WGU D391 / HEALTHCARE ECOSYSTEMS
Objective Assessment
Practice Quiz Bank
150 original multiple-choice questions with complete answer keys,
explanatory rationales and integrated healthcare scenarios.
150 10 3
ORIGINAL QUESTIONS CONTENT SECTIONS COURSE STRANDS
EDITION
Aligned to the publicly documented October 2026 WGU course description. Supplemental framework
questions are based on reputable healthcare reference sources and reported study needs.
Important distinction
This is an original, independent preparation resource. It does not contain official WGU assessment questions,
reproduce an official pre-assessment, or claim an externally verified OA blueprint.
Prepared for independent study and skills practice | October 2026
,WGU D391 / HEALTHCARE ECOSYSTEMS INDEPENDENT OA PRACTICE | 2026/2027
01 Assessment alignment & verification
WGU’s October 2026 catalog lists D391 Healthcare Ecosystems (HLTH 2012, 3 CUs) and identifies three
broad priorities: access/affordability/quality; regulators/providers/producers/funders; and insurance,
reimbursement, and healthcare decision-making. The public catalog does not give item-level OA
specifications.
Evidence tier What we can responsibly say
Official WGU (confirmed) Course identity, credit value, and published course scope.
Public healthcare authorities Insurance terminology, Medicare, HIPAA, SHARE, and quality-improvement
frameworks.
Student reports (context only) D391 students describe OA preparation involving SHARE, STEEEP, DECIDE, and
PDSA.
Not independently verified Exact live OA questions, exam length, question-type mix, competency weights,
or pass threshold.
Use this bank in three passes
• Pass 1 - Complete Q1-150 without looking at the answer section. Note questions you are unsure about.
• Pass 2 - Review every incorrect answer and restate the reasoning in your own words.
• Pass 3 - Retake weak topics and explain why the distractors are less appropriate.
The grouping below is editorial, not an official OA weighting or sequence.
Section Questions Preparation emphasis
01 Healthcare aims and ecosystem relationships 001-015 Published course core
02 Stakeholder roles and interdependence 016-030 Published course core
03 Care settings, delivery design, and coordination 031-045 Applied topic / supplemental
04 Access, equity, health literacy, and populations 046-060 Published course core
05 Insurance networks and patient cost sharing 061-075 Published course core
06 Medicare, Medicaid, insurance regulation, and 076-090 Published course core
compliance
07 Reimbursement and financial incentives 091-105 Published course core
Independent educational material • Not endorsed by WGU 02
,WGU D391 / HEALTHCARE ECOSYSTEMS INDEPENDENT OA PRACTICE | 2026/2027
08 Quality, safety, and STEEEP 106-120 Applied topic / supplemental
09 PDSA, Lean, measurement, and DECIDE 121-135 Applied topic / supplemental
10 SHARE and integrated healthcare scenarios 136-150 Applied topic / supplemental
02 High-yield concept reference
Use these distinctions when reviewing your answers; these are teaching summaries, not WGU-issued
exam instructions.
Stakeholder map
Regulators: set or enforce standards. Providers: deliver care. Producers: develop drugs, equipment, or other health
products. Funders: payors and purchasers that finance covered care. Patients, families, and communities are
affected by—and help shape—these decisions.
Three system aims
Access: can people obtain needed services? Affordability: can patients and payors sustain the cost? Quality: is care
safe, timely, effective, efficient, equitable, and person-centered?
STEEEP
Safe; Timely; Effective; Efficient; Equitable; Patient-centered. Evaluate trade-offs: better waiting time must not
come at the expense of medication safety, for example.
SHARE
Seek patient participation; Help compare options; Assess values and preferences; Reach a shared decision;
Evaluate how the decision works. Use evidence, clear risk communication, and patient priorities.
PDSA
Plan a small test and prediction; Do the test; Study results versus the prediction; Act by adopting, adapting, or
abandoning the idea. Repeat with new cycles.
DECIDE
Define problem; Establish criteria; Consider alternatives; Identify best alternative; Develop and implement action
plan; Evaluate and monitor. The label is used as a practical decision aid; local course wording may vary.
