F) Competition among hospitals has further fueled the increase in health costs. b. distal radius Health care is provided by individuals who are not employees of the HMO or who do not belong to a specially formed medical group that serves the HMO. 2.13) Which of the following best describes the purpose of managed care? These include provider networks, provider oversight, prescription drug tiers, and more. It lowers cost through the elimination of waste and excess. A ) . D. For a State to qualify for Federal disaster assistance from FEMA, it is best if the State has laws that are consistent with those of Federal emergency management law. 5. Disaster advice from the USDA is provided by the Cooperative Extension Service. Individual Practice Association (IPA) HMO Network Model HMO. Health care is provided in an HMO-owned center or satellite clinic or by physicians who belong to a specially formed medical group that serves the HMO. B. C) The nurse is considered the gatekeeper in the managed care system. All definitions of institutions generally entail that there is a level of persistence and continuity. Citizens discuss the ideal of equal access to health care for everyone, including care for indigents. B. Responsible for reviewing health care provided by managed care organizations. D) Pension benefits attributable to the employer, s contributions are not taxed until the employee retires or, 2) Beta Corporation has 1,000 employees eligible to participate in the firm, employees are considered highly compensated. C. The most likely route of entry of a Foreign Animal Disease is from wind blowing the agent across the borders. D. Large-scale disasters affecting livestock never have serious implications for State revenues. 22. Es el medioda y t tienes hambre. Consumer-directed health plans (CDHPS) provide incentives for controlling health care expenses and give individuals an alternative to traditional health insurance and managed care coverage. Do you think Krauthammer fairly characterizes libertarian thinking? Exclusive provider organization (EPO) patients must receive care from participating providers, which can include emergency departments at participating hospitals, or they pay for all costs incurred. B. A. 24 Providers are employees of the organization. 2.10) Which of the following best describes how alternative health therapies are being perceived? Which of the following accurately describes relationship between disasters and the economic impact on livestock farmers? Select all that apply. Correctly identify disorders of the wrist. D. Landslides rarely affect agricultural property. Point-of-service plan (POS) c. D) Risk management is a spontaneous response to an unexpected incident. Study Resources. The appropriateness, efficiency, and medical necessity of health care provided to patients is reviewed on a prospective and retrospective basis. A. A variety of measures can be used; measures may be simple or complex; it is recommended that measures be straightforward, understandable, and valid. Managed care plans emphasize cost controls and preventative care. An EOB is a statement from your health insurance plan describing what costs it will cover for medical care or products youve received. Which of the following statements iscorrectregarding the disposal ofcarcasses? Expert Help. Managed care plans also require the development of patient care plans for the coordination and provision of care for complicated cases in a cost-effective manner, which is called __________. Select all that apply. A. The Healthcare Effectiveness Data and Information Set (HEDIS), sponsored by the National Committee for Quality Assurance, consists of performance measures used to evaluate managed care plans (e.g., rate of Pap smears performed among women of a certain age). U.S. Treasury Department and Internal Revenue Service issued tax guidance information for HRAS in 2002. Integrated delivery system (IDS) d. distals carpals, Use the integral test to find whether the following series converge or diverge. Because a ________ would have the practical effect of prohibiting a physician from giving a patient the full range of advice and counsel that is clinically appropriate, it would result in the managed care plan not providing all covered Medicare services to its enrollees, in violation of the managed care plan's responsibilities. which of the following statements describes managed care? C. The number of animals that need to be evacuated from a farm is an important factor in determining how quickly a farm can be evacuated. Laws, rules, social conventions and norms are all examples of institutions. A) The contribution rate is fixed. A. Which of the following statements is correct regarding the identification of animals in disasters? An elderly woman has total care of her husband with Alzheimer's disease. Describe the three levels of Sumerian society. d. Network model Which of the following statements about managed care are true? A. a. D. Many animals look sufficiently distinct for most persons other than the owner to be able to distinguish one animal from another. 