question

States try to protect the public from receiving incompetent care by licensing certain health professions. Certification differs from licensing, in that certification:

answer

only recognizes special education or training

question

At the outset of the nurse practitioner movement, educational requirements were often limited to relatively short certificate programs. Today, it is generally accepted that nurse practitioners should be registered nurses with:

answer

a master's degree

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Complementary medicine differs from alternative medicine in that complementary medicine:

answer

is used together with conventional medical treatment while alternative medicine is used in place of conventional medical treatment

question

A physician residency training program is best described as:

answer

an accredited training program of at least 3 years post-medical school, that prepares physicians to practice in a medical specialty

question

Major obstacles to ensuring an efficient and rational health workforce in the future include:

answer

separate and often conflicting interests of governments, educational institutions, professional organizations, insurers and providers

question

Health care system changes, including advancing technology, will likely result in new and more highly specialized health occupations. Which of the following is NOT one of the expected effects of this development?

answer

hospitals becoming more resistant to employing multi-skilled personnel

question

Each year approximately 6,000 international medical graduates (IMGs) enter the U.S. to practice. IMGs are vitally important to the health care delivery system because they

answer

they fill a shortfall in the number of residents required by US hospitals

question

Unlike medicine, dentistry primarily serves only those with dental insurance or who can afford to pay out-of-pocket. For this reason

answer

many of the population groups with the greatest need have no access to service

question

The category of allied health professionals, "therapeutic science practitioners" concerned with the treatment and rehabilitation of patients with all types of diseases and injuries include which of the following professions?

answer

physical and occupational therapists, speech language pathologists

question

The widespread use and popularity of complementary and alternative medicine in the U.S. resulted in which of the following developments?

answer

the national institutes of health creating the national center for complementary and alternative medicine (NCCAM)

question

The ACA addressed numerous long-standing health workforce issues. Most importantly, it established the National Health Care Workforce Commission with the overall mandate to

answer

evaluate and make recommendations in areas such as training and support for workers at all levels, efficient workforce deployment professional compensation, and coordination among different types of providers

question

Major obstacles to ensuring an efficient and rational health workforce in the future include

answer

separate and often conflicting interest of governments, educational institutions, professional organizations, insurers, and providers

question

The managed care concept called "capitation" refers to:

answer

physicians agreeing to provide all medical care an individual requires for a specified time period, for a prepaid fee

question

By focusing on insured populations rather than individuals, managed care organizations can project health service use by:

answer

demographic factors such as age, gender, and other factors

question

An aim of managed care is to transfer some measure of financial risk to providers and, to a lesser extent, to patients. Transferring financial risk to patients is accomplished by:

answer

requiring co-pays for specified services

question

The phenomenon of managed care "backlash" is best characterized by which of the following:

answer

protests of organized medicine, other health care providers and consumers against MCO policies viewed as unduly restrictive

question

In retrospect, implementation of the DRG system demonstrated that:

answer

hospitals could profit from instituting more efficient patient care procedures

question

Although the ACA will enact sweeping U.S. health care system reforms, one fundamental element of the system that will remain unchanged is

answer

financing of health care expenditures through a combination of public and private sources

question

The current highest personal care expenditure in the U.S. is for

answer

hospital care

question

Despite U.S. health care spending exceeding the expenditures of 28 other developed nations, U.S. health outcomes lag far behind. Extensive research has concluded that reasons for high U.S. health expenditures include

answer

higher US per capita income and much higher US prices for medical care

question

Major drivers of U.S. health expenditures include

answer

advancing medical technology, growth in the older population, and reimbursement system incentives

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The basic concept of health insurance is different than the premise on which personal or property insurance was historically defined because

answer

other forms of insurance were intended to cover individuals against the low risk of unlikely events while health insurance provides coverage for unlikely events in addition to routine and discretionary services.

question

The establishment of Blue Cross for hospital care and Blue Shield for physicians' services signaled a new era in health care delivery and financing. Which of the following was NOT among their major impacts?

answer

caused for-profit insurers to use "experience" rather than "community" ratings to establish premiums

question

The 1973 HMO legislation responded to which of the following national concerns?

