WGU D050 HISTORY OF HEALTHCARE IN AMERICA OBJECTIVE ASSESSMENT ACTUAL EXAM STUDY GUIDE 2025/2026 ACCURATE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES || 100% GUARANTEED PASS <BRAND NEW VERSION>

WGU D050 HISTORY OF HEALTHCARE IN AMERICA OBJECTIVE ASSESSMENT ACTUAL EXAM STUDY GUIDE 2025/2026 ACCURATE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES || 100% GUARANTEED PASS &lt;BRAND NEW VERSION&gt; 1. When was healthcare first created in the United States? - ANSWER 1798 Act for Relief of the Sick and Disabled Seaman 2. What was created in 1915? - ANSWER American Association for Labor Legislation... created in the model bill 3. What was the precursor of Medicare and Medicaid? - ANSWER Social security passed in 1935 4. What are the three main goals of ACA? - ANSWER expand access to health insurance, reduce healthcare costs, support innovative delivery methods 5. What area *medicare or medicaid* was improved by the ACA? - ANSWER medicare 6. How many children were on CHIP as of Feb 2020? - ANSWER 6 million 7. What year was medicare and medicaid formed? - ANSWER 1965 8. What areas can Mezzo interactions influence? - ANSWER organizations, schools, buisnesses and political relms 9. What areas do Macro interactions influence? - ANSWER interactions between healthcare workers and patients/support systems of patients 10. When was Medicare and Medicaid established? - ANSWER 1965 by pres johnson as an amendment to the social security act 11. What is unique about Medicaid? - ANSWER federal matches funds given by state gov 12. audit post-payments procedures and claims. - ANSWER medicaid recovery audits 13. To avoid fraud, providers are required to submit all claims within - ANSWER one year of service; bundle billing 14. identifies diagnosing and treatment errors and recoups funds when errors are identified. - ANSWER comprehensive error rate testing 15. The insured person—the individual who purchases insurance from the insurance company - ANSWER Layer I 16. The insurance company and providers—the organization that manages the insurance policy - ANSWER Layer II 17. The insurance policy—the policy that is purchased by the first party and managed by the second party - ANSWER Layer III 18. Establishes new protocols for service and payment structures. - ANSWER office of attorney general 19. Represents the legality of third-party payments and offers legal enforcement of established practices. - ANSWER department of justifce 20. Regulates the accuracy of services rendered vs. services paid. - ANSWER dept of health and human services 21. What are third party audits regulated by? - ANSWER 2005 deficit reduction act 22. In substance abuse case planning, what should the care coordinator do? - ANSWER chief gatekeeper and main support system for pt, facilitate services/resources, involve the client, be community based and be flexible 23. What is the goal outcome for intensive case management? - ANSWER employability, housing, mental health stability, and social status, education, food 24. When did intensive based care originate? - ANSWER inception of mass deinstitutionalization 25. ICM has 5 main principles. what are they? - ANSWER family based, individually tailored, strengths-based, sustanibility and goal focused 26. What are the three main concepts of strength based care plans? - ANSWER self-worth, self-determination, and self-regulation 27. Where did the strength based care plan originate? - ANSWER University of Kansas due to failing health system 28. Intensive Case Management Model - ANSWER Treatment team, community based model focused on helping patient maintain life skills/ psychosocial needs (housing, employability, mental health, social status, life skills) 29. Intensive Case Management Model - ANSWER Family Focused provide support and education to families 30. Intensive Case Management Model - ANSWER Individually tailored multisystem perspectives provide individual based services by several treatment team members 31. Intensive Case Management Model - ANSWER Strength based - leveraging interventions based on patients strengths 32. Intensive Case Management Model - ANSWER Sustainability - sold problem solutions with independent mesaures 33. Intensive Case Management Model - ANSWER Goal focused - define clear goals and objectives monitor practice 34. Strengths Based Care Manager Model - ANSWER patient already has access to knowledge of resources 35. Strengths Based Care Manager Model - ANSWER Three primary concepts - self-worth, self-determination, self-regulation 36. Strengths Based Care Manager Model - ANSWER Characteristics of Strength-based approach: Enhances inner strengths, builds on established charactersicts 37. Advantages of Strength based care management model - ANSWER Quality of life for the patient improves, rather than becoming depended on a system, patient builds independence and becomes an effective problem solver. 