3. B) Employers, insurance companies, and other health insurance benefit providers are typical groups that contract with PPOs. B. Most countries charge a tax on an individual's income as well as on corporate income. In outbreaks reported from acute care settings in the U.S. following implementation of unive. The appropriateness, efficiency, and medical necessity of health care provided to patients is reviewed on a prospective and retrospective basis. define employer contributions and ask employees to be more responsible for health care decisions and cost-sharing. B. Livestock that are adapted to cold can tolerate low temperatures if they have adequate feed intake. Federal agencies are usually activated directly in response to requests from local emergency managers. B. Specialty Pharmacy J. Industry/Manufacturing. Managed care programs have been successful in containing costs and limiting unnecessary services, resulting in the current trend for health care plans to offer the SSO as a benefit, not a requirement. Premiums and other revenue are paid to the HMO. A. a and b only. 2. Which of the following statements about the history of home healthcare nursing is most accurate? In economic terms, taxation transfers wealth from households or businesses to the . Which of the following is a characteristic of primary healthcare? Contracted health care services are provided to subscribers by two or more physician multispecialty group practices. 11. The nurse in charge of the clinic asks herself, "Who needs this medicine most?" The _______ is responsible for supervising and coordinating health care services for enrollees and approves referrals to specialists and inpatient hospital admissions (except in emergencies). A) Managed care systems control the cost of care with a lower quality of care. 17. A Colles fracture occurs at the: The term "managed care" is used to describe a type of health care focused on helping to reduce costs, while keeping quality of care high. The following are examples of hospital joint ventures that are unlikely to raise significant antitrust concerns. 9 ways Android and Windows 10 can work well together, We asked a leading cosmetic doctor for his top anti-ageing tips. Typically, it is an illegal seizure of power by a political faction, politician, cult, rebel group, military, or a dictator. es importante los pasajeros seguir las instrucciones de seguridad Health maintenance organization (HMO) She is receiving chemotherapy at a hospital and interacts with many other healthcare providers in the course of her treatment. In exchange for an initial payment, known as the premium, the insurer promises to pay for loss caused by perils covered under the policy . B. Institutions vary in their level of formality and informality. A. Relationships are not critical in the delivery of health services. a. A. Disasters can be a threat to animal well-being. After a stroke, a patient is having difficulty swallowing. C) The patient gets the bill and pays out-of-pocket costs. B. Livestock agricultures reliance on machines and technology has increased the need for evacuation procedures. F) Planning and monitoring are conducted to ensure standards are followed. C. New animal arrivals to a farm should be placed in quarantine until a suitable time has lapsed to rule out the introduction ofcontagious disease. This idea supports which of the following economic theories for which Rawles was a proponent? horse hind leg tendon sheath. Compute the expected value of the damages and fill in the chart below. In large-scale disasters, the Director of Emergency Management is responsible for declaring a disaster. Under the auspices of its Health Care Reform Program, established in July 1993, The Commonwealth Fund is focusing on the need to expand knowledge about managed care organizations. II. 5. "Sign up for childbirth classes." c. "Sign up for the WIC program." d. "Take your prenatal vitamins daily." A Which of the following statements accurately describe an aspect of managed care? D. For a State to qualify for Federal disaster assistance from FEMA, it is best if the State has laws that are consistent with those of Federal emergency management law. Health care can be purchased or given freely in Country A, but there is no entitlement program to ensure basic health care to vulnerable people. Why is this plan called a third-party payer? A) physical therapist C) social worker B) speech therapist D) respiratory therapist, 15. Health plans, purchasers, clinicians, and the public share responsibility for the appropriate stewardship of health care resources. Select all that apply. C. Construction of a new barn at a site above a floodplain. It is a system that is based on patient and provider autonomy. A. Yet, segments of the health care system maintain aspects of a free-market competition. 2.18) In 2007, how much of the world's population relied on alternative medicine? In abreva commercial girl or guy the elizabethan poor laws of 1601 quizletabreva commercial girl or guy the elizabethan poor laws of 1601 quizlet A) do their job and do it well B) refuse to participate in organizations C) support legislation to improve care D) become a member of a support group, Julie S Snyder, Linda Lilley, Shelly Collins. B. It is the result of a joint venture between hospitals and members of their medical staff. Personal preparedness is rarely effective at minimizing losses from disasters. A risk pool is created when a number of people are grouped for insurance purposes (e.g., employees of an organization); the cost of health care coverage is determined by employees' health status, age, sex, and occupation. A. It attempts to control costs by modifying the behavior of providers and patients. The intent was to replace conventional fee-for-service plans with more affordable quality care to health care consumers and providers who agreed to certain restrictions (e.g., patients would receive care only from providers who are members of a managed care organization). The company has collected the following information on product sales: Total Polices Gender Location Female Male Northwest. Which of the following statements describes appropriate procedures for dealing withanimal health/disease? In the following sentences, circle each incorrectly used lowercase letter. C) Reimbursement is usually based on fee-for-service. In large-scale disasters, the Director of Emergency Management is responsible for declaring a disaster. (A) Give the symmetry number for each of the following molecules: 17. D.Carcassesmust be disposed of onsite. 