WGU C425 OA TEST 2024-2025 ACTUAL EXAM
WGU C425 OA TEST 2024-2025 ACTUAL
EXAM TEST BANK QUESTIONS AND
CORRECT DETAILED ANSWERS
Which of the following is true in regards to health care today in the United States?
There are more primary care physicians than specialty physicians.
Primary care receives a higher reimbursement in professional fees.
There are more specialty physicians than primary physicians.
Outpatient care is slowly decreasing. -Correct Answer ✔There are more specialty
physicians than primary physicians.
What triggered the downsizing phase in the U.S. hospital industry during the 1980s?
Hill-Burton Act
Managed care
Prospective payment system
Medicare and Medicaid -Correct Answer ✔Prospective payment system
Designated Related Groups (DRG) -based reimbursement necessitated hospitals to do
what?
Admit new patients at a faster rate than before
Admit a greater number of Medicare patients than before
Reduce the length of stay for hospitalized patients
Admit a smaller number of Medicare patients than before -Correct Answer ✔Reduce the
length of stay for hospitalized patients
In which type of utilization management is a primary care physician's opinion necessary
in referring or not referring a patient to a specialist?
Concurrent
Retrospective
Gatekeeping
Precertification -Correct Answer ✔Gatekeeping
What is one aspect in which managed care differs from conventional insurance?
Collection of premiums
Assumption of risk
Responsibility for delivery of services
Payments to providers -Correct Answer ✔Responsibility for delivery of services
What is the purpose of Skilled Nursing Facilities (SNF) certification?
It enables a facility to be operated as a skilled nursing facility.
It is required to legally operate a nursing home.
WGU C425 OA TEST 2024-2025 ACTUAL EXAM
, WGU C425 OA TEST 2024-2025 ACTUAL EXAM
It enables a facility to serve Medicare clients.
It enables a facility to serve both Medicare and Medicaid clients. -Correct Answer ✔It
enables a facility to serve Medicare clients.
What is the main goal of long-term care as it relates to a patient's function?
Restore function
Provide assistance
Promote independence
Adapt to change -Correct Answer ✔Promote independence
The U.S. government plays a limited role in the health delivery system. The
government's role in the arena of health care delivery consists of:
developing private hospital organizations.
regulating public and private programs at the local levels.
being the responsible party for health care delivery through Medicare and Medicaid
programs.
aiding in competition among managed care organizations. -Correct Answer ✔being the
responsible party for health care delivery through Medicare and Medicaid programs.
The ideology system that emphasizes the well-being of the community over an
individual is called the:
social justice system.
market justice system.
money market system.
universal health care system. -Correct Answer ✔social justice system.
Which of the following are characteristics of the medical care determinants of health?
Health care factors include access to technology but do not include access to
alternative therapies.
Mental health services are excluded from the WHO's primary health care framework.
Whereas some services (preventive and primary care) contribute to general health
status, others are more influential in end-of-life situations (hospice and long-term care).
The medical system is highly coordinated so that throughout the phases of their lives
patients are rarely faced with poor continuity of care. -Correct Answer ✔Whereas some
services (preventive and primary care) contribute to general health status, others are
more influential in end-of-life situations (hospice and long-term care).
Which of the following has been the primary factor that has shielded the U.S. health
care system from a major overhaul?
Beliefs and values
Science and technology
Social factors
Economic forces -Correct Answer ✔Beliefs and values
WGU C425 OA TEST 2024-2025 ACTUAL EXAM
WGU C425 OA TEST 2024-2025 ACTUAL
EXAM TEST BANK QUESTIONS AND
CORRECT DETAILED ANSWERS
Which of the following is true in regards to health care today in the United States?
There are more primary care physicians than specialty physicians.
Primary care receives a higher reimbursement in professional fees.
There are more specialty physicians than primary physicians.
Outpatient care is slowly decreasing. -Correct Answer ✔There are more specialty
physicians than primary physicians.
What triggered the downsizing phase in the U.S. hospital industry during the 1980s?
Hill-Burton Act
Managed care
Prospective payment system
Medicare and Medicaid -Correct Answer ✔Prospective payment system
Designated Related Groups (DRG) -based reimbursement necessitated hospitals to do
what?
Admit new patients at a faster rate than before
Admit a greater number of Medicare patients than before
Reduce the length of stay for hospitalized patients
Admit a smaller number of Medicare patients than before -Correct Answer ✔Reduce the
length of stay for hospitalized patients
In which type of utilization management is a primary care physician's opinion necessary
in referring or not referring a patient to a specialist?
Concurrent
Retrospective
Gatekeeping
Precertification -Correct Answer ✔Gatekeeping
What is one aspect in which managed care differs from conventional insurance?
Collection of premiums
Assumption of risk
Responsibility for delivery of services
Payments to providers -Correct Answer ✔Responsibility for delivery of services
What is the purpose of Skilled Nursing Facilities (SNF) certification?
It enables a facility to be operated as a skilled nursing facility.
It is required to legally operate a nursing home.
WGU C425 OA TEST 2024-2025 ACTUAL EXAM
, WGU C425 OA TEST 2024-2025 ACTUAL EXAM
It enables a facility to serve Medicare clients.
It enables a facility to serve both Medicare and Medicaid clients. -Correct Answer ✔It
enables a facility to serve Medicare clients.
What is the main goal of long-term care as it relates to a patient's function?
Restore function
Provide assistance
Promote independence
Adapt to change -Correct Answer ✔Promote independence
The U.S. government plays a limited role in the health delivery system. The
government's role in the arena of health care delivery consists of:
developing private hospital organizations.
regulating public and private programs at the local levels.
being the responsible party for health care delivery through Medicare and Medicaid
programs.
aiding in competition among managed care organizations. -Correct Answer ✔being the
responsible party for health care delivery through Medicare and Medicaid programs.
The ideology system that emphasizes the well-being of the community over an
individual is called the:
social justice system.
market justice system.
money market system.
universal health care system. -Correct Answer ✔social justice system.
Which of the following are characteristics of the medical care determinants of health?
Health care factors include access to technology but do not include access to
alternative therapies.
Mental health services are excluded from the WHO's primary health care framework.
Whereas some services (preventive and primary care) contribute to general health
status, others are more influential in end-of-life situations (hospice and long-term care).
The medical system is highly coordinated so that throughout the phases of their lives
patients are rarely faced with poor continuity of care. -Correct Answer ✔Whereas some
services (preventive and primary care) contribute to general health status, others are
more influential in end-of-life situations (hospice and long-term care).
Which of the following has been the primary factor that has shielded the U.S. health
care system from a major overhaul?
Beliefs and values
Science and technology
Social factors
Economic forces -Correct Answer ✔Beliefs and values
WGU C425 OA TEST 2024-2025 ACTUAL EXAM