Insurance designs
PPO: broader out-of-network options at higher cost; HMO: generally in-network integrated care; EPO: generally
in-network except emergencies; POS: often requires PCP specialist referrals and favors in-network providers.
Cost sharing
Premium = coverage cost; deductible = covered cost paid before typical plan sharing; copay = fixed
covered-service charge; coinsurance = percentage of allowed covered charges. Plan terms and exceptions matter.
Independent educational material • Not endorsed by WGU 03
, WGU D391 / HEALTHCARE ECOSYSTEMS INDEPENDENT OA PRACTICE | 2026/2027
Public programs
Medicare A: hospital insurance; B: medical/outpatient insurance; C: Medicare Advantage; D: prescription drug
benefit. Medicaid is a joint federal-state program; dual eligibility means both Medicare and Medicaid qualification.
Reimbursement models
Fee-for-service rewards billable volume; capitation pays fixed amounts per covered person; bundled payment
covers a defined episode; value-based payment ties incentives to quality and/or cost performance.
QI measures
Outcome = result for patients; process = care activity performed; balancing = unintended consequences
elsewhere in the system. Use subgroup data to uncover disparities.
03 Question bank
Select the single best answer for each original question. Use the answer tracker or mark your selection in
the margin. The complete key and rationales follow all 150 questions.
SECTION 01
Healthcare aims and ecosystem relationships
15 questions | select one best answer | answers and rationales appear after the bank
The October 2026 WGU course description emphasizes access, affordability, quality, and relationships among
ecosystem elements.
001. A rural county opens evening primary-care appointments for shift workers. Which
healthcare aim is addressed MOST directly?
A. Access to care
B. Device innovation
C. Provider credentialing
D. Payment accuracy
002. A hospital reports fewer preventable complications after implementing standardized
handoffs. Which central healthcare aim is MOST directly improved?
A. Pharmaceutical supply
B. Premium collection
C. Insurance enrollment
D. Quality of care
Independent educational material • Not endorsed by WGU 04
Objective Assessment
Practice Quiz Bank
150 original multiple-choice questions with complete answer keys,
explanatory rationales and integrated healthcare scenarios.
150 10 3
ORIGINAL QUESTIONS CONTENT SECTIONS COURSE STRANDS
EDITION
Aligned to the publicly documented October 2026 WGU course description. Supplemental framework
questions are based on reputable healthcare reference sources and reported study needs.
Important distinction
This is an original, independent preparation resource. It does not contain official WGU assessment questions,
reproduce an official pre-assessment, or claim an externally verified OA blueprint.
Prepared for independent study and skills practice | October 2026
,WGU D391 / HEALTHCARE ECOSYSTEMS INDEPENDENT OA PRACTICE | 2026/2027
01 Assessment alignment & verification
WGU’s October 2026 catalog lists D391 Healthcare Ecosystems (HLTH 2012, 3 CUs) and identifies three
broad priorities: access/affordability/quality; regulators/providers/producers/funders; and insurance,
reimbursement, and healthcare decision-making. The public catalog does not give item-level OA
specifications.
Evidence tier What we can responsibly say
Official WGU (confirmed) Course identity, credit value, and published course scope.
Public healthcare authorities Insurance terminology, Medicare, HIPAA, SHARE, and quality-improvement
frameworks.
Student reports (context only) D391 students describe OA preparation involving SHARE, STEEEP, DECIDE, and
PDSA.
Not independently verified Exact live OA questions, exam length, question-type mix, competency weights,
or pass threshold.
Use this bank in three passes
• Pass 1 - Complete Q1-150 without looking at the answer section. Note questions you are unsure about.
• Pass 2 - Review every incorrect answer and restate the reasoning in your own words.
• Pass 3 - Retake weak topics and explain why the distractors are less appropriate.
The grouping below is editorial, not an official OA weighting or sequence.
