Healthcare Administration Evolution, Systems and Leadership
Questions and Answers
1. health care: an act or deed between the healthcare provider and the patient to
maintain or improve the patient's healthcare status
2. biomedical model: a theoretical framework in healthcare that views illness and
disease as primarily resulting from biological factors
3. holistic health: an approach to wellness that simultaneously addresses the
physical, mental, emotional, social, and spiritual components of health
4. holistic medicine: the practice of healthcare professionals using a diverse range
of disciplines, religious philosophies, and cultural practices to heal individuals,
communities, and the environment
5. functional organizational structure: The organization is split into departments
based on the employees' expertise, such as the manager or chief executive officer,
commercial and marketing, finance, accounting, managerial, facilities, etc.
6. functional organizational structure advantages: -Enhanced coordination &
control
-Centralized decision-making
-Enhanced organizational-level perspective
-More efficient use of managerial & technical talent
-Facilitated career paths in specialized areas
7. functional organizational structure disadvantages: Specialization can lead to
departments operating in silos
Potential for decreased communication
Narrow business perspectives
8. multi-divisional organizational structure: The chief corporation comprises sev-
eral smaller business units or divisions based on geographic locations, products, or
services so that the daily processes or functions occur at the unit or divisional level,
allowing the separate units or divisions to operate independently
9. multi-divisional organizational structure advantages: Ability to hold corporate
executives accountable for the results of local operations that are within their control
10. multi-divisional organizational structure disadvantages: Duplication of func-
tions, such as products and services across divisions, which threatens the quality
and costs of healthcare
Increased operational costs due to the inability to achieve economies of scale
Leads to a lack of standardization and inefficiencies
11. Matrix organizational structure: comprises the functional structure and a tem-
porary project structure, which requires using two managers simultaneously
12. Matrix organizational structure advantages: Clearly defined project objec-
tives
Seamless integration of project and functional objectives
Efficient use of limited human resources
, Healthcare Administration Evolution, Systems and Leadership
Questions and Answers
Fluid streaming of information throughout the project
Prompt diffusion of team members back into the functional organization upon project
completion without organizational disruption
Ability of functional management to handle conflicts arising at the project level
13. Matrix organizational structure disadvantages: Increases the complexity of
the organization
Problems derived from having employees answer to too many bosses and having
conflicting managerial directives
Difficulty in establishing priorities for functional and project management
Delay in management reactions
14. accountable care organization (ACO): a network of doctors, hospitals, and
other healthcare providers that voluntarily come together to provide coordinated,
high-quality care to their patients
15. managed care organization (MCO): a type of healthcare delivery system that
aims to manage the cost, quality, and accessibility of healthcare services; MCOs
are commonly associated with HMOs, PPOs, and POS plans
16. delivery: the provision of healthcare services by various providers in exchange
for payment for services rendered
17. health maintenance organization: a type of managed care organization that
provides health insurance coverage through a network of healthcare providers who
offer services to members for a fixed fee
18. Integrated Delivery System (IDS): a network of organizations that provides or
arranges to provide an organized variety of services to specific populations and is
held accountable for the outcomes and health status of those populations
19. consumer-driven health plan (CDHP): (also known as a high-deductible health
plan) a type of health insurance plan that encourages individuals to manage their
healthcare costs
20. Fee-for-service (FFS): a system wherein healthcare is provided as individual
units of service, such as magnetic resonance imaging (MRI) or other X-ray, medical
examination, flu shot, or other service
21. preferred provider: a type of organization that provides services based on
contracts with groups of physicians and hospitals that are referred to as preferred
providers
22. First contact as the gateway to the healthcare system.: primary care
23. Occur when needed after the patient has been seen at primary care.: spe-
cialty care
24. In integrated systems such as managed care, Primary care physicians
(PCP) serve as: gatekeepers to control cost, usage of services, and allocation of
resources.
