HCA Final Exam Questions with 100% Correct Answers | Verified | Latest Update, Exams of Advanced Education

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HCA Final Exam Questions with 100% Correct Answers | Verified | Latest Update An accountable care organization is a _________ of payers, physicians, hospitals and other healthcare providers that voluntarily ______ to provide efficient, _______ and coordinated care to an assigned population of patients - Correct Answer-group, collaborate, high-quality If providers reduce costs and/or improve specified quality metrics in a certain timeframe, they are able to receive ______________ rewards from or share in the savings with Medicare or a commercial payer. - Correct Answer-financial ACO arrangements can also involve _________, in which the provider would have to pay back a portion or all of the costs that exceeded the payer's established benchmark. - Correct Answer-risk The goals of ACOs are nicely summarized in something known as "the triple aim," which was first articulated by Donald Berwick, MD, former acting CMS administrator. The three aims are (1) improving the experience of __________, (2) improving the ______________ of populations and (3) reducing per capita costs of healthcare. - Correct Answer-care, health 5) Along with physician groups, health systems and insurers, ACOs can include a range of care ______________. These include inpatient rehabilitative facilities, long-term acute-care hospitals, skilled nursing facilities and small physician practices. _______________ groups are the largest leaders of ACOs, although _____________ systems are a close second. - Correct Answer-settings, physician, hospital ACOs require a robust network of ___ physicians to manage the health of a population. Some of the main goals behind ACOs are improved care _________________, enhanced ____________ care delivery and the reduction or elimination of duplicative services. - Correct Answer-primary care, coordination, preventative ____________ ACOs now represent 52 percent of all ACOs, as there are 253 organizations contracting with CMS for accountable care. - Correct Answer-Medicare Unlike a health maintenance organization, beneficiaries do not join ACOs - their _______________ do. Patients are notified of their providers' participation in a commercial or Medicare ACO. - Correct Answer-providers Patient-centered medical homes are often seen as the "building blocks" of ACOs. The model is specific to primary care practices. In a PCMH, primary care physicians are part of a care team, which often includes health coaches who engage patients as active _______________ in their own health. - Correct Answer-participants ACOs strive to move reimbursement away from the fee-for-service model toward pay- for-performance. Under FFS, physicians are paid episodically based on how __________ patients they treat or how many tests they run - they get paid for the services they provide. Under a P4P model, physicians are reimbursed for their __________, based on a range of metrics that can include care quality, patient safety and outcomes, and cost of care. - Correct Answer-many, performance CMS measures quality of care using metrics in four main categories: patient/caregiver ______, care coordination/patient safety, preventive health and _________ population, which includes diabetes, hypertension, ischemic vascular disease, heart failure and coronary artery disease. - Correct Answer-experience, at-risk A common role in ACOs is that of the care ___________ or care coordinator. These are specially trained professionals, many times registered nurses, who help patients navigate the care continuum. In plainer language, this means they can help patients with a range of tasks, such as arranging and ensuring the patient gets to _appointments_______, locating healthcare resources in the patient's community, providing follow-up contact to ensure medication compliance and _______________ barriers the patient faces in his or her treatment plan. - Correct Answer-navigator, appointments, reducing It is a proven fact that chronic diseases and ____________ health conditions have a significant economic impact on healthcare in this country and that many __________ diseases and mental health conditions are caused by negative _______________. - Correct Answer-mental, chronic, lifestyle choices Symptoms of chronic diseases and mental health conditions are often treated rather than their underlying _______________ which creates a high rate of ____________ visits to the doctor without ever getting to the root ______________. - Correct Answer- causes, return, causes Two programs regarding the education of patients about the implications of specific diseases for which they may be at risk are called _________ and ____________. - Correct Answer-prevention and wellness Healthier children and/or adults have an impact on increased levels of ________________ both on the job and in the classroom as well as a decrease in _________________________ spending. - Correct Answer-productivity, healthcare Examples of prevention and wellness include _________________ to protect against childhood disease ______________ cessation and annual _______________ with a PCP. - Correct Answer-vaccination, smoking, checkup The Medicare program is designed to benefit people that are _______________ and must have worked a minimum number of "quarters" - there are exceptions to this rule. - Correct Answer-65+ There is only _________ Medicare program, is 100% federally funded and is financed by our payroll taxes and is correlated to the rate of __________________________. - Correct Answer-one, employment There are 4 parts to the Medicare program - Parts _____, _______, ________ and _______. - Correct Answer-a, b, c, d Managed Care is a ______________________ interdisciplinary delivery of care lead by primary care doctors and other contracted providers. - Correct Answer-coordinated Managed care is designed to provide high quality care while saving money through actively _______________________ each member's on-going care and treatment. - Correct Answer-managing Managed care companies have contractual agreements with employers to cover their employees and families. True/False - Correct Answer-true Health care ethics (a/k/a "medical" ethics or "bioethics"), at its simplest, is a set of _________ principles, beliefs and values that _________________ us in making choices about medical care. - Correct Answer-moral, guide At the core of health care ethics is our sense of right and __________ and our beliefs about rights we possess and duties we owe others. - Correct Answer-wrong ___________________ carefully about the ethical aspects of health care decisions helps us make choices that are right, good, fair and just. - Correct Answer-thinking An ______________ ________________ is a legal document which assigns a person to speak on behalf of another who is unable to do so due to their lack of consciousness as a result of a _______________ illness or accident. - Correct Answer-advance directive, terminal Unfortunately too many people do not have this document and ________ in hospitals in pain at great expense and would prefer another way to be cared for at their end of _________. - Correct Answer-die, life Two reasons why people do not have this document include their _____________ beliefs and the influence of their attending ________________. - Correct Answer- religious, family Statistically only about ___________ percent of adults have either a ______________ Will or Durable Power of ______________ for Healthcare. - Correct Answer- One potion for end of life care consists of _____________ care for those with a life expectance of ____________ months or less - unfortunately this service is underutilized. - Correct Answer-hospice, 6 This end of life care is provided in three specific Points of Care which are ___________, ______________ ______________ and ________________. - Correct Answer- If someone does not take responsibility for their healthcare and fail to follow through with their physician' orders they are called ____________________. - Correct Answer- noncompliant This phenomenon is responsible for wasting approximately __________________ billion each year and includes patient's failure to take their _______________ or attend ____________________ visits to their PCP. - Correct Answer-1.7, medication, annual