WGU D545 Exam
1. Healthcare Systems and Structures
Q: What is the primary function of the Centers for Medicare & Medicaid Services
(CMS)?
A: CMS oversees the administration of Medicare, Medicaid, and the Children’s
Health Insurance Program (CHIP), ensuring compliance with federal healthcare
regulations.
Q: What is the difference between for-profit and non-profit healthcare
organizations?
,A: For-profit hospitals generate revenue for shareholders and investors, while non-
profit hospitals reinvest earnings into improving healthcare services and community
benefits.
2. Healthcare Policies and Regulations
Q: What is the purpose of the Affordable Care Act (ACA)?
A: The ACA aims to increase healthcare access, reduce costs, and improve quality by
expanding Medicaid, creating insurance marketplaces, and preventing coverage
denials due to pre-existing conditions.
Q: What is HIPAA and why is it important?
A: The Health Insurance Portability and Accountability Act (HIPAA) protects patient
privacy by setting standards for electronic healthcare transactions and ensuring
confidentiality of medical records.
3. Leadership and Management in Healthcare
Q: Describe transformational leadership in healthcare.
A: Transformational leaders inspire and motivate employees by fostering a shared
vision, encouraging innovation, and promoting personal and professional
development.
Q: What is the difference between transactional and servant leadership?
A: Transactional leadership focuses on structure, rewards, and punishments to
ensure performance, whereas servant leadership prioritizes employee well-being
and growth, fostering a supportive work environment.
4. Healthcare Quality and Patient Safety
Q: What are key components of the Triple Aim in healthcare?
A: The Triple Aim focuses on improving patient experience, reducing costs, and
enhancing population health.
Q: What is root cause analysis (RCA) in healthcare?
,A: RCA is a systematic method used to investigate errors, identify underlying causes,
and implement corrective actions to prevent recurrence.
5. Healthcare Economics and Finance
Q: What is the difference between fee-for-service and value-based care?
A: Fee-for-service (FFS) reimburses providers for each service rendered, while value-
based care (VBC) incentivizes quality and efficiency by linking payments to patient
outcomes.
Q: What is the role of capitation in healthcare payment models?
A: Capitation is a payment model where providers receive a fixed amount per patient
per month, encouraging cost-effective care management.
6. Ethical and Legal Issues in Healthcare
Q: What is the principle of beneficence in healthcare ethics?
A: Beneficence refers to the obligation to act in the best interest of patients by
promoting their well-being and preventing harm.
Q: What is informed consent, and why is it necessary?
A: Informed consent ensures that patients understand and voluntarily agree to
medical treatments or procedures after receiving full disclosure of risks, benefits,
and alternatives.
7. Healthcare Technology and Informatics
Q: What are the benefits of Electronic Health Records (EHRs)?
A: EHRs improve patient care by enabling efficient data sharing, reducing errors,
enhancing clinical decision-making, and supporting interoperability.
Q: What is telehealth, and how has it changed healthcare delivery?
A: Telehealth involves remote patient care through digital platforms, increasing
accessibility, reducing costs, and improving healthcare delivery in rural areas.8.
Public Health and Population Health
, Q: What is the difference between public health and population health?
A: Public health focuses on policies and interventions that protect the health of
entire communities, while population health examines health outcomes and
determinants within specific groups.
Q: What are the social determinants of health (SDOH)?
A: SDOH include factors like economic stability, education, healthcare access,
neighborhood environment, and social/community networks that influence health
outcomes.
9. Healthcare Accreditation and Quality Standards
Q: What is the role of The Joint Commission in healthcare?
A: The Joint Commission accredits healthcare organizations by ensuring compliance
with safety, quality, and performance standards.
Q: What is the Institute for Healthcare Improvement (IHI) Model for Improvement?
A: It is a framework that guides quality improvement in healthcare by using Plan-Do-
Study-Act (PDSA) cycles to test and implement changes.
10. Healthcare Leadership and Organizational Culture
Q: What are the key characteristics of situational leadership?
A: Situational leadership involves adapting leadership styles (directing, coaching,
supporting, or delegating) based on employees' skill levels and readiness.
Q: What is the importance of a just culture in healthcare?
A: A just culture promotes accountability while encouraging open reporting of errors
to improve safety without fear of punishment.
11. Healthcare Reimbursement and Insurance
Q: What is the difference between Medicare and Medicaid?