1. Employees contribute funds to the FSA through a salary reduction agreement and withdraw funds to pay medical bills. C. Pre-existing economic difficulties can exacerbate the impact of disasters on livestock farmers. Plans are required to meet minimum performance levels and to show demonstrable and measurable improvement in specified broad clinical areas (e.g., preventive services, acute ambulatory care, chronic care, and hospital care) based on performance improvement projects that each plan identifies. Direct contract model B. C. Do not tie animals to unhitched trailers, as many animals are strong enough to pull the trailer away. Which of the following ethical theories of justice are based upon the rule that it is good to maximize the greatest good for the greatest number of people? D) Hospitals are the preferred setting for service delivery. The only loss in disasters is to affected farms. Fixed-price reimbursement is a feature of managed care. A. 2. 53. immunizations and screenings included in benefits 54. Select all that apply. B) The family of the patient is required to pay costs. Which of the following statements about the nursing process is true. es posible nosotros permanecer sentado(s) C. Practice a fire drill every month throughout the fire season. Select one: O a. To create flexibility in managed care plans, some HMOS and preferred provider organizations have implemented a _______, under which patients have freedom to use the managed care panel of providers or to self-refer to out-of-network providers. Which of the following statements correctly describe liability issues in disasters? Yo almuerzo_______ (almorzar-entender) en la cafetera. 2.4) Which of the following best describes the process of screening in the medical office setting? (a) CO2\mathrm{CO}_2CO2, (b) O3\mathrm{O}_3O3, (c) SO3\mathrm{SO}_3SO3, (d) SF6\mathrm{SF}_6SF6, and (e) Al2Cl6\mathrm{Al}_2 \mathrm{Cl}_6Al2Cl6. 2.12) Which of the following does not apply to the role of a medical assistant? B) epidemiology. The owner of an escaped animal may be held liable for damages his/her animal creates. PPOS do not routinely establish contracts for laboratory or pharmacy services, but they do offer reduced-rate contracts with specific hospitals. C. Volunteer organizations are the only source of disaster assistance at the locallevel. A. Indemnity payments to farmers for crop losses that are covered by insurance are managed by the USDA Risk Management Agency. Free Printable Vegetable Bingo: an easy way to teach food groups & nutrition. 16. The ________ (e.g., physician, physician's assistant, nurse practitioner, nurse, or social worker) submits written confirmation, authorizing treatment, to the provider. Beginning in 2006, the Physician Quality Reporting System (formerly called Physician Quality Reporting Initiative or PQRI system) established a _____ incentive for eligible professionals who participate in a ________ quality reporting program. 26. of The most common health plans available today often include features of managed care. B) The contribution rate is fixed, and the retirement benefit is known in advance. Examples of health care cost containment in the 1980s included: 1 Marcos and his horse will lead the tyler fourth of july parade. Which of the following statements best describes an integrated delivery system? Managed care is categorized according to six models: exclusive provider organizations, integrated delivery systems, health maintenance organizations, point-of-service plans, preferred provider organizations, and triple option plans. e. The traditional health care system in the United States is: A PPO is not an HMO, but it is similar to an HMO because it is a managed care plan that provides enrollees with discounted health care through a network of providers. D. All of the above. Which of the following statements accurately describe an aspect of managed care? The National Committee for Quality Assurance (NCQA) reviews managed care plans and develops report cards to allow health care consumers to make informed decisions when selecting a plan. Who would be most likely to teach the classes? Richard Milhous Nixon (January 9, 1913 - April 22, 1994) was the 37th president of the United States, serving from 1969 to 1974.A member of the Republican Party, he previously served as a representative and senator from California and was the 36th vice president from 1953 to 1961 under President Dwight D. Eisenhower.His five years in the White House saw reduction of U.S. involvement in the . A. Staff Model HMO FEMA IS-120.C: An Introduction to Exercises Answers. d. A. Which of the following statements will NOT reduce risks arising from wildfires? It attempts to control costs by modifying the behavior of providers and patients. A) those requiring care to improve health B) children with chronic illnesses C) dying persons and their loved ones D) older adults requiring long-term care, 13. Who provides physicians with the authority to admit and provide care to patients requiring hospitalization? B. d. Discontinued Capitation, adopted fee-for-service. HMOS often require a copayment (or copay), which is a fee paid by the patient to the provider at the time health care services are rendered. Which of the following phrases is characteristic of case management as a method of healthcare delivery? B. Composting is no longer used to dispose of any livestockcarcasses. C) Employer contributions are considered taxable income to employees but are taxed at capital gains rates. (sometimes called a participating provider organization) is a managed care network of physicians and hospitals that have joined together to contract with insurance companies, employers, or other organizations to provide health care to subscribers for a discounted fee. prestar mucha atencin. Contracted health care services are delivered to subscribers by individual physicians in the community. HEDIS data also are the centerpiece of most health plan "report cards" that appear in national magazines and local newspapers. Health Savings Account (HSA); Health Savings Security Account (HSSA). a payment system based on Diagnosis related groups (DRGs). It is attentive to the needs of the membership group and individual patients. Son las diez de la noche y nosotras estamos cansadas. 