HADM 3000 FINAL EXAM QUESTIONS
& ANSWERS RATED 100%
CORRECT!!!
what had the greatest impact on the expansion of hospitals? CORRECT ANSWERS
once hospitals became institutions of medial practice, serving the needs of all members
of society and making a profit.
Volume of surgical work, which at that time could be done only in hospitals.
Congress passing the Hospital survey and construction act of 1946 aka Hill-Burton Act
Difference between federal hospitals that are public hospitals but why they aren't
community hospitals CORRECT ANSWERS community hospitals- nonfederal, short-
stay, services are available to the public (85% of hospitals)
public hospitals- connotes government ownership, hospitals owned by agencies of
federal state, or local governments(25% of hospitals) more speciality hospitals
Difference between general hospitals and speciality hospitals CORRECT ANSWERS
(The difference lies in the nature of services rather than the quality)
General hospitals- provides diagnostic, treatment, and surgical services for patients with
a variety of acute medical conditions
Speciality hospitals- admit only certain types of patients or those with specified illnesses
of conditions; specifically tuberculosis, psychiatric, rehab, children's hospitals.
Review information about mental health, where its received and who is more likely to
need it CORRECT ANSWERS ranks second as a nationwide burden on health and
productivity. services are provided by the de facto system which combines specialized
services with generalized counseling services. Homeless & women (anxiety, eating,
depression). Services provided in Psychiatric Hospitals (speciality hospitals)
What type of reimbursement method involves a fixed monthly payment- CORRECT
ANSWERS captation; is used by HMO's under managed care. Under this
reimbursement scheme a provider is paid a set monthly fee per enrollee, regardless of
whether the enrollee sees the provider or not, and regardless of how often an enrollee
sees the provider
Discussion of utilization of uninsurance companies, which has the tightest control?
CORRECT ANSWERS HMO's employ higher utilization controls than other types of
managed care plans. The methods most commonly used for utilization monitoring are
gatekeeping and utilization review
Managed care defined CORRECT ANSWERS a mechanism of providing health care
services in which a single organization takes on the management of financing,
insurance, delivery, and payment
, 3 Main approaches to monitor and control the utilization of services CORRECT
ANSWERS 1.expert evaluation of which services are medically necessary in a given
case
2. determination of how services can be provided most inexpensively while maintaining
acceptable standards of quality
3. review of the process of care and changes in the patient's condition to revise the
course of medical treatment if necessary
Gate keeping Method CORRECT ANSWERS requires a primary care physician to
coordinate all health care services needed by the enrollee. emphasizes preventative
care, routine physical examinations, and other primary care services that are delivered
by the primary care gatekeeper. Secondary care services, such as diagnostic testing,
consultation from specialists, and admission to a hospital are provided only a referral
from the gatekeeper. In this way, the gatekeeper controls access to costly medical
services.
Concurrent, prospective and retrospective utilization CORRECT ANSWERS
Prospective (before you get there) (to prevent unnecessary institutionalization, such as
surgery)
Concurrent (if you go to EAMC, someone will be looking @ chart while you're there)
(monitoring the length of inpatient stays/discharging)
Retrospective (after you leave)
Medicare managed care option; part C what is it called? CORRECT ANSWERS
Medicare Advantage, extra benefits such as basic dental and vision benefits, helps with
out of pocket costs.
Why is long term care special? what is it about long term care that makes it different?
CORRECT ANSWERS individualized- well coordinated services that promote the max
possible independence for people with functional limitations and are provided over an
extended period of time in accordance with a holistic approach, while maximizing their
quality of life.
word for end of life care that is not hospice CORRECT ANSWERS palliative care
Long term care facilities and what is important CORRECT ANSWERS not restricted to
the elderly; anyone with a chronic condition
- associated with nursing homes, skilled nursing facilities, subacute care facilities,
specialized care facilities
other long term facilities CORRECT ANSWERS community based LTC, Home Health
Care, Adult Day-Care, Senior Centers, Home-delivered and congregate meals,
Handyman services, emergency response systems, retirement facilities, Personal care
facilities, skilled nursing facilities, subacute care facilities
& ANSWERS RATED 100%
CORRECT!!!
what had the greatest impact on the expansion of hospitals? CORRECT ANSWERS
once hospitals became institutions of medial practice, serving the needs of all members
of society and making a profit.
