ch 10 healthcare organizations

Question 1

what organizations are considered institutional providers (3)

Answer 1

-acute care hospitals
-long term care facilities
-rehab facilities

Question 2

average length of stay for acute care hospital

Answer 2

<30 days

Question 3

3 categories in spectrum of care services

Answer 3

1. primary care - first access care
2. secondary care - disease restorative care
3. tertiary care - rehab/long term care

Question 4

organizations that are classified as primary healthcare organizations (7)

Answer 4

-ambulatory care centers
-physicians’ offices
-preferred provider organizations
-nursing centers
-independent provider organizations
-health maintenance organizations
-school health clinics

Question 5

organizations that are classified as secondary healthcare organizations (4)

Answer 5

-home health care
-ambulatory care centers
-free standing E.R.s
-nursing centers

Question 6

organizations that are classified as tertiary healthcare organizations (5)

Answer 6

-home health centers
-long term care facilities
-rehab centers
-skilled nursing facilities
-assisted living programs/retirement centers

Question 7

5 major characteristics that differentiate healthcare organizations

Answer 7

-type of services provided
-length of direct care services provided
-ownership
-teaching status
-accreditation status

Question 8

ownership organizations that provide health services to individuals under the support and/or direction of local, state, or federal government

Answer 8

public institutions

Question 9

federal service recipients of public institutions (4)

Answer 9

-veterans
-members of military
-native americans
-inmates of correctional facilities

Question 10

ownership organizations that are controlled by voluntary boards or trustees and provide care to a mix of paying and charity patients

Answer 10

private nonprofit/ not-for-profit

Question 11

ownership organizations that operate with the specific intent of earning a profit by providing healthcare services to individuals who can afford to pay for these services

Answer 11

for-profit

Question 12

ownership organizations that coordinate care and chronic disease management and improve the overall quality of care provided to Medicare patients

Answer 12

accountable care organizations (ACO)

Question 13

2 accrediting healthcare organizations

Answer 13

-the joint committee (TJC)
-national committee for quality assurance (NCQA)

Question 14

form of group practice in which physicians in private offices are paid on a fee-for-service basis by a prepaid plan to deliver care to enrolled members

Answer 14

independent practice associations (IPA)

Question 15

form of group practice in which contracts are developed with private practice physicians, but fees are discounted from their usual and customary charges. In return, physicians are guaranteed prompt payment

Answer 15

preferred provider organizations (PPO)

Question 16

healthcare agencies that provide basic and supplemental health maintenance and treatment services to voluntary enrollees who prepay a fixed periodic fee without regard to the amount of services used

Answer 16

health maintenance organizations (HMO)

Question 17

what does medicare part a cover (3)

Answer 17

-inpatient hospital stays
-SNF stays
-hospice care

(known as hospital insurance)

Question 18

what does medicare part b cover (4)

Answer 18

-doctor services
-outpatient care
-medical supplies
-primary prevention care

(known as medical insurance)

Question 19

what does medicare part c and d cover

Answer 19

-prescription drug coverage

(known as medicare advantage plans)

Question 20

the approval, recognition, or certification by an official review board that an organization has met certain standards

Answer 20

accreditation

Question 21

When organizations that provide similar services come together, the arrangement is referred to as ?

ex: group of acute care facilities that come together to provide coverage for an expanded region

Answer 21

horizontal integration

Question 22

When organizations align to provide a full array or continuum of services, the arrangement is referred to as ?

Answer 22

vertical integration

Question 23

theory that attempts to explain productivity in terms of a unifying whole as opposed to a series of unrelated parts

Answer 23

systems theory

Question 24

four elements that make up a system within systems theory

Answer 24

1. structure
2. technology
3. people
4. environment

Question 25

what is considered ‘input’ in systems theory (3)

Answer 25

-people
-money
-materials

Question 26

theory that believes the universe is chaotic and requires organizations to be self-organizing and adaptive to survive

Answer 26

chaos theory