19694 Which of the following statements correctly describes animal disease outbreaks? C. Hurricanes frequently cause flooding along the coast, but not inland. Costs from animal disease outbreaks include loss of production andreplacementof animals. B. Designating access to barns and water for firefighters. B. C. Annual property loss resulting from thunderstorms, including damage to farms and barns, is estimated in the hundreds of millions of dollars. Costs from animal disease outbreaks include loss of production andreplacementof animals. D. All of the above. The federal _________ plan requires managed care plans that contract with Medicare or Medicaid to disclose information about ________ plans to CMS or state Medicaid agencies before a new or renewed contract receives final approval. Qu hacemos? What is one way in which nurses can help shape healthcare reform? Large-scale disposal ofcarcassescan be contracted to specialty firms that deal with hazardousmaterialsdisposal, such as from superfund sites. D) profession and income. It is necessary for it to be raining to be struck by lightning. A patient has a private insurance policy that pays for most healthcare costs and services. C. Pre-existing economic difficulties can exacerbate the impact of disasters on livestock farmers. 27. The marketing department is launching a new advertising campaign. C. Snow has to fall at rates of greater than 12 inches per hour to cause severe disruptions. c. HEDIS results are included in_________, an interactive, web-based comparison tool that allows users to view plan results and benchmark information. A) Medicaid C) health maintenance organization B) preferred provider organization D) long-term care insurance, 18. Out-of-pocket payments for health care expenses, which are made after the tax-exempt account is expended and before the deductible for high-deductible insurance has been met; this tier actually represents a gap in coverage This question suggests which of the following? Managed care plans implement _______ as a method of controlling health care costs and quality of care. Countries or subunits often also impose wealth taxes, inheritance taxes, estate taxes, gift taxes, property taxes, sales taxes, use taxes, payroll taxes, duties and/or tariffs . Patient care delivery 2. Select one: a.Health insurance must be compulsory for the lower-income two thirds of the population and payments must be proportional to income. True or false? Chapter 1 Medical Assisting Profession Quiz, Chapter 2 Health Care Settings and Health Car, Unit 3, Real Estate License Law And Commissio, Chapter 1: The Medical Assisting Profession, Chapter 2: Health Care Settings and the Healt, Julie S Snyder, Linda Lilley, Shelly Collins, Exercise Physiology: Theory and Application to Fitness and Performance, Edward Howley, John Quindry, Scott Powers. . Which of the following statements accurately describes disaster assistance? A. e. B. C. Emergency loans from the USDA in disasters are managed by the Farm Service Agency. Included in HEDIS is the________, which measures members' satisfaction with their care in areas such as claims processing, customer service, and getting needed care quickly. ayudar a los otros pasajeros A) care of acute illnesses C) health promotion B) care of chronic illnesses D) health restoration. C. Annual property loss resulting from thunderstorms, including damage to farms and barns, is estimated in the hundreds of millions of dollars. 51) Which of the following statements about managed care plans is (are) true? 2.3) Which of the following statements best describes a health maintenance organization (HMO)? Utilitarian theories Which of the following statements apply to the transportation of livestock? If enrollees choose to receive all medical care from the managed network of health care providers, or obtain an authorization from their POS primary care provider for specialty care with an out-of-network provider, they pay only the regular copayment or a small charge for the visit and they pay no deductible or coinsurance costs. Even though managed care. B. B. Patients' needs are assessed and prioritized. Accreditation organizations develop standards (requirements) that are reviewed during a survey (evaluation) process that is conducted both offsite (e.g., managed care plan submits an initial document for review) and onsite (at the managed care plan's facilities). Patients do not need to be well informed about the financial benefit issues that affect the provision of care. D. All of the above. B. 4. Usually, network providers sign exclusive contracts with the EPO, which means they cannot contract with other managed care plans. Unused balances "roll over" from year to year; if an employee changes jobs, he or she can continue to use the HSA to pay for qualified health care expenses. es necesario el capitn hacerun anuncio EJEMPLO: Es probable que nosotros evitemos una tempestad. 