Section Questions Preparation emphasis
01 Healthcare aims and ecosystem relationships 001-015 Published course core
02 Stakeholder roles and interdependence 016-030 Published course core
03 Care settings, delivery design, and coordination 031-045 Applied topic / supplemental
04 Access, equity, health literacy, and populations 046-060 Published course core
05 Insurance networks and patient cost sharing 061-075 Published course core
06 Medicare, Medicaid, insurance regulation, and 076-090 Published course core
compliance
07 Reimbursement and financial incentives 091-105 Published course core
Independent educational material • Not endorsed by WGU 02
,WGU D391 / HEALTHCARE ECOSYSTEMS INDEPENDENT OA PRACTICE | 2026/2027
08 Quality, safety, and STEEEP 106-120 Applied topic / supplemental
09 PDSA, Lean, measurement, and DECIDE 121-135 Applied topic / supplemental
10 SHARE and integrated healthcare scenarios 136-150 Applied topic / supplemental
02 High-yield concept reference
Use these distinctions when reviewing your answers; these are teaching summaries, not WGU-issued
exam instructions.
Stakeholder map
Regulators: set or enforce standards. Providers: deliver care. Producers: develop drugs, equipment, or other health
products. Funders: payors and purchasers that finance covered care. Patients, families, and communities are
affected by—and help shape—these decisions.
Three system aims
Access: can people obtain needed services? Affordability: can patients and payors sustain the cost? Quality: is care
safe, timely, effective, efficient, equitable, and person-centered?
STEEEP
Safe; Timely; Effective; Efficient; Equitable; Patient-centered. Evaluate trade-offs: better waiting time must not
come at the expense of medication safety, for example.
SHARE
Seek patient participation; Help compare options; Assess values and preferences; Reach a shared decision;
Evaluate how the decision works. Use evidence, clear risk communication, and patient priorities.
PDSA
Plan a small test and prediction; Do the test; Study results versus the prediction; Act by adopting, adapting, or
abandoning the idea. Repeat with new cycles.
DECIDE
Define problem; Establish criteria; Consider alternatives; Identify best alternative; Develop and implement action
plan; Evaluate and monitor. The label is used as a practical decision aid; local course wording may vary.
Insurance designs
PPO: broader out-of-network options at higher cost; HMO: generally in-network integrated care; EPO: generally
in-network except emergencies; POS: often requires PCP specialist referrals and favors in-network providers.
Cost sharing
Premium = coverage cost; deductible = covered cost paid before typical plan sharing; copay = fixed
covered-service charge; coinsurance = percentage of allowed covered charges. Plan terms and exceptions matter.
Independent educational material • Not endorsed by WGU 03
, WGU D391 / HEALTHCARE ECOSYSTEMS INDEPENDENT OA PRACTICE | 2026/2027
Public programs
Medicare A: hospital insurance; B: medical/outpatient insurance; C: Medicare Advantage; D: prescription drug
benefit. Medicaid is a joint federal-state program; dual eligibility means both Medicare and Medicaid qualification.
Reimbursement models
Fee-for-service rewards billable volume; capitation pays fixed amounts per covered person; bundled payment
covers a defined episode; value-based payment ties incentives to quality and/or cost performance.
QI measures
Outcome = result for patients; process = care activity performed; balancing = unintended consequences
elsewhere in the system. Use subgroup data to uncover disparities.
03 Question bank
Select the single best answer for each original question. Use the answer tracker or mark your selection in
the margin. The complete key and rationales follow all 150 questions.
SECTION 01
Healthcare aims and ecosystem relationships
15 questions | select one best answer | answers and rationales appear after the bank
The October 2026 WGU course description emphasizes access, affordability, quality, and relationships among
ecosystem elements.
001. A rural county opens evening primary-care appointments for shift workers. Which
healthcare aim is addressed MOST directly?
A. Access to care
B. Device innovation
C. Provider credentialing
D. Payment accuracy
002. A hospital reports fewer preventable complications after implementing standardized
handoffs. Which central healthcare aim is MOST directly improved?
A. Pharmaceutical supply
B. Premium collection
C. Insurance enrollment
D. Quality of care
Independent educational material • Not endorsed by WGU 04
