CWRU NTRN 201 Exam 1 Study Guide QUESTIONS AND CORRECT ANSWERS | ALREADY
GRADED A+ WITH COMPLETE SOLUTIONS
Safe
Effective
Patient Centered
Timely
Equitable - Identify elements of a well-functioning health care delivery system
Establish a national focus
Identifying and learning from errors
Raising performance standards and expectations
Implementing safety systems in health care organizations
pay for
performance
penalties for excess readmissions - Describe strategies to increase access to affordable, high-
quality care.
Until recently, physicians were private/solo and had fee-for-service practice
Most hospitals were not-for-profit, and physicians held a lot of power over hospitals because
they were not employees
,Physicians had a lot of power because hospitals depended on physicians to admit patients or
refer them for treatment
The fee-for-service arrangement caused financial incentive for physicians doing more care, not
necessarily better care - Compare and contrast these health care delivery systems:
physicians and hospitals
-Late 1800s, Mayo Clinic founded in Rochester, MN.
-Physicians of different specialties came together and shared income, expenses, facilities, ect. To
provide better, more comprehensive care
-Serve specific communities - Compare and contrast these health care delivery systems:
multispecialty practice groups
-Regionalized services for vulnerable communities, emphasis on primary care and education.
-Goal is for everyone to have access to care regardless of ability to pay.
-Mary Breckenridge's clinic in rural KY was the first of its kind.
-Nurses provide primary care. - Compare and contrast these health care delivery systems:
community health centers
-Either no fee or co-payment required.
-Goal of primary care is reducing costs by preventing illness. Popular with managed care of large
employers.
-HMOs (health maintenance organizations) allow subscribers to receive medical services
required through a group of affiliated providers.
-PPOs (preferred provider organizations), allow third party payer (insurance company) to work
with a group of providers to provide cheaper services in return for prompt payment and
, guaranteed patient volumes - Compare and contrast these health care delivery systems:
prepaid group practices
-Originated from PPACA (patient protection and the affordable care act).
-Provide incentives for doing well coordinated, integrated care instead of high volume of
services.
-Made up of hospitals, primary care settings, specialty care practices. Only one bill for all
services received across all settings. - Compare and contrast these health care delivery
systems: accountable care organizations
-Enhanced primary care model providing coordinated, comprehensive, whole-person care.
-1960s, by American Academy of Pediatrics, became common in 2007 under PCMH (patient-
centered _______ _____) view.
-Advancement of nursing homes, raising standards since 2012. - Compare and contrast
these health care delivery systems: medical homes
Agency for Healthcare Research and Quality (AHRQ) defines a ________ ______________ as:
-a PCMH, and other clinicians, providing care for patients within the nursing home as well as
community and service organizations as well as state and local public health agencies.
-Focusing on individual patient care while also incorporating community health needs as well as
aspects of population health. - Compare and contrast these health care delivery systems:
medical neighborhoods
Out-of-pocket payment
Individual private insurance
GRADED A+ WITH COMPLETE SOLUTIONS
Safe
Effective
Patient Centered
Timely
Equitable - Identify elements of a well-functioning health care delivery system
Establish a national focus
Identifying and learning from errors
Raising performance standards and expectations
Implementing safety systems in health care organizations
pay for
performance
penalties for excess readmissions - Describe strategies to increase access to affordable, high-
quality care.
Until recently, physicians were private/solo and had fee-for-service practice
Most hospitals were not-for-profit, and physicians held a lot of power over hospitals because
they were not employees
,Physicians had a lot of power because hospitals depended on physicians to admit patients or
refer them for treatment
The fee-for-service arrangement caused financial incentive for physicians doing more care, not
necessarily better care - Compare and contrast these health care delivery systems:
physicians and hospitals
-Late 1800s, Mayo Clinic founded in Rochester, MN.
-Physicians of different specialties came together and shared income, expenses, facilities, ect. To
provide better, more comprehensive care
-Serve specific communities - Compare and contrast these health care delivery systems:
multispecialty practice groups
-Regionalized services for vulnerable communities, emphasis on primary care and education.
-Goal is for everyone to have access to care regardless of ability to pay.
-Mary Breckenridge's clinic in rural KY was the first of its kind.
-Nurses provide primary care. - Compare and contrast these health care delivery systems:
community health centers
-Either no fee or co-payment required.
-Goal of primary care is reducing costs by preventing illness. Popular with managed care of large
employers.
-HMOs (health maintenance organizations) allow subscribers to receive medical services
required through a group of affiliated providers.
-PPOs (preferred provider organizations), allow third party payer (insurance company) to work
with a group of providers to provide cheaper services in return for prompt payment and
, guaranteed patient volumes - Compare and contrast these health care delivery systems:
prepaid group practices
-Originated from PPACA (patient protection and the affordable care act).
-Provide incentives for doing well coordinated, integrated care instead of high volume of
services.
-Made up of hospitals, primary care settings, specialty care practices. Only one bill for all
services received across all settings. - Compare and contrast these health care delivery
systems: accountable care organizations
-Enhanced primary care model providing coordinated, comprehensive, whole-person care.
-1960s, by American Academy of Pediatrics, became common in 2007 under PCMH (patient-
centered _______ _____) view.
-Advancement of nursing homes, raising standards since 2012. - Compare and contrast
these health care delivery systems: medical homes
Agency for Healthcare Research and Quality (AHRQ) defines a ________ ______________ as:
-a PCMH, and other clinicians, providing care for patients within the nursing home as well as
community and service organizations as well as state and local public health agencies.
-Focusing on individual patient care while also incorporating community health needs as well as
aspects of population health. - Compare and contrast these health care delivery systems:
medical neighborhoods
Out-of-pocket payment
Individual private insurance
