Healthcare Quality Improvement and Risk Management - C430 exam 2023 with complete solution graded A+

Fee-for-service (FFS) - ___ ___ ___ is a payment model where services are unbundled and paid for separately. In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care. capitation - Payments agreed upon in a ______ contract by a health insurance company and a medical provider. It is a fixed, pre-arranged monthly payment received by a physician, clinic or hospital per patient enrolled in a health plan with a capitated contract. Joint Commission - The ___ ____ is an independent, not-for-profit group in the United States that administers voluntary accreditation programs for hospitals and other healthcare organizations. Quality Assurance (NCQA) - The National Committee for ____ ____ is an independent 501(c)(3) non-profit organization in the United States that works to improve health care quality through the administration of evidence-based standards, measures, programs, and accreditation. Joint Commission - Medicare accepts a JCAHO (aka ____ _____ or TJC) accreditation as evidence that a hospital meets Medicare conditions of participation Red Rules - Unbreakable Rules FMEA - ____ is a structured method for examining any system, process, or complex array of equipment for risk of failure before it fails. An expert team studies each step or component, evaluates its weaknesses or defects, and assigns it a risk score. OSHA (The Occupational Safety and Health Administration) - _____ , an agency of the US government under the Department of Labor with the responsibility of ensuring safety at work and a healthful work environment. ____'s mission is to prevent work-related injuries, illnesses and deaths.Centers for Medicare and Medicaid - a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid. Can deny reimbursement