WGU D391 Exam Questions and Answers Latest Update

WGU D391 Exam Questions and Answers Latest Update healthcare ecosystem - Answers a system composed of elements that create a community healthcare system - Answers an organization of individuals, institutions, and resources that deliver services to clients stakeholders - Answers a group of people with a common interest, especially in a business provider - Answers a person or institution that performs a service; for example, a healthcare worker performs health services. healthcare producers - Answers diverse individuals with various skills and knowledge who provide services to patients product - Answers multiple client services and treatment in the healthcare system licensure - Answers education and qualifications for healthcare providers payers - Answers individuals or organizations who cover the costs of healthcare services, either through self-pay or insurance companies purchasers - Answers an individual or organization that purchases healthcare coverage on behalf of their employees investors - Answers individuals or organizations who invest in healthcare services National Committee for Quality Assurance (NCQA) - Answers monitors payer organizations Joint Commission on Accreditation of Healthcare Organizations (JCAHO) - Answers helps improve and monitor providers' quality of care U.S. Department of Health and Human Services - Answers government organization that protects consumers from harm government regulations - Answers helps reduce harm to healthcare patients and employees health insurance - Answers payment for health services fee-for-service - Answers providers receive payment for services performed health maintenance organizations - 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 - 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 - Answers payments such as deductibles, premiums, and co-pays Moral hazards - 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 - 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 - Answers provider of service awards for quality patient care wellness and prevention - Answers reduce cost and improve patient outcomes legislation - Answers standardizes care and protects patients Affordable Care Act - Answers a law that states everyone in the United States can receive affordable, accessible, quality care Medicare - Answers health insurance for people over age 65 and people on social security disability reimbursement - Answers funds paid to providers for services rendered Food and Drug Administration (FDA) - Answers approves food, drugs, biological products, and medical devices Federal Trade Commission (FTC) - Answers federal agency responsible for enforcing antitrust laws and preventing monopolies from developing Medicaid - Answers insurance for the low socioeconomic population Children Health Insurance Program (CHIP) - Answers insurance for families with children that do not qualify for Medicaid group health insurance - Answers insurance offered by an employer or union health savings account - Answers tax-free financial healthcare account that pays for future medical expenses cost sharing - Answers Healthcare payments are shared by the insured and the company. premiums - Answers monthly payments for health insurance self-pay - Answers paying for medical care up-front efficiency - Answers obtaining the most significant health benefit in a way that minimizes costs and resource use quality - Answers evidence-based care that delivers positive outcomes SHARE approach - Answers a decision-making framework involving a client and care providers S: seek your patient's participation