WGU D391 Answer Key With Rationales
1. B — Payer
Payers (insurance companies, Medicare, Medicaid) reimburse providers for
services. Providers deliver care; patients receive care.
2. B — Primary care
Annual checkups and first-contact routine care are primary care functions.
3. C — CMS
Centers for Medicare & Medicaid Services administers Medicare and
oversees Medicaid rules with states.
4. B — Secondary
A cardiologist is a specialist, which is secondary care after referral.
5. C — Premium
A premium is the recurring monthly payment to maintain insurance
coverage.
6. B — Value-based care
This model ties reimbursement to quality, outcomes, and efficiency rather
than volume alone.
7. B — HIPAA
HIPAA protects patient health information privacy and security.
8. B — Housing stability
Housing is a classic social determinant affecting health outcomes and
access.
9. C — Improving population health
The Triple Aim = better patient experience, better population health, lower
cost.
10. B — Medicaid
Medicaid primarily supports eligible low-income individuals/families.
11. B — Root cause analysis
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, Used after adverse events to identify underlying system causes, not just
blame individuals.
12. A — CDC
Centers for Disease Control and Prevention focuses on disease prevention
and public health response.
13. C — Copay
A copay is a fixed fee paid at time of service, such as $25 for a visit.
14. C — Tertiary
Highly specialized advanced care such as transplants or trauma centers is
tertiary care.
15. B — Systems can exchange data
Interoperability means health IT systems communicate and share usable
data.
16. B — Vaccination
Vaccines are preventive services intended to avoid disease before it occurs.
17. B — Prescription drugs
Medicare Part D covers outpatient prescription medications.
18. A — FDA
Food and Drug Administration regulates medication and device safety.
19. B — Fee-for-service
Providers are paid per test/procedure/visit completed.
20. B — Duplicate services
Care coordination reduces repeated tests, fragmented treatment, and
readmissions.
21. C — Autonomy
Autonomy means respecting a patient’s right to make informed decisions.
22. B — Nonmaleficence
This ethical principle means avoid causing harm.
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1. B — Payer
Payers (insurance companies, Medicare, Medicaid) reimburse providers for
services. Providers deliver care; patients receive care.
2. B — Primary care
Annual checkups and first-contact routine care are primary care functions.
3. C — CMS
Centers for Medicare & Medicaid Services administers Medicare and
oversees Medicaid rules with states.
4. B — Secondary
A cardiologist is a specialist, which is secondary care after referral.
5. C — Premium
A premium is the recurring monthly payment to maintain insurance
coverage.
6. B — Value-based care
This model ties reimbursement to quality, outcomes, and efficiency rather
than volume alone.
7. B — HIPAA
HIPAA protects patient health information privacy and security.
8. B — Housing stability
Housing is a classic social determinant affecting health outcomes and
access.
9. C — Improving population health
The Triple Aim = better patient experience, better population health, lower
cost.
10. B — Medicaid
Medicaid primarily supports eligible low-income individuals/families.
11. B — Root cause analysis
1
, Used after adverse events to identify underlying system causes, not just
blame individuals.
12. A — CDC
Centers for Disease Control and Prevention focuses on disease prevention
and public health response.
13. C — Copay
A copay is a fixed fee paid at time of service, such as $25 for a visit.
14. C — Tertiary
Highly specialized advanced care such as transplants or trauma centers is
tertiary care.
15. B — Systems can exchange data
Interoperability means health IT systems communicate and share usable
data.
16. B — Vaccination
Vaccines are preventive services intended to avoid disease before it occurs.
17. B — Prescription drugs
Medicare Part D covers outpatient prescription medications.
18. A — FDA
Food and Drug Administration regulates medication and device safety.
19. B — Fee-for-service
Providers are paid per test/procedure/visit completed.
20. B — Duplicate services
Care coordination reduces repeated tests, fragmented treatment, and
readmissions.
21. C — Autonomy
Autonomy means respecting a patient’s right to make informed decisions.
22. B — Nonmaleficence
This ethical principle means avoid causing harm.
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