38. Advantages of Strength based care management model - ANSWER Patients start to walk in their strengths and family view changes 39. Advantages of Strength based care management model - ANSWER Responsibility and accountability levels increase 40. Brokerage Case Management Model - ANSWER Brokering of resources between case manager and client 41. Brokerage Case Management Model - ANSWER Assess the clients immediate needs and then connects the client w/ list of available resources to meet those needs 42. Brokerage Case Management Model - ANSWER Sometimes called the generalist case management model 43. Clinical Case Management Model - ANSWER Focuses on the combination of services to deliver a tailored care plan 44. Clinical Case Management Model - ANSWER Case Manager is more hands on, or may coordinate the clients psychotherapist, physiotherapist, counselor, depending on what services the client needs. 45. Clinical Case Management Model - ANSWER Close relationship is formed between the client and the professional 46. Case Management Models Must: - ANSWER Offer single point of contact between the patient/client and the overall health/social system 47. Case Management Models Must: - ANSWER Provide social and/or clinical support services that are client-driven, whether by need or otherwise 48. Case Management Models Must: - ANSWER Involve patient/client advocacy 49. Case Management Models Must: - ANSWER Be community based 50. Case Management Models Must: - ANSWER Be pragmatic, anticipatory, flexible and culturally sensitive 51. What are the six main strengths of the strength based care plan? - ANSWER focus on patient not pathology, self-determination, community based resources, intervention should be aggressive, patients can learn/grown/change 52. What is the goal of the brokerage case model? - ANSWER assess client immediate needs and link them to community resources (broker a deal) 53. What is the brokerage case model also known as? - ANSWER generalist case management model 54. In 2018, how many children were covered under the Children's Health Insurance Program (CHIP)? - ANSWER 9 million 55. What year did Congress pass An Action for Relief of Sick and Disabled Seaman? - ANSWER 1798 56. In 1932, Blue Cross Networks was established in which American city? - ANSWER Sacramento 57. Which statement is true about COBRA? - ANSWER Allows employees to carry their own health insurance 58. What is social security? - ANSWER A federal program that provides healthcare to those who are retired, unemployed, disabled, widows, and/or child survivors of those eligible for services 59. Standard Gamble - ANSWER Determines the value of health/life expectancy by making simple conclusions based on actions 60. Time Trade Off - ANSWER Determines quality-adjusted life year(QALY) calculations and health outcome values 61. Scale - ANSWER Evaluates the type of healthcare services most effective for community interventions 62. Health Utility Index - ANSWER Measures general health and quality of life 63. EuroQoL - ANSWER This instrument measures health on avertical and visual analogue scale 64. Rosser and Kind Index - ANSWER Measures life quality and health status 65. Person Trade-Off - ANSWER Is an estimate of social values and healthcare interventions 66. Homeless - ANSWER working less than full time/without regular employment 67. Macro - ANSWER direct interactions between providers and patients 68. Social Factors - ANSWER norms, safety, access to community resources 69. Mezzo - ANSWER focus on smaller groups and institutions 70. Economic factors - ANSWER working poor, chronic homeless 71. Felons - ANSWER constantly denied the opportunity to rebuild 72. ESRD QIP (end stage renal disease quality incentive program) - ANSWER Promotes the use of outpatient dialysis centers to reduce inpatient treatment fees 73. HVBP (Hospital value based purchasing) - ANSWER This program forced hospitals to focus on patient care rather than the quantity of services 74. HRR (hospital readmission reduction) - ANSWER When patients are readmitted, hospitals receive fines/lower service costs for duplicate services 75. VM (value modifier) - ANSWER Measures service quality and adjusts provide payments based on patient outcomes 76. HAC (hospital acquired condition) - ANSWER Incentives are based on the number of admissions that do not contract hospital-based illnesses 77. Which are the primary fee-for-service (FFS) payment systems? - ANSWER FFS Health Plans and Medicare FFS 78. Which fee-for-service model are lump-sum payments paid by nonprofit, for profit, and medical organizations? - ANSWER Membership fees 79. Which is an advantage of fee-for-service? - ANSWER Patients have the flexibility to schedule appointments with any doctor/provider 80. Which provision of value-based care is important when coordinating care for a patient with end-stage renal disease? - ANSWER Provide the best care at the lowest cost. 81. Which action could a healthcare coordinator take when providing value based care to an obese patient? - ANSWER Provide follow-up communication to support adoption of healthy behavior changes. 82. A care coordinator is explaining value-based care to a patient with cancer. Which statement should be included in the teaching? - ANSWER "This model provides incentives to providers based on patient health outcomes." 