D391 || Questions and Correct Detailed Answers
healthcare ecosystem correct answers a system composed of elements that create a community
healthcare system correct answers an organization of individuals, institutions, and resources that
deliver services to clients
stakeholders correct answers a group of people with a common interest, especially in a business
provider correct answers a person or institution that performs a service; for example, a healthcare
worker performs health services.
healthcare producers correct answers diverse individuals with various skills and knowledge who
provide services to patients
product correct answers multiple client services and treatment in the healthcare system
licensure correct answers education and qualifications for healthcare providers
payers correct answers individuals or organizations who cover the costs of healthcare services,
either through self-pay or insurance companies
purchasers correct answers an individual or organization that purchases healthcare coverage on
behalf of their employees
investors correct answers individuals or organizations who invest in healthcare services
National Committee for Quality Assurance (NCQA) correct answers monitors payer
organizations
,Joint Commission on Accreditation of Healthcare Organizations (JCAHO) correct answers helps
improve and monitor providers' quality of care
U.S. Department of Health and Human Services correct answers government organization that
protects consumers from harm
government regulations correct answers helps reduce harm to healthcare patients and employees
health insurance correct answers payment for health services
fee-for-service correct answers providers receive payment for services performed
health maintenance organizations correct answers a model in which providers are paid capitation
payments, restricting patients to a preferred list of providers and controlling access to care
insurance risk correct answers an event covered by insurance; the risk of payment is borne by the
insurer, so insurance companies work hard to manage risk for both individuals and groups
insurance expenses correct answers payments such as deductibles, premiums, and co-pays
Moral hazards correct answers situation in which individual incurs no consequence for a
decision, allowing for extravagant choices such as using more medical services than are
necessary
adverse selection correct answers in insurance terms, a situation in which the insured person has
information that the insurer does not have, gaining coverage at a cost below the true level of risk
value-based care correct answers provider of service awards for quality patient care
,wellness and prevention correct answers reduce cost and improve patient outcomes
legislation correct answers standardizes care and protects patients
Affordable Care Act correct answers a law that states everyone in the United States can receive
affordable, accessible, quality care
Medicare correct answers health insurance for people over age 65 and people on social security
disability
reimbursement correct answers funds paid to providers for services rendered
Food and Drug Administration (FDA) correct answers approves food, drugs, biological products,
and medical devices
Federal Trade Commission (FTC) correct answers federal agency responsible for enforcing
antitrust laws and preventing monopolies from developing
Medicaid correct answers insurance for the low socioeconomic population
Children Health Insurance Program (CHIP) correct answers insurance for families with children
that do not qualify for Medicaid
group health insurance correct answers insurance offered by an employer or union
health savings account correct answers tax-free financial healthcare account that pays for future
medical expenses
, cost sharing correct answers Healthcare payments are shared by the insured and the company.
premiums correct answers monthly payments for health insurance
self-pay correct answers paying for medical care up-front
efficiency correct answers obtaining the most significant health benefit in a way that minimizes
costs and resource use
quality correct answers evidence-based care that delivers positive outcomes
SHARE approach correct answers a decision-making framework involving a client and care
providers
S: seek your patient's participation
H: help your patient explore and compare treatment options
A: assess your patient's values and preferences
R: reach a decision with your patient
E: evaluate your patient's decision
DECIDE model correct answers a decision-making approach that involves six different activities
Defining the problem,
Exploring alternatives,
Considering the consequences, Identifying values,
Deciding and acting,
Evaluating the decision.
healthcare ecosystem correct answers a system composed of elements that create a community
healthcare system correct answers an organization of individuals, institutions, and resources that
deliver services to clients
stakeholders correct answers a group of people with a common interest, especially in a business
provider correct answers a person or institution that performs a service; for example, a healthcare
worker performs health services.
healthcare producers correct answers diverse individuals with various skills and knowledge who
provide services to patients
product correct answers multiple client services and treatment in the healthcare system
licensure correct answers education and qualifications for healthcare providers
payers correct answers individuals or organizations who cover the costs of healthcare services,
either through self-pay or insurance companies
purchasers correct answers an individual or organization that purchases healthcare coverage on
behalf of their employees
investors correct answers individuals or organizations who invest in healthcare services
National Committee for Quality Assurance (NCQA) correct answers monitors payer
organizations
,Joint Commission on Accreditation of Healthcare Organizations (JCAHO) correct answers helps
improve and monitor providers' quality of care
U.S. Department of Health and Human Services correct answers government organization that
protects consumers from harm
government regulations correct answers helps reduce harm to healthcare patients and employees
health insurance correct answers payment for health services
fee-for-service correct answers providers receive payment for services performed
health maintenance organizations correct answers a model in which providers are paid capitation
payments, restricting patients to a preferred list of providers and controlling access to care
insurance risk correct answers an event covered by insurance; the risk of payment is borne by the
insurer, so insurance companies work hard to manage risk for both individuals and groups
insurance expenses correct answers payments such as deductibles, premiums, and co-pays
Moral hazards correct answers situation in which individual incurs no consequence for a
decision, allowing for extravagant choices such as using more medical services than are
necessary
adverse selection correct answers in insurance terms, a situation in which the insured person has
information that the insurer does not have, gaining coverage at a cost below the true level of risk
value-based care correct answers provider of service awards for quality patient care
,wellness and prevention correct answers reduce cost and improve patient outcomes
legislation correct answers standardizes care and protects patients
Affordable Care Act correct answers a law that states everyone in the United States can receive
affordable, accessible, quality care
Medicare correct answers health insurance for people over age 65 and people on social security
disability
reimbursement correct answers funds paid to providers for services rendered
Food and Drug Administration (FDA) correct answers approves food, drugs, biological products,
and medical devices
Federal Trade Commission (FTC) correct answers federal agency responsible for enforcing
antitrust laws and preventing monopolies from developing
Medicaid correct answers insurance for the low socioeconomic population
Children Health Insurance Program (CHIP) correct answers insurance for families with children
that do not qualify for Medicaid
group health insurance correct answers insurance offered by an employer or union
health savings account correct answers tax-free financial healthcare account that pays for future
medical expenses
, cost sharing correct answers Healthcare payments are shared by the insured and the company.
premiums correct answers monthly payments for health insurance
self-pay correct answers paying for medical care up-front
efficiency correct answers obtaining the most significant health benefit in a way that minimizes
costs and resource use
quality correct answers evidence-based care that delivers positive outcomes
SHARE approach correct answers a decision-making framework involving a client and care
providers
S: seek your patient's participation
H: help your patient explore and compare treatment options
A: assess your patient's values and preferences
R: reach a decision with your patient
E: evaluate your patient's decision
DECIDE model correct answers a decision-making approach that involves six different activities
Defining the problem,
Exploring alternatives,
Considering the consequences, Identifying values,
Deciding and acting,
Evaluating the decision.
