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Exam (elaborations)

D545 SECTION 1 GLOSSARY EXAM QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2026/2027

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D545 SECTION 1 GLOSSARY EXAM QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2026/2027 • health care - Answers an act or deed between the healthcare provider and the patient to maintain or improve the patient's healthcare status • biomedical model - Answers a theoretical framework in healthcare that views illness and disease as primarily resulting from biological factors • holistic health - Answers an approach to wellness that simultaneously addresses the physical, mental, emotional, social, and spiritual components of health • holistic medicine - Answers the practice of healthcare professionals using a diverse range of disciplines, religious philosophies, and cultural practices to heal individuals, communities, and the environment • accountable care organization (ACO) - Answers a network of doctors, hospitals, and other healthcare providers that voluntarily come together to provide coordinated, high-quality care to their patients • structure - Answers how specific activities are performed to ensure the mission and vision of the organization are achieved • functional organization structure - Answers splits the organization into departments based on the expertise of employees (also referred to as bureaucratic organizational structure) • matrix organizational structure - Answers a type of organizational design that combines two or more types of organizational structures, typically functional and project-based • financing - Answers premiums established through negotiations between employers and the MCO • insurance - Answers a financial arrangement that protects against financial loss or liability, typically by allowing individuals or entities to pool the risk of potential losses in exchange for regular payments known as premiums • managed care organization (MCO) - Answers a type of healthcare delivery system that aims to manage the cost, quality, and accessibility of healthcare services; MCOs are commonly associated with HMOs, PPOs, and POS plans

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D545 SECTION 1 GLOSSARY EXAM QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE
2026/2027



• health care - Answers an act or deed between the healthcare provider and the patient to
maintain or improve the patient's healthcare status

• biomedical model - Answers a theoretical framework in healthcare that views illness and
disease as primarily resulting from biological factors

• holistic health - Answers an approach to wellness that simultaneously addresses the physical,
mental, emotional, social, and spiritual components of health

• holistic medicine - Answers the practice of healthcare professionals using a diverse range of
disciplines, religious philosophies, and cultural practices to heal individuals, communities, and
the environment

• accountable care organization (ACO) - Answers a network of doctors, hospitals, and other
healthcare providers that voluntarily come together to provide coordinated, high-quality care to
their patients

• structure - Answers how specific activities are performed to ensure the mission and vision of
the organization are achieved

• functional organization structure - Answers splits the organization into departments based on
the expertise of employees (also referred to as bureaucratic organizational structure)

• matrix organizational structure - Answers a type of organizational design that combines two or
more types of organizational structures, typically functional and project-based

• financing - Answers premiums established through negotiations between employers and the
MCO

• insurance - Answers a financial arrangement that protects against financial loss or liability,
typically by allowing individuals or entities to pool the risk of potential losses in exchange for
regular payments known as premiums

• managed care organization (MCO) - Answers a type of healthcare delivery system that aims to
manage the cost, quality, and accessibility of healthcare services; MCOs are commonly
associated with HMOs, PPOs, and POS plans

• delivery - Answers the provision of healthcare services by various providers in exchange for
payment for services rendered

, • payment function - Answers to determine fees for services, how much a provider should be
paid for services rendered, and the actual payment to the provider after services have been
rendered

• health maintenance organization (HMO) - Answers a type of managed care organization that
provides health insurance coverage through a network of healthcare providers who offer
services to members for a fixed fee

• preferred provider organization (PPO) - Answers a type of managed care organization that
provides health insurance coverage where members can receive care from both in-network and
out-of-network providers, with greater flexibility and higher coverage for in-network services

• integrated delivery system (IDS) - Answers a network of organizations that provides or
arranges to provide an organized variety of services to specific populations and is held
accountable for the outcomes and health status of those populations

• payer-provider integration - Answers a system comprising a merger between the payers of
healthcare and the providers of healthcare to control healthcare costs and improve the delivery
of healthcare services

• consumer-driven health plan (CDHP) - Answers (also known as a high-deductible health plan)
a type of health insurance plan that encourages individuals to manage their healthcare costs

• point-of-service plan - Answers a type of managed care health insurance that combines
features of HMOs and PPOs; it offers a blend of flexibility and cost-efficiency, with an emphasis
on coordinated care

• fee-for-service - Answers a system wherein healthcare is provided as individual units of
service, such as magnetic resonance imaging (MRI) or other X-ray, medical examination, flu
shot, or other service

• preferred provider - Answers a type of organization that provides services based on contracts
with groups of physicians and hospitals that are referred to as preferred providers

• Patient Protection and Affordable Care Act (ACA) - Answers also known as the Affordable Care
Act and Obamacare; a U.S. federal statute enacted in 2010 aimed at expanding health insurance
coverage, reducing healthcare costs, and improving healthcare system efficiency and quality

• health insurance marketplace - Answers system established to facilitate the purchase of health
insurance in organized markets (also referred to as health insurance exchanges)

• healthcare reform - Answers the process of improving the efficiency, accessibility, and quality
of healthcare services, often involving changes to policies, regulations, and practices within
healthcare systems

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