answer

rapidly increasing Medicare expenditures and concerns about the quality of care

question

Cost-control initiatives undertaken by managed care organizations to improve communications with chronic disease patients in the hope of avoiding unnecessary, costly care are known by the term

answer

disease management

question

The most influential managed care quality assurance organization that accredits many different aspects of managed care organizations on a voluntary basis is

answer

the national committee on quality assurance

question

The Healthcare Effectiveness Data and Information Set (HEDIS) may be best described as

answer

a standardized method for managed care organizations to collect, calculate and report information about their performance to facilitate purchasers' and consumers' comparisons of different insurance plans on a variety of parameters.

question

The Medicare program enacted in 1965 as Title XVIII of the 1935 Social Security Act is characterized as the most sweeping social legislation ever enacted by the federal government because it

answer

was only the second mandated U.S. health insurance program after worker's compensation and signaled the federal government's entry into the personal healthcare financing arena.

question

Enacted in 1983, the Diagnosis-related Group payment methodology shifted hospital reimbursement from the retrospective to prospective basis. The major purpose of this new payment system was to

answer

provide financial incentives for hospitals to spend no more than needed to produce optimal outcomes for hospitalized patients.

question

The primary purpose of the Centers for Medicare & Medicaid Services "Hospital Compare" web-based program is to

answer

provide consumers with objective criteria that allow comparisons of hospitals' use of evidence-based practices and patient satisfaction ratings.

question

Enacted in 1965 as Title XIX of the Social Security Act, Medicaid is

answer

a joint federal-state program supporting basic health services for low income individuals in which federal and state support is shared based on a state's per capita income.

question

The intent of the Medicaid Child Health Insurance Program (CHIP) was to

answer

enroll 10 million uninsured children in Medicaid whose family incomes were too high to qualify for Medicaid but too low to purchase private health insurance.

question

Medicaid and CHIP quality initiatives are carried out through partnerships with the respective states' programs using five quality criteria that include which of the following?

answer

prevention and health promotion, management of acute conditions, management of chronic conditions, family experience of care, availability of services

question

Under the ACA, most Americans will be required to have health insurance or be penalized with an annual tax. In the ACA legislation, this requirement is popularly known as the

answer

individual mandate

question

As defined and required by the ACA, health insurance exchanges (HIEs) intend to

answer

create a competitive health insurance market by providing web-based, easily understandable comparative information to consumers on plan choices with standardized rules regarding health plan offers and pricing.

question

The ACA's "Bundled Payments for Care Improvement Initiative" intends to address which of the following long-standing concerns about the Medicare program's costs and quality?

answer

fee-for service payments for individual services provided during a beneficiary's illness resulting in fragmented care with minimal coordination across providers and settings that result in rewarding service quantity rather than quality.

question

Long-term care is best described as:

answer

services provided in both home and institutional settings for persons of all ages with varying levels of medical, social, and personal care needs.

question

The US history of institutional long-term care began with:

answer

communal care settings operated by charitable community members and government supported almshouses.

question

Which of the following societal factors increases the need for formal long-term care services?

answer

all of the above

question

The development of formal home care services, such as those provided by the Visiting Nurses Association originated as:

answer

a social response intended to improve unhealthy living conditions of immigrants residing in crowded urban tenements and prevent the spread of infectious diseases.

question

Long-term care and nursing-home reform legislation of the 1970s occurred as a response to which of the following:

answer

widespread media reports and ensuing Congressional hearings on nursing home and residential care facility abuses and negligence

question

The major distinction between skilled-nursing and residential care facilities is that skilled nursing facilities:

answer

provide care primarily for people requiring intensive nursing, rehabilitation, or related services.

question

Which of the following was not a driver of expanded home care services during the 1980s through the 1990s?

answer

audits documenting significant fraud and abuse of Medicare billing.

question

Which of the following best describes the informal long-term care system?

answer

care and assistance provided in the home by family members and friends

question

Respite care is best defined as:

answer

temporary, Medicaid-supported vacations for caregivers of a physically or mentally-dependent family member.

question

The enactment of Medicare and Medicaid in 1965 affected the long-term care industry in many ways. Which of the following was NOT an effect of the Medicare and Medicaid enactment on the long-term care industry?

answer

Prohibition of for-profit providers' participation in Medicare and Medicaid long-term care reimbursement

question

The hospice movement is concerned with care for terminally ill patients. Which of the following is not a major goal of hospice care?

answer

decreasing costs of care for the terminally ill by avoiding use of expensive technology

question

The "naturally occurring retirement community" is best defined as

answer

apartment complexes, neighborhoods, or sections of communities where residents have opted to age-in-place.

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