Question 1

Medical Insurance Plan Restricted to limited panel, except emergencies

Accepted Answer

Exclusive Provider Organization

Question 2

Medical Insurance Plan Restricