WGU D545 HEALTHCARE
ADMINISTRATION EVOLUTION SYSTEMS
AND LEADERSHIP UPDATED EXAM
QUESTIONS AND CORRECT ANSWERS
●● uninsured
Answer: individuals who do not have health insurance coverage through
private companies, government programs, or other means, and therefore,
may face difficulties in accessing healthcare services
●● health insurance marketplace
Answer: system established to facilitate the purchase of health insurance
in organized markets (also referred to as health insurance exchanges)
●● health care
Answer: an act or deed between the healthcare provider and the patient
to maintain or improve the patient's healthcare status
●● biomedical model
Answer: a theoretical framework in healthcare that views illness and
disease as primarily resulting from biological factors
●● holistic health
,Answer: an approach to wellness that simultaneously addresses the
physical, mental, emotional, social, and spiritual components of health
●● holistic medicine
Answer: 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)
Answer: a network of doctors, hospitals, and other healthcare providers
that voluntarily come together to provide coordinated, high-quality care
to their patients
●● structure
Answer: how specific activities are performed to ensure the mission and
vision of the organization are achieved
●● functional organization structure
Answer: splits the organization into departments based on the expertise
of employees (also referred to as bureaucratic organizational structure)
●● matrix organizational structure
Answer: a type of organizational design that combines two or more
types of organizational structures, typically functional and project-based
,●● financing
Answer: premiums established through negotiations between employers
and the MCO
●● insurance
Answer: 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)
Answer: 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
Answer: the provision of healthcare services by various providers in
exchange for payment for services rendered
●● payment function
Answer: 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)
Answer: 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)
Answer: 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)
Answer: 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
Answer: 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)
Answer: (also known as a high-deductible health plan) a type of health
insurance plan that encourages individuals to manage their healthcare
costs
ADMINISTRATION EVOLUTION SYSTEMS
AND LEADERSHIP UPDATED EXAM
QUESTIONS AND CORRECT ANSWERS
●● uninsured
Answer: individuals who do not have health insurance coverage through
private companies, government programs, or other means, and therefore,
may face difficulties in accessing healthcare services
●● health insurance marketplace
Answer: system established to facilitate the purchase of health insurance
in organized markets (also referred to as health insurance exchanges)
●● health care
Answer: an act or deed between the healthcare provider and the patient
to maintain or improve the patient's healthcare status
●● biomedical model
Answer: a theoretical framework in healthcare that views illness and
disease as primarily resulting from biological factors
●● holistic health
,Answer: an approach to wellness that simultaneously addresses the
physical, mental, emotional, social, and spiritual components of health
●● holistic medicine
Answer: 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)
Answer: a network of doctors, hospitals, and other healthcare providers
that voluntarily come together to provide coordinated, high-quality care
to their patients
●● structure
Answer: how specific activities are performed to ensure the mission and
vision of the organization are achieved
●● functional organization structure
Answer: splits the organization into departments based on the expertise
of employees (also referred to as bureaucratic organizational structure)
●● matrix organizational structure
Answer: a type of organizational design that combines two or more
types of organizational structures, typically functional and project-based
,●● financing
Answer: premiums established through negotiations between employers
and the MCO
●● insurance
Answer: 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)
Answer: 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
Answer: the provision of healthcare services by various providers in
exchange for payment for services rendered
●● payment function
Answer: 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)
Answer: 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)
Answer: 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)
Answer: 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
Answer: 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)
Answer: (also known as a high-deductible health plan) a type of health
insurance plan that encourages individuals to manage their healthcare
costs
