - ANSWER Title XIX (Social Security Act, 1965) to make health care available to those people
with less than the minimum income who do not qualify for Medicare
medical home - ANSWER an enhanced model of primary care that provides whole-person, accessible,
comprehensive, ongoing, and coordinated patient-centered care
medical neighborhood - ANSWER a patient-centered medical home and the constellation of other
clinicians providing health care services to patients within it, along with community and social service
organizations and state and local public health agencies
Medicare - ANSWER Title XVIII (Social Security Act, 1965) to provide a measure of health coverage to all
Social Security recipients
multipayer system - ANSWER a health care system in which care is paid for by both private insurance
companies and the government
ambulatory care - ANSWER health care settings located in areas that are convenient for people to walk
into and receive care; may be provided in hospitals, clinics, or centers
multispecialty group practice - ANSWER organization of physicians from different specialties joined to
share income, expenses, facilities, equipment, and support staff; the group practice can better provide
comprehensive care
outpatient - ANSWER person who requires health care services but does not need to stay in an
institution for those services
