exam 4

Question 1

What is accreditation?

Answer 1

A process of setting standards for educational and training institutions and enforcing these standards using a regularly scheduled institutional self study and an outside review

Question 2

What does CEPH stand for?

Answer 2

council on education for public health

Question 3

what is certification?

Answer 3

proffession led process in which applicants who have completed the required educational process take an examination; recgonition of completing a program and showing competency

Question 4

what is licensure

Answer 4

a legal document that provides permission to engage In an activity such as a practice of a health profession

Question 5

what is credentialing

Answer 5

process of verifying that an individual has the desirable or required qualifications to practice a profession

Question 6

impatient facilities

Answer 6

patients remain in the facility for at least 24 hours; includes hospitals, skilled nursing and rehabilitation facilities, nursing homes, and institutional hospices

Question 7

outpatient facilities

Answer 7

provide clinical services by one or more clinicians and those providing diagnostic testing or treatment

Question 8

which kind of hospitals are most common in the us

Answer 8

not for profit

Question 9

4 categories to determine medical malpractice

Answer 9

1. a duty was owed
2. a duty was breached
3. a breach caused an injury
4. damages occured

Question 10

what does structure measure focus on?

Answer 10

physical and functional infrastructure

Question 11

what does process measures focus on?

Answer 11

procedures and formal processes that go into delivering care

Question 12

what does outcome measures focus on?

Answer 12

focuses on result of care

Question 13

3 different types of insurance in the us

Answer 13

government financed
employment based
health insurance exchanges

Question 14

Medicare

Answer 14

federal government program
anyone over 65
50 million Americans are eligible

Question 15

part A of medicare

Answer 15

covers hospitals care, skilled nursing care, hospice care, home health care after hospitalization

Question 16

part b of medicare

Answer 16

voluntary supplemental insurance that covers diagnostic and therapeutic services

Question 17

part c of medicare

Answer 17

a program designed to encourage medicare beneficiaries to enroll in prepaid health plans

Question 18

part d of medicare

Answer 18

prescription drug plan opens to individuals enrolled in parts a and b

Question 19

medicaid

Answer 19

federal plus state program designed to pay for health services for specific categories of poor people and other designated groups: disabled, childre, pregnant etc…

Question 20

What is the largest single category of insurance coverage

Answer 20

Employment based health inusance

Question 21

When health care is payed by one source?

Answer 21

single payer

Question 22

payment mechanism in which clinicians charge insurance companies and/or patients for each patient visit or procedure is called what?

Answer 22

fee for service

Question 23

which part of medicare covers out patient drugs?

Answer 23

medicare part D

Question 24

capitation

Answer 24

a fixed number of dollars per month to provide services to an enrolled number regardless of the number of services provided

Question 25

premium

Answer 25

the price paid by the purchaser for the insurance policy on a monthly or yearly basis

Question 26

out of pocket expenses

Answer 26

any cost of health care that is not covered by insurance and is the responsibility of the insured.

Question 27

deductible

Answer 27

The amount of and indivual or family is responsible for paying before being eligible for insurance coverage

Question 28

co-payment

Answer 28

An amount the insured is responsible for paying even when the service is covered by the insurance

Question 29

cost sharing

Answer 29

effort to reduce healthcare costs by shifting costs to individuals

Question 30

cap

Answer 30

a limit on the total amount that the insurance will pay for a service per year, per benefit period, or per lifetime

Question 31

skimming

Answer 31

enrolling prominently healthy individuals

Question 32

factors that increase the cost of healthcare

Answer 32

1. aging of the population
2. technological innovations that expand treatment option
3. success of medical care has raised patient expenses