1. Healthcare Systems and Structures
Q: What is the primary function of the Centers for Medicare & Medicaid Services
(CMS)?
A: CMS oversees the administration of Medicare, Medicaid, and the Children’s
Health Insurance Program (CHIP), ensuring compliance with federal healthcare
regulations.
Q: What is the difference between for-profit and non-profit healthcare
organizations?
,A: For-profit hospitals generate revenue for shareholders and investors, while non-
profit hospitals reinvest earnings into improving healthcare services and community
benefits.
2. Healthcare Policies and Regulations
Q: What is the purpose of the Affordable Care Act (ACA)?
A: The ACA aims to increase healthcare access, reduce costs, and improve quality by
expanding Medicaid, creating insurance marketplaces, and preventing coverage
denials due to pre-existing conditions.
Q: What is HIPAA and why is it important?
A: The Health Insurance Portability and Accountability Act (HIPAA) protects patient
privacy by setting standards for electronic healthcare transactions and ensuring
confidentiality of medical records.
3. Leadership and Management in Healthcare
Q: Describe transformational leadership in healthcare.
A: Transformational leaders inspire and motivate employees by fostering a shared
vision, encouraging innovation, and promoting personal and professional
development.
Q: What is the difference between transactional and servant leadership?
A: Transactional leadership focuses on structure, rewards, and punishments to
ensure performance, whereas servant leadership prioritizes employee well-being
and growth, fostering a supportive work environment.
4. Healthcare Quality and Patient Safety
Q: What are key components of the Triple Aim in healthcare?
A: The Triple Aim focuses on improving patient experience, reducing costs, and
enhancing population health.
Q: What is root cause analysis (RCA) in healthcare?
,A: RCA is a systematic method used to investigate errors, identify underlying causes,
and implement corrective actions to prevent recurrence.
5. Healthcare Economics and Finance
Q: What is the difference between fee-for-service and value-based care?
A: Fee-for-service (FFS) reimburses providers for each service rendered, while value-
based care (VBC) incentivizes quality and efficiency by linking payments to patient
outcomes.
Q: What is the role of capitation in healthcare payment models?
A: Capitation is a payment model where providers receive a fixed amount per patient
per month, encouraging cost-effective care management.
6. Ethical and Legal Issues in Healthcare
Q: What is the principle of beneficence in healthcare ethics?
A: Beneficence refers to the obligation to act in the best interest of patients by
promoting their well-being and preventing harm.
Q: What is informed consent, and why is it necessary?
A: Informed consent ensures that patients understand and voluntarily agree to
medical treatments or procedures after receiving full disclosure of risks, benefits,
and alternatives.
7. Healthcare Technology and Informatics
Q: What are the benefits of Electronic Health Records (EHRs)?
A: EHRs improve patient care by enabling efficient data sharing, reducing errors,
enhancing clinical decision-making, and supporting interoperability.
Q: What is telehealth, and how has it changed healthcare delivery?
A: Telehealth involves remote patient care through digital platforms, increasing
accessibility, reducing costs, and improving healthcare delivery in rural areas.8.
Public Health and Population Health
, Q: What is the difference between public health and population health?
A: Public health focuses on policies and interventions that protect the health of
entire communities, while population health examines health outcomes and
determinants within specific groups.
Q: What are the social determinants of health (SDOH)?
A: SDOH include factors like economic stability, education, healthcare access,
neighborhood environment, and social/community networks that influence health
outcomes.
9. Healthcare Accreditation and Quality Standards
Q: What is the role of The Joint Commission in healthcare?
A: The Joint Commission accredits healthcare organizations by ensuring compliance
with safety, quality, and performance standards.
Q: What is the Institute for Healthcare Improvement (IHI) Model for Improvement?
A: It is a framework that guides quality improvement in healthcare by using Plan-Do-
Study-Act (PDSA) cycles to test and implement changes.
10. Healthcare Leadership and Organizational Culture
Q: What are the key characteristics of situational leadership?
A: Situational leadership involves adapting leadership styles (directing, coaching,
supporting, or delegating) based on employees' skill levels and readiness.
Q: What is the importance of a just culture in healthcare?
A: A just culture promotes accountability while encouraging open reporting of errors
to improve safety without fear of punishment.
11. Healthcare Reimbursement and Insurance
Q: What is the difference between Medicare and Medicaid?