, Healthcare Administration Evolution, Systems and Leadership
Questions and Answers
25. Treats the person holistically: primary care physicians
26. Trains in ambulatory care setting to learn how to treat many patient condi-
tions and diseases.: Primary care
27. public health services: services provided by local health departments, includ-
ing well-baby care, venereal disease clinics, family planning services, screening and
treatment for tuberculosis, and ambulatory mental health services
28. Which organizational structure used by healthcare facilities incorporates
a temporary project structure using a project and a department manager?: -
matrix
29. A rural clinic that provides services to families who lack access to ade-
quate healthcare has improved the quality and health status of this population.
A recent survey showed the patients are satisfied with the services.
Which type of healthcare organization is described in this scenario?: account-
able care organization (ACO)
30. Which type of healthcare financing includes savings options such as a
health savings account or a health reimbursement account?: consumer-driven
health plan
31. health insurance marketplace: system established to facilitate the purchase
of health insurance in organized markets (also referred to as health insurance
exchanges)
32. consumerism: the trend of patients increasingly acting as consumers who
make informed choices about their healthcare services based on quality, cost, and
other factors
33. Radio Frequency Identification (RFID): a technology used in healthcare to
track and manage medical equipment, pharmaceuticals, and sometimes patient
information, using radio waves for automatic identification and tracking
34. Information Technology (IT): the use of digital technologies, like EHRs and
telemedicine, for managing patient information, delivering healthcare services, and
supporting decision-making processes
35. Affordable Care Act (ACA): Enacted in 2010, the ACA aimed to increase the
quality and affordability of health insurance. It expanded Medicaid, created health
insurance marketplaces, and implemented regulations prohibiting insurers from
denying coverage due to pre-existing conditions
36. Food and Drug Administration Safety and Innovation Act (FDASIA): Enact-
ed in 2012, FDASIA aimed to enhance the regulation of medical products by the
FDA. It included provisions to expedite the review of new drugs and medical devices,
improve drug safety monitoring, and strengthen the FDA's authority to regulate
drug-compounding pharmacies.
, Healthcare Administration Evolution, Systems and Leadership
Questions and Answers
37. Health Information Technology for Economic and Clinical Health Act
(HITECH Act): Enacted in 2009, the HITECH Act promotes the adoption and mean-
ingful use of electronic health records (EHRs) and strengthens HIPAA privacy and
security provisions related to electronic health information
38. Consolidated Omnibus Budget Reconciliation Act (COBRA): enacted in
1985, requires employers with 20 or more employees to offer temporary continu-
ation of health coverage to eligible employees and their dependents after certain
qualifying events, such as job loss or reduced hours.
39. Emergency Medical Treatment and Labor Act (EMTALA): enacted in 1986,
requires hospitals that participate in Medicare to provide emergency medical treat-
ment to individuals regardless of their ability to pay or insurance status
40. False Claims Act (FCA): a federal law that prohibits knowingly submitting false
or fraudulent claims for payment to the government, including claims submitted
to Medicare, Medicaid, and other federal healthcare programs, whether directly or
indirectly
41. Federal Anti-Kickback Statute (AKS): a federal criminal law that prohibits
exchanging anything of value in return for referrals or recommendations for items
or services covered by federal healthcare programs, such as Medicare or Medicaid.
42. Stark Law: also known as the Physician Self-Referral Law, prohibits physicians
from referring Medicare or Medicaid patients to entities with which they have a
financial relationship for certain designated health services.
43. The Joint Commission on Accreditation of Healthcare Organizations (JC-
AHO): now known simply as The Joint Commission, is a nonprofit organization that
accredits and certifies healthcare organizations and programs in the United States
44. Centers for Medicare and Medicaid Services (CMS): a federal agency within
the U.S. Department of Health and Human Services that administers Medicare and
Medicaid programs
45. Agency for Healthcare Research and Quality (AHRQ): a federal agency
within the U.S. Department of Health and Human Services that conducts research
and provides evidence-based information to improve healthcare quality, safety,
efficiency, and effectiveness
46. National Committee for Quality Assurance (NCQA): a private, nonprofit or-
ganization that accredits and certifies healthcare organizations and programs in
the United States, focusing on quality measurement and improvement in healthcare
delivery
47. Accreditation Commission for Healthcare (ACHC): nonprofit organization
that accredits healthcare organizations and programs across various sectors, in-
cluding home health, hospice, pharmacy, and behavioral health.
