FACHE EXAM QUESTIONS WITH CORRECT ANSWERS GRADED TO PASS

Sarbanes Oxley - US federal law that set new or expanded requirements for all US public company boards, management and public accounting firms. Cover responsibilities of a public corporation's board of directors, adds criminal penalties and required SEC to create regulations FMLA - 1993: law requiring covered employers to provide employees with job-protected and unpaid leave for qualified medical family reasons Purpose of any HCO - to provide care to individual patients and is usually stated in organization's "mission" Population Health - defining the population (by geography, sociodemographic factors, disease state, risk, insurance coverage or in some other way), measuring the current state of health in the population, setting goals for improvement and directing resources to making improvements. US HSS specifies national goals and objectives for population health in the Healthy People 2020 program Caregiving/Clinical/Logistic/Strategic Teams - Caregiving Teams: Provide care to patients with similar needs (PCP, ACUTE, rehab) Clinical Support Teams: provide specific clinical services to Caregiving Teams (clinical laboratory, pharmacy, imaging, cardiopulmonary) Logistic Support Teams - provide trained personnel, information, facilities, accounting, cash, management and supplies Strategic Support Teams: provide marketing, governance, internal consulting, finance, stakeholder relations management and strategic positioning Service Lines - Patient care teams coordinated around a set of similar diseases or patient needs Premise of a Healthy Community - Costs tend to rise and benefits to decline as care moves away from the healthy state. Therefore, optimum care maximizes use of prevention, health maintenance, and health improvement PCP, Acute inpatient or specialty outpatient care, rehab, continuing care in home or nursing home setting, continuing care in home or nursing home setting, palliative care and death Stakeholders - Individuals or groups who have a direct interest in the organization's success and shape its mission and strategies. Include buyers, workers, suppliers, regulators and owners. Patients are the MOST important HCO stakeholders. They expect and deserve care that meets the goals summarized in IOM's report: Crossing the Quality Chasm Patient-centered care - care that is respectful of and responsive to individual patient preferences, needs and values and involving patients and families in care planning and decision making Fiscal intermediaries - Outside contractor that processes claims for US government programs such as medicare and medicaid and provide most of the revenue to HCOs, making them essential stakeholders Patient Protection and Affordable Care Act (ACA) - A federal law providing for a fundamental reform of the US healthcare and health insurance system, signed by President Obama in 2010. It includes: increase insurance coverage for many patients, new approaches to support those with chronic disease, and a greater accountability for the cost and quality of care. Part of the "Triple Aim" - improving the individual patient experience with healthcare, improving the health of the population, and reducing per capita cost of care Value-based purchasing - Linking financial incentives to the quality of care provided - reward HCOs for quality and sustained patient health Certificate-of-need laws - Certificate or approval of new services and construction and renovation of hospitals or related facilities; issued in many states. Require that HCOs seek permission for construction or expansion. EMTALA - Emergency Medical Treatment and Active Labor Act - Requires all HCOs providing emergency care to accept all patients, regardless of ability to pay, until they are stabilized and can be safely moved The Joint Commission - A voluntary consortium of professional provider organizations that evaluates and accredits a wide range of different HCOs. HCOs MUST have an accreditation by a CMS deemed-status organization in order to receive funds from Medicare. Some insurance plans are accredited by the National Committee for Quality Assurance (NCQA) Associates - People who give their time and energy to the organization. They can be employees, trustees and other volunteers and medical staff members. Licensed Independent Practitioners (LIPs) - Caregivers granted legal status to provide specific kinds of healthcare, categorized as primary care or specialist providers who are usually physicians or advanced practice nurses (NPs, nurse midwives) Primary Care Practitioners (PCPs) - physicians and advanced practice nurses specializing in family medicine, general internal medicine, pediatrics, obstetrics, and psychiatry and are the most common initial contacts for patients and specialize in family medicine, general internal medicine, peds, OB/GYN, and psychiatry Specialist Practitioners - LIPs who care for patients referred by PCPs on a more limited and transiet basis. More likely to manage episodes of inpatient care Hospitalists - Accept relatively broad categories of patients and manage inpatient care only