28. As she pays her co-payment, she says "Oh dear, the doctor told me to see someone, but I can't remember what he said. 1. Triple option plan. POS enrollees who receive care from out-of-network providers pay higher deductible and coinsurance amounts. Which of the following correctly describes the role of the USDA in disasters? Select all that apply. fern storage cabinet anthropologie / normaliser un vecteur propre / normaliser un vecteur propre utilization management (or utilization review). Faculty of English Commerce Ain Shams University, Ajman University of Science and Technology Ajman), BSBLDR403 Lead team effectiveness Assessment 2.docx, SELECT CURTIME SELECT CURTIME 0 HOUR time Returns the hour for time This code, 32 Extraction of data Data extraction improves strategies for incorporating, It is convenient to subdivide the receiver into two parts the demodulator and, The_Impact_of_Financial_Structure__Financial_Leverage_and_Profitability_on_Industrial_Companies_Shar, designates subordinate commanders to serve as joint functional component, Tutorial 5-Midterm RUBRIC-Feb 27[3643].pdf, existence of this power to increase sentences since legislation now provides for, 534 Consultation Status after Flare up The study also collected data on whether, private station rather than have had the glories of command If indeed such, through-the-cognitive-functions-lens-a-socio-technical-analysis.pdf, Which of the following statements about life insurance cash values is (are) true? Medicare established the __________ to ensure the accountability of managed care plans in terms of objective, measurable standards (requirements). B. Healthcare Effectiveness Data and Information Set (HEDIS). A POS plan is not an HMO, but it is a managed care plan that combines the characteristics of an HMO and a preferred provider organization (PPO) (discussed below). D. All of the above. Practicing veterinarians are the officials who must conduct the investigation of a suspected Foreign Animal Disease. Which of the following statements correctly describes the role of the Federal Emergency Management Agency (FEMA) in disasters? 2.14) Mrs. J. has just seen her provider. What is the confusion that might arise concerning her treatment and care is a problem known as? Under extreme heat conditions, livestock require less than 10%body weightof water per day. The owner of an escaped animal may be held liable for damages his/her animal creates. They are intended to prevent the problem of covering members who are sicker than the general population (called adverse selection). (b) What range of wavelengths would distinguish B\mathrm{B}B and C\mathrm{C}C ? Patients' needs are assessed and prioritized. Continuing Healthcare Funding issues - why isn't it simple to apply? 2. Answer: DQuestion Status: Previous Edition 6) Which of the following statements describes a defined-contribution pension plan? is owned by hospital(s) and physician groups that obtain managed care plan contracts; physicians maintain their own practices and provide health care services to plan members. A. C. In most States, Good Samaritan Laws do not directly apply to the care of animals. A. 3. Which of the following statements is correct regarding disasters? An outbreak of a Foreign Animal Disease in the U.S. would likely require the disposal of large numbers ofcarcasses. C. The disposal ofcarcassesmust require the permission of the State or Federal Environmental Protection Agency and Department of Natural Resources. Medicare uses a prospective payment plan based on diagnosis-related groups (DRGs). 2.20) Which of the following is not recognized by the WHO as potentially treatable by acupuncture? 7. The Incident Command System provides a consistent method to respond to all types of emergencies. All parties should foster an ethical environment for the delivery of effective and efficient quality health care. State disaster declarations can only be made when more than one community is affected. You might think of a CDHP as a sort of "401(k) plan for health care" (recalling the shift from employer defined-benefit pension plans to employer defined-contribution 401(k) plans). 2.4) Which of the following best describes the process of screening in the medical office setting? . In each of the given sentences, underline the subordinate clause. Most natural disasters affect local communities least of all. EPOS are regulated by _______ (unlike HMOS, which are regulated by either the _____ or __________, depending on state requirements). b. Managed care plans are a type of health insurance. Which of the following statements arecorrectregarding injuries and damages that result from earthquakes? plans emphasize cost control, total health benefit costs continue to increase. C. Do not dress animals with vests, blankets, and othermaterialsthat would prevent them from sweating. State disaster declarations can only be made when more than one community is affected. This type of health care financing is commonly called: Which of the following health care financing systems has a strong focus on the principle of autonomy? Even when a storm serve has flooded a pasture land, livestock can be left to graze without concern for injuries. D. All of the above. C. Housing animals so that heavy objects do not fall on them in earthquakes is an important preparedness activity for earthquakes. Managed care plans that are "federally qualified" and those that must comply with state quality review mandates (laws) are required to establish ___________. The attachment of preauthorization documentation to health insurance claims submitted to some MCOS. C. Snow has to fall at rates of greater than 12 inches per hour to cause severe disruptions. 15. Which of the following ethical theories place the community, rather than the individual, the state, the nation, or any other entity, at the center of the value system? Qu haces t? establishes a contract that allows physicians to maintain their own offices and share services (e.g., appointment scheduling and billing).
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