Questions and Answers
1. health care: an act or deed between the healthcare provider and the patient to
maintain or improve the patient's healthcare status
2. biomedical model: a theoretical framework in healthcare that views illness and
disease as primarily resulting from biological factors
3. holistic health: an approach to wellness that simultaneously addresses the
physical, mental, emotional, social, and spiritual components of health
4. holistic medicine: the practice of healthcare professionals using a diverse range
of disciplines, religious philosophies, and cultural practices to heal individuals,
communities, and the environment
5. functional organizational structure: The organization is split into departments
based on the employees' expertise, such as the manager or chief executive officer,
commercial and marketing, finance, accounting, managerial, facilities, etc.
6. functional organizational structure advantages: -Enhanced coordination &
control
-Centralized decision-making
-Enhanced organizational-level perspective
-More efficient use of managerial & technical talent
-Facilitated career paths in specialized areas
7. functional organizational structure disadvantages: Specialization can lead to
departments operating in silos
Potential for decreased communication
Narrow business perspectives
8. multi-divisional organizational structure: The chief corporation comprises sev-
eral smaller business units or divisions based on geographic locations, products, or
services so that the daily processes or functions occur at the unit or divisional level,
allowing the separate units or divisions to operate independently
9. multi-divisional organizational structure advantages: Ability to hold corporate
executives accountable for the results of local operations that are within their control
10. multi-divisional organizational structure disadvantages: Duplication of func-
tions, such as products and services across divisions, which threatens the quality
and costs of healthcare
Increased operational costs due to the inability to achieve economies of scale
Leads to a lack of standardization and inefficiencies
11. Matrix organizational structure: comprises the functional structure and a tem-
porary project structure, which requires using two managers simultaneously
12. Matrix organizational structure advantages: Clearly defined project objec-
tives
Seamless integration of project and functional objectives
Efficient use of limited human resources
, Healthcare Administration Evolution, Systems and Leadership
Questions and Answers
Fluid streaming of information throughout the project
Prompt diffusion of team members back into the functional organization upon project
completion without organizational disruption
Ability of functional management to handle conflicts arising at the project level
13. Matrix organizational structure disadvantages: Increases the complexity of
the organization
Problems derived from having employees answer to too many bosses and having
conflicting managerial directives
Difficulty in establishing priorities for functional and project management
Delay in management reactions
14. accountable care organization (ACO): a network of doctors, hospitals, and
other healthcare providers that voluntarily come together to provide coordinated,
high-quality care to their patients
15. managed care organization (MCO): a type of healthcare delivery system that
aims to manage the cost, quality, and accessibility of healthcare services; MCOs
are commonly associated with HMOs, PPOs, and POS plans
16. delivery: the provision of healthcare services by various providers in exchange
for payment for services rendered
17. health maintenance organization: a type of managed care organization that
provides health insurance coverage through a network of healthcare providers who
offer services to members for a fixed fee
18. Integrated Delivery System (IDS): a network of organizations that provides or
arranges to provide an organized variety of services to specific populations and is
held accountable for the outcomes and health status of those populations
19. consumer-driven health plan (CDHP): (also known as a high-deductible health
plan) a type of health insurance plan that encourages individuals to manage their
healthcare costs
20. Fee-for-service (FFS): a system wherein healthcare is provided as individual
units of service, such as magnetic resonance imaging (MRI) or other X-ray, medical
examination, flu shot, or other service
21. preferred provider: a type of organization that provides services based on
contracts with groups of physicians and hospitals that are referred to as preferred
providers
22. First contact as the gateway to the healthcare system.: primary care
23. Occur when needed after the patient has been seen at primary care.: spe-
cialty care
24. In integrated systems such as managed care, Primary care physicians
(PCP) serve as: gatekeepers to control cost, usage of services, and allocation of
resources.
