HCD II Flashcards

1
Q

Types of problems that may benefit from QI process

A

recent outcomes have declined from previous outcomes
recent outcomes are lower than the benchmark
practice deviates from some known standard practice

NO: compliance is less than 100%

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2
Q

What does a run chart display?

A

key QI data over time

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3
Q

Process mapping helps the team develop

A

a shared mental model

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4
Q

Tools to DEFINE and UNDERSTAND quality problem

A

process map
voice of the customer
root cause analysis

NO: hierarchy of interventions (this falls Improving your problem)

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5
Q

general supervision

A

PTA

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6
Q

PTA stands for…

A

physical THERAPIST assistant

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7
Q

Who is EXCLUDED from individuals that a PT can supervise (at one time) under CO Physical Therapy Practice Act?

A

SPT, PTA student

Who is included? PTA, aide, other regulated professionals (massage therapists, OT, etc.)

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8
Q

Which is most likely to result in PT license revocation?

A

felony conviction for sexual assault

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9
Q

Who can sign off PT POC for medicare

A

PA, MD, DO, NP

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10
Q

what should be documented when a patient has medicare part B

A

total time spent with patient
total time spent on 1:1 services

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11
Q

T/F If states adopt a work requirement under medicaid, all individuals will be required to work

A

FALSE — work requirement does not just mean getting a job. It can also be the person is in school, volunteering, job training, etc.

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12
Q

T/F federal law requires that cost sharing for individuals on medicaid is identical, regardless of income

A

FALSE — states impose out of pocket costs, and the amounts that can be charged vary with income !!

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13
Q

Medicare therapy cap

A
  • applies to all OP therapy settings
  • PT and SLP combined capped benefit of $2150
  • therapy cap: limited therapy services to set $ amount
    -“soft” therapy cap: technically can exceed set $ if deemed necessary by PT via using modifiers
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14
Q

regressive tax

A

type of tax on spending habit
e.g. sales tax, car registration, tobacco, utilities, SSN

hurts poor more than wealthy

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15
Q

progressive tax

A

ex: federal income tax system
you get taxed more if you make more money

hurts wealthy more than poor

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16
Q

flat tax

A

taxes all income at same rate regardless of income level, spending habit, or asset level

17
Q

An insurer offering a part C plan is most likely to experience which of the following outcomes when there are high numbers of enrollees?

A

Favorable selection

18
Q

PDPM

A

SNF

19
Q

PDGM

A

Home health

20
Q

Part B medicare co-insurance for PT is what % of the medicare fee schedule?

A

20%

21
Q

Most physical therapists generated charges in an acute care hospital are used to determine productivity, and may not even leave the building to be billed to medicare. Why?

A

The hospital is paid based on DRG

22
Q

Definition of value?

A

Health outcomes achieved per dollar spent

23
Q

Federal public option vs. state public option

A

Federal public option: federal government adds a public insurance (like medicare) but all can apply

State public option: public-private partnership— state contracts with private companies to create new insurance options, overseen by government (similar to Plan C)

24
Q

When did private health insurance premiums/deductibles begin to rise?

A

BEFORE the ACA was passed

25
Q

Who typically discloses errors or adverse events related to patient care?

A

Clinicians directly involved in patient care

26
Q

Who does the CO PT board have jurisdiction over?

A

Individuals who claim to be physical therapists

27
Q

Dieticians in CO

A

Have title protection for the term dietician