Health Systems

Question 1

Habeus cortis

Answer 1

allows a person to report unlawful restriction

Question 2

Habeus cortis

Answer 2

allows a person to report unlawful restriction

Question 3

Horizontal integration

Answer 3

expansion of core products or services at the same part of the production process in the same part of an industry.

ex. hospital acquires a nerby hospital

Question 4

Divestiture

Answer 4

elimination of product s or services, closure of facilities, or withdrawal from a market area

Question 5

Retrenchment

Answer 5

reduction of the scope or intensity of services or products

Question 6

Vertical integration

Answer 6

offering a broad range of patient care and support services in a functionally unified manner by operating more than a single point on the chain of production.

Ex. hospital adding a fitness center.

Question 7

Interorganizational relationships

Answer 7

joint venture, mergers, and consolidations. Can be combined with other strategies.

Question 8

Value based purchasing

Answer 8

payment strategies that offer financial incentives based on defined measure to achieve greater value in halth care while slowing spending.

Question 9

Risk corridor

Answer 9

Provision in the ACA that intends to promote accurate premiums int he health care exchange

Question 10

What are the 9 major domains in the National Committee on Quality Assurance Recognition Module for Patient Centered Medical homes.

Answer 10

Access and Communication
Patient Tracking and Registry functions
Care Management
Patient Self management support
E prescribing
test tracking
referral tracking
Performance reporting and improvement
Advances electronic communication

Question 11

Utilization Management

Answer 11

Set of techniques used by or on behalf of purchasers of health care benefits to manage health care cost by influencing patient care decision making through case my case assessment of appropriateness of care before its provision.

Organization continually evaluating the medical necessity and appropriateness using evidence based criteria

Question 12

How long do laboratory have to comply with patient request for labs
and what is the CLIA exception

Answer 12

30 days
If it may cause harm to patient or others by judgement of HCP, then it can be denied

Question 13

“Final Rule” related to labs

Answer 13

Allows individuals to receive lab results directly from the lab.

Question 14

Medicare Access and CHIP reauthorization Act

Answer 14

Eliminated the sustainable growth rate formula

Question 15

Antikickback law

Answer 15

Requires proof of intent

Question 16

What is the Federal Food, Drug, and Cosmetic Act and when was it enacted

Answer 16

Enacted in 1938, FDA responsible for public health in the areas of food saftey, drugs, dietary supplements and medical devices

Question 17

What does the Resource Conservation and Recovery Act regulate

Answer 17

Generation, transportation, treatment, storage, and disposal of hazardous waste
Passed in 1976. known as cradle to grave

Question 18

which health service had the greatest growth from 1997 to 2007

Answer 18

prescription drugs

Question 19

What is the primary objective of utilization management

Answer 19

cost containment.

Question 20

What are the three components of measuring health care quality proposed by donebedian

Answer 20

Structure: the attributes of the settings in which care occurs.
2. process: What is actually done in actual giving and receiving of care
3. outcome measures: capture the effect of an intervention on health status specific clinical finding, or patients perception of care.

Question 21

What part of medicare is based on prospective payments. explain

Answer 21

Medicare A. Hospital payment is based on diagnosis related groups which provide a schedule for payments before they are delivered.

Question 22

HMO group vs network model

Answer 22

Group is when on one group is contracted to provided covered services. In a network model, more than one multispecialty group is ontracted.

Question 23

What does the comprehensive energy response, compensation and liability act do

Answer 23

Provides for liability that is joint, several and retrospective. Legislation that established a “superfund” for clean up of abandoned or active sites contaminated by hazardous waste.

Question 24

What does the clean water act of 1977 do

Answer 24

Provides for regulation of discharge of pollutants into water. Goal of making surface waters swimmable or fishable

Question 25

What did the safe drinking water act of 1974 do

Answer 25

Established standards for public water systems and provided protection of ground water.