, Healthcare Administration Evolution, Systems and Leadership
Questions and Answers
25. Treats the person holistically: primary care physicians
26. Trains in ambulatory care setting to learn how to treat many patient condi-
tions and diseases.: Primary care
27. public health services: services provided by local health departments, includ-
ing well-baby care, venereal disease clinics, family planning services, screening and
treatment for tuberculosis, and ambulatory mental health services
28. Which organizational structure used by healthcare facilities incorporates
a temporary project structure using a project and a department manager?: -
matrix
29. A rural clinic that provides services to families who lack access to ade-
quate healthcare has improved the quality and health status of this population.
A recent survey showed the patients are satisfied with the services.
Which type of healthcare organization is described in this scenario?: account-
able care organization (ACO)
30. Which type of healthcare financing includes savings options such as a
health savings account or a health reimbursement account?: consumer-driven
health plan
31. health insurance marketplace: system established to facilitate the purchase
of health insurance in organized markets (also referred to as health insurance
exchanges)
32. consumerism: the trend of patients increasingly acting as consumers who
make informed choices about their healthcare services based on quality, cost, and
other factors
33. Radio Frequency Identification (RFID): a technology used in healthcare to
track and manage medical equipment, pharmaceuticals, and sometimes patient
information, using radio waves for automatic identification and tracking
34. Information Technology (IT): the use of digital technologies, like EHRs and
telemedicine, for managing patient information, delivering healthcare services, and
supporting decision-making processes
35. Affordable Care Act (ACA): Enacted in 2010, the ACA aimed to increase the
quality and affordability of health insurance. It expanded Medicaid, created health
insurance marketplaces, and implemented regulations prohibiting insurers from
denying coverage due to pre-existing conditions
36. Food and Drug Administration Safety and Innovation Act (FDASIA): Enact-
ed in 2012, FDASIA aimed to enhance the regulation of medical products by the
FDA. It included provisions to expedite the review of new drugs and medical devices,
improve drug safety monitoring, and strengthen the FDA's authority to regulate
drug-compounding pharmacies.
, Healthcare Administration Evolution, Systems and Leadership
Questions and Answers
37. Health Information Technology for Economic and Clinical Health Act
(HITECH Act): Enacted in 2009, the HITECH Act promotes the adoption and mean-
ingful use of electronic health records (EHRs) and strengthens HIPAA privacy and
security provisions related to electronic health information
38. Consolidated Omnibus Budget Reconciliation Act (COBRA): enacted in
1985, requires employers with 20 or more employees to offer temporary continu-
ation of health coverage to eligible employees and their dependents after certain
qualifying events, such as job loss or reduced hours.
39. Emergency Medical Treatment and Labor Act (EMTALA): enacted in 1986,
requires hospitals that participate in Medicare to provide emergency medical treat-
ment to individuals regardless of their ability to pay or insurance status
40. False Claims Act (FCA): a federal law that prohibits knowingly submitting false
or fraudulent claims for payment to the government, including claims submitted
to Medicare, Medicaid, and other federal healthcare programs, whether directly or
indirectly
41. Federal Anti-Kickback Statute (AKS): a federal criminal law that prohibits
exchanging anything of value in return for referrals or recommendations for items
or services covered by federal healthcare programs, such as Medicare or Medicaid.
42. Stark Law: also known as the Physician Self-Referral Law, prohibits physicians
from referring Medicare or Medicaid patients to entities with which they have a
financial relationship for certain designated health services.
43. The Joint Commission on Accreditation of Healthcare Organizations (JC-
AHO): now known simply as The Joint Commission, is a nonprofit organization that
accredits and certifies healthcare organizations and programs in the United States
44. Centers for Medicare and Medicaid Services (CMS): a federal agency within
the U.S. Department of Health and Human Services that administers Medicare and
Medicaid programs
45. Agency for Healthcare Research and Quality (AHRQ): a federal agency
within the U.S. Department of Health and Human Services that conducts research
and provides evidence-based information to improve healthcare quality, safety,
efficiency, and effectiveness
46. National Committee for Quality Assurance (NCQA): a private, nonprofit or-
ganization that accredits and certifies healthcare organizations and programs in
the United States, focusing on quality measurement and improvement in healthcare
delivery
47. Accreditation Commission for Healthcare (ACHC): nonprofit organization
that accredits healthcare organizations and programs across various sectors, in-
cluding home health, hospice, pharmacy, and behavioral health.
