HHS 300 | ACE EVERY TEST | 100% VERIFIED
ANSWERS INSIDE.
MCOs (privatization & corporatization) - Answer: These are companies that manage
health insurance plans by working with health providers and facilities to offer cost-
effective and quality care to members.
Privatization: The process by which healthcare services, previously run by the
government, are transferred to private companies.
Corporatization: The transformation of healthcare facilities and services into business-
like entities, focusing on efficiency and profitability, even if they are still owned by the
public sector.
Goals of Managed Care - Answer: Reduce healthcare costs.
Improve the quality of care.
Make sure patients have access to necessary healthcare services.
Local Public Health Departments - Answer: provide services to local communities—
focusing on the reporting of communicable diseases, public health nursing, health
education, environmental sanitation, maternal and child health services, and public
health clinics.
HMO (Health Maintenance Organization) - Answer: A type of health insurance plan that
provides healthcare services to members through a network of doctors, hospitals, and
other providers for a fixed, prepaid fee.
Medicare (all parts) - Answer: Part A: Covers inpatient hospital stays, care in a skilled
nursing facility, hospice care, and some home health care.
Part B: Covers certain doctors' services, outpatient care, medical supplies, and
preventive services.
1
APPHIA - Crafted with Care and Precision for Academic Excellence.
, Part C (Medicare Advantage): Offers an alternative way to receive Medicare benefits
through private insurance plans that cover all Part A and Part B services and sometimes
additional services.
Part D: Provides prescription drug coverage.
Medicare - Answer: A federal health insurance program in the United States primarily
for people aged 65 and older, as well as for some younger people with disabilities and
those with End-Stage Renal Disease.
Payment Methods - Answer: Fee-for-Service: Providers are paid for each individual
treatment or service they render.
Capitation: Providers receive a set payment for each enrolled patient regardless of the
number of services provided.
Salary: Providers are paid a fixed salary by the employer, such as a hospital or clinic.
Bundled Payment: Providers receive a single bundled payment for all services related to
a specific treatment or condition over a defined period.
Pay-for-Performance: Providers are incentivized with bonuses for meeting specific
quality benchmarks or improving patient outcomes.
ACA (Affordable Care Act) - Answer: A comprehensive healthcare reform law enacted
in March 2010, often known as Obamacare, aimed at expanding health insurance
coverage, controlling healthcare costs, and improving the healthcare system.
2
APPHIA - Crafted with Care and Precision for Academic Excellence.
ANSWERS INSIDE.
MCOs (privatization & corporatization) - Answer: These are companies that manage
health insurance plans by working with health providers and facilities to offer cost-
effective and quality care to members.
Privatization: The process by which healthcare services, previously run by the
government, are transferred to private companies.
Corporatization: The transformation of healthcare facilities and services into business-
like entities, focusing on efficiency and profitability, even if they are still owned by the
public sector.
Goals of Managed Care - Answer: Reduce healthcare costs.
Improve the quality of care.
Make sure patients have access to necessary healthcare services.
Local Public Health Departments - Answer: provide services to local communities—
focusing on the reporting of communicable diseases, public health nursing, health
education, environmental sanitation, maternal and child health services, and public
health clinics.
HMO (Health Maintenance Organization) - Answer: A type of health insurance plan that
provides healthcare services to members through a network of doctors, hospitals, and
other providers for a fixed, prepaid fee.
Medicare (all parts) - Answer: Part A: Covers inpatient hospital stays, care in a skilled
nursing facility, hospice care, and some home health care.
Part B: Covers certain doctors' services, outpatient care, medical supplies, and
preventive services.
1
APPHIA - Crafted with Care and Precision for Academic Excellence.
, Part C (Medicare Advantage): Offers an alternative way to receive Medicare benefits
through private insurance plans that cover all Part A and Part B services and sometimes
additional services.
Part D: Provides prescription drug coverage.
Medicare - Answer: A federal health insurance program in the United States primarily
for people aged 65 and older, as well as for some younger people with disabilities and
those with End-Stage Renal Disease.
Payment Methods - Answer: Fee-for-Service: Providers are paid for each individual
treatment or service they render.
Capitation: Providers receive a set payment for each enrolled patient regardless of the
number of services provided.
Salary: Providers are paid a fixed salary by the employer, such as a hospital or clinic.
Bundled Payment: Providers receive a single bundled payment for all services related to
a specific treatment or condition over a defined period.
Pay-for-Performance: Providers are incentivized with bonuses for meeting specific
quality benchmarks or improving patient outcomes.
ACA (Affordable Care Act) - Answer: A comprehensive healthcare reform law enacted
in March 2010, often known as Obamacare, aimed at expanding health insurance
coverage, controlling healthcare costs, and improving the healthcare system.
2
APPHIA - Crafted with Care and Precision for Academic Excellence.