Volume of surgical work, which at that time could be done only in hospitals.
Congress passing the Hospital survey and construction act of 1946 aka Hill-Burton Act
Difference between federal hospitals that are public hospitals but why they aren't
community hospitals CORRECT ANSWERS community hospitals- nonfederal, short-
stay, services are available to the public (85% of hospitals)
public hospitals- connotes government ownership, hospitals owned by agencies of
federal state, or local governments(25% of hospitals) more speciality hospitals
Difference between general hospitals and speciality hospitals CORRECT ANSWERS
(The difference lies in the nature of services rather than the quality)
General hospitals- provides diagnostic, treatment, and surgical services for patients with
a variety of acute medical conditions
Speciality hospitals- admit only certain types of patients or those with specified illnesses
of conditions; specifically tuberculosis, psychiatric, rehab, children's hospitals.
Review information about mental health, where its received and who is more likely to
need it CORRECT ANSWERS ranks second as a nationwide burden on health and
productivity. services are provided by the de facto system which combines specialized
services with generalized counseling services. Homeless & women (anxiety, eating,
depression). Services provided in Psychiatric Hospitals (speciality hospitals)
What type of reimbursement method involves a fixed monthly payment- CORRECT
ANSWERS captation; is used by HMO's under managed care. Under this
reimbursement scheme a provider is paid a set monthly fee per enrollee, regardless of
whether the enrollee sees the provider or not, and regardless of how often an enrollee
sees the provider
Discussion of utilization of uninsurance companies, which has the tightest control?
CORRECT ANSWERS HMO's employ higher utilization controls than other types of
managed care plans. The methods most commonly used for utilization monitoring are
gatekeeping and utilization review
Managed care defined CORRECT ANSWERS a mechanism of providing health care
services in which a single organization takes on the management of financing,
insurance, delivery, and payment
, 3 Main approaches to monitor and control the utilization of services CORRECT
ANSWERS 1.expert evaluation of which services are medically necessary in a given
case
2. determination of how services can be provided most inexpensively while maintaining
acceptable standards of quality
3. review of the process of care and changes in the patient's condition to revise the
course of medical treatment if necessary
Gate keeping Method CORRECT ANSWERS requires a primary care physician to
coordinate all health care services needed by the enrollee. emphasizes preventative
care, routine physical examinations, and other primary care services that are delivered
by the primary care gatekeeper. Secondary care services, such as diagnostic testing,
consultation from specialists, and admission to a hospital are provided only a referral
from the gatekeeper. In this way, the gatekeeper controls access to costly medical
services.
Concurrent, prospective and retrospective utilization CORRECT ANSWERS
Prospective (before you get there) (to prevent unnecessary institutionalization, such as
surgery)
Concurrent (if you go to EAMC, someone will be looking @ chart while you're there)
(monitoring the length of inpatient stays/discharging)
Retrospective (after you leave)
Medicare managed care option; part C what is it called? CORRECT ANSWERS
Medicare Advantage, extra benefits such as basic dental and vision benefits, helps with
out of pocket costs.
Why is long term care special? what is it about long term care that makes it different?
CORRECT ANSWERS individualized- well coordinated services that promote the max
possible independence for people with functional limitations and are provided over an
extended period of time in accordance with a holistic approach, while maximizing their
quality of life.
word for end of life care that is not hospice CORRECT ANSWERS palliative care
Long term care facilities and what is important CORRECT ANSWERS not restricted to
the elderly; anyone with a chronic condition
- associated with nursing homes, skilled nursing facilities, subacute care facilities,
specialized care facilities
other long term facilities CORRECT ANSWERS community based LTC, Home Health
Care, Adult Day-Care, Senior Centers, Home-delivered and congregate meals,
Handyman services, emergency response systems, retirement facilities, Personal care
facilities, skilled nursing facilities, subacute care facilities