83. Value based healthcare - ANSWER a system in which healthcare providers (doctors and hospitals) are paid based on patient health outcomes. 84. Act for the Relief of Sick and Disabled Seamen - ANSWER that required privately employed sailors to purchase health insurance. To pay for this healthcare, the government taxed sailors' wages 1% 85. Model Bill - ANSWER This bill provided comprehensive benefits for low-income workers, coordination of insurance companies, and the concept of premium contributions by employers, employees, and the state. 86. Blue Cross and Blue Shield - ANSWER established in Sacramento 1932 under the AMA 87. Social Security Act of 1935 - ANSWER federal insurance program that provides benefits to individuals who are retired, unemployed, disabled, and widows and/or child survivors of parents who were eligible due to their employment history 88. Medicare - ANSWER benefits to those over the age of 65 and those who are disabled, and sufferers of end-stage renal disease. 89. Medicaid - ANSWER which is both federally and state-funded, provides benefits to low-income families, pregnant women, those with disabilities, and those in need of long-term care. 90. Hill-Burton Act - ANSWER This act allowed hospitals to receive money to modernize hospitals, in exchange for providing free or reduced services to patients who were unable to pay 91. Consolidated Omnibus Budget Reconciliation Act (COBRA) - ANSWER allow employees to carry their insurance coverage in the event they were no longer covered by the company's health insurance plan. 92. Health Insurance Portability and Accountability Act (HIPAA) in 1996 - ANSWER his allowed for more privacy standards and changed how group health plans handle preexisting conditions. 93. Children's Health Insurance Program (CHIP) - ANSWER which helped uninsured children up to the age of 19. state-administered program that follows federal regulations. 94. Macro level - ANSWER as the allocation and utilization of resources within healthcare settings as a whole. 95. Meta-level - ANSWER The healthcare decisions that are made by politicians and healthcare administrators to support large populations. Service delivery is balanced by financial and humanitarian aspects of care. 96. Macro-level - ANSWER Decisions about best practices to allocate resources within a region, organization, and hospital. These decisions help identify large group healthcare needs. 97. Meso-level - ANSWER Decisions on optimal treatment policies. These are clinical decisions made by clinical organizations/associations on the effective treatment methods. Decisions on the individuals who receive treatment are determined as well. 98. Micro-level - ANSWER Decisions based on individual patient needs and conditions. Patient preferences are solicited and incorporated with clinical decisions to result in final treatment decisions. 99. Macro realm - ANSWER Macro involves direct interactions between healthcare providers (doctors, direct care staff, nurses, etc.) and patients/patient support systems (families, other providers, loved ones, etc.). Marco connections are small scale and individual-based. 100. Mezzo realm - ANSWER Mezzo interactions occur on a larger scale than macro factors with a focus on smaller groups and institutions. Mezzo concepts are used on large-scale problems in organizations, schools, businesses, and political realms. Mezzo involves implementing social service initiatives to support healthcare access on the community and institutional levels. 101. Shared Risks - ANSWER This type requires healthcare organizations to focus on below-market spending and high-quality outcomes. 102. Bundles - ANSWER This cost-cutting type significantly reduces patient expenditure by combining services. 103. Global capitation - ANSWER This is a contract system in which patients share long- and short-term medical costs. Patients pay monthly fees as a shared-cost initiative. 104. Shared savings - ANSWER This value-based payment type is a target-based budget system. Healthcare organizations gain incentives when their services are deemed to be high-quality with positive patient outcomes. 105. FFS (fee for service) - ANSWER a healthcare payment model that bills patients for each service (tests, procedures, and treatments) rather than bundling the billing. This system rewards physicians based on the volume of services provided, despite the outcome of service delivery. 106. FFS Health Plans - ANSWER Commonly referred to as indemnity plans, these are individualized health plans that give patients the ability to choose their care providers and treatment placements (residential, hospital, etc.). These plans have high out-of-pocket expenses, requiring patients to pay up-front fees and submit bills for reimbursements. 107. Medicare FFS - ANSWER This two-part insurance program contains hospital insurance (surgeries, hospice, and nursing home care) and supplementary medical insurance (outpatient care, medical equipment, prevention treatments, etc.). Medicare FFS is a government-funded