D545 Healthcare Admin.-QUESTIONS WITH 100%
CORRECT ANSWERS!! 2025
Systems Theory
A theoretical framework that views organizations as interconnected systems, with each part
affecting & being affected by others
Accountable Care Organization (ACO)
A network of doctors, hospitals and other healthcare providers that voluntarily come together
to provide high quality care to their patients
Integrated Delivery System (IDS)
A network of organizations that provides or arranges to provide a coordinated continuum of
services to a defined population and is willing to be held accountable for the outcomes and
health status of the population serviced
Health Maintenance Organization (HMO)
A managed care organization that provides health insurance coverage through a network of
healthcare providers who offer services to members for a fixed fee
Managed Care Organization (MCO)
A healthcare delivery system that aims to manage the cost, quality and accessibility of
healthcare services
Functional Organizational Structure
(AKA bureaucratic organizational structure) splits the organization into departments based on
the expertise of employees
Open Systems Model (OSM)
Views patient care as a system involving various interactions (inputs & outputs) among
patients, healthcare providers & the environment
, Rational Goal Model (RGM)
Management theory that focuses on an organizations' ability to achieve its goals effectively
Strategic Alliance
The establishment of a long-term relationship between two or more organizations/groups that
have developed mutually beneficial goals & needs
Health Information Exchange (HIE)
A system that enables the electronic sharing of patient health info among healthcare
organizations
Human Relations Model (HRM)
Focuses on employees & stresses participation, openness, commitment and morale
Competing Values Framework (CVF)
Used for assessing organizational effectiveness and culture, focusing on adaptability, flexibility,
stability and control
Internal Process Model (IPM)
Based on harmony and efficiency internal environment, emphasis the process of accountability,
measuring, documenting and record keeping
Federal Anti-Kickback Statute (AKS)
Criminal law that prohibits exchanging anything of value in return for referrals or
recommendations
Stark Law
(AKA Physician self-referral law) prohibits physicians from referring medicare/medicaid patients
to entities with which they have a financial relationship for certain designated health services
Stakeholders
CORRECT ANSWERS!! 2025
Systems Theory
A theoretical framework that views organizations as interconnected systems, with each part
affecting & being affected by others
Accountable Care Organization (ACO)
A network of doctors, hospitals and other healthcare providers that voluntarily come together
to provide high quality care to their patients
Integrated Delivery System (IDS)
A network of organizations that provides or arranges to provide a coordinated continuum of
services to a defined population and is willing to be held accountable for the outcomes and
health status of the population serviced
Health Maintenance Organization (HMO)
A managed care organization that provides health insurance coverage through a network of
healthcare providers who offer services to members for a fixed fee
Managed Care Organization (MCO)
A healthcare delivery system that aims to manage the cost, quality and accessibility of
healthcare services
Functional Organizational Structure
(AKA bureaucratic organizational structure) splits the organization into departments based on
the expertise of employees
Open Systems Model (OSM)
Views patient care as a system involving various interactions (inputs & outputs) among
patients, healthcare providers & the environment
, Rational Goal Model (RGM)
Management theory that focuses on an organizations' ability to achieve its goals effectively
Strategic Alliance
The establishment of a long-term relationship between two or more organizations/groups that
have developed mutually beneficial goals & needs
Health Information Exchange (HIE)
A system that enables the electronic sharing of patient health info among healthcare
organizations
Human Relations Model (HRM)
Focuses on employees & stresses participation, openness, commitment and morale
Competing Values Framework (CVF)
Used for assessing organizational effectiveness and culture, focusing on adaptability, flexibility,
stability and control
Internal Process Model (IPM)
Based on harmony and efficiency internal environment, emphasis the process of accountability,
measuring, documenting and record keeping
Federal Anti-Kickback Statute (AKS)
Criminal law that prohibits exchanging anything of value in return for referrals or
recommendations
Stark Law
(AKA Physician self-referral law) prohibits physicians from referring medicare/medicaid patients
to entities with which they have a financial relationship for certain designated health services
Stakeholders
