HA 3309 Test 2 Questions and Answers.
Affordable Care Act - Answer federal legislation designed to increase the number of insured
Americans and positively affect the quality and cost of health care. It was sign into law in march
2010.
Health Benefit Exchange - Answer A mechanism to assist American in purchasing healthcare
insurance that is provided through the state or federal government
Individual Mandate - Answer A provision of the ACA that requires all non-exempt American
citizens to have health insurance or pay a fine
Mandate - Answer An official order to do something, such as to purchase health insurance
State Sovereignty - Answer The right of a state to do what is needed to govern itself. It
includes the right to make and enforce laws and levy taxes.
Case Managment - Answer A mechanism used in managed care to evaluate appropriate use of
resources for patient care.
Disease Managment - Answer The mechanism used to control the acuity of chronic diseases
and reduce acute care episodes
Gatekeeper - Answer A feature of managed care in which the primary provider authorizes
referrals to specialists and other services. Authorization is needed for the plan to cover services.
HEDIS - Answer Healthcare Effectiveness Data and information Set; the quality assessment
data set used by the national committee for quality assurance. The data gathered for HEDIS
assists with quality control and provide quality indicators for managed care organizations.
Integrative Medicine - Answer Sometimes called complementary and alternative medicine; an
area of medicine that includes services not traditionally covered in medical schools. Examples
include massage and acupuncture.
Managed Care - Answer A generic term for a number of healthcare insurance options whose
mission is to provide quality and cost-effective health care
Affordable Care Act - Answer federal legislation designed to increase the number of insured
Americans and positively affect the quality and cost of health care. It was sign into law in march
2010.
Health Benefit Exchange - Answer A mechanism to assist American in purchasing healthcare
insurance that is provided through the state or federal government
Individual Mandate - Answer A provision of the ACA that requires all non-exempt American
citizens to have health insurance or pay a fine
Mandate - Answer An official order to do something, such as to purchase health insurance
State Sovereignty - Answer The right of a state to do what is needed to govern itself. It
includes the right to make and enforce laws and levy taxes.
Case Managment - Answer A mechanism used in managed care to evaluate appropriate use of
resources for patient care.
Disease Managment - Answer The mechanism used to control the acuity of chronic diseases
and reduce acute care episodes
Gatekeeper - Answer A feature of managed care in which the primary provider authorizes
referrals to specialists and other services. Authorization is needed for the plan to cover services.
HEDIS - Answer Healthcare Effectiveness Data and information Set; the quality assessment
data set used by the national committee for quality assurance. The data gathered for HEDIS
assists with quality control and provide quality indicators for managed care organizations.
Integrative Medicine - Answer Sometimes called complementary and alternative medicine; an
area of medicine that includes services not traditionally covered in medical schools. Examples
include massage and acupuncture.
Managed Care - Answer A generic term for a number of healthcare insurance options whose
mission is to provide quality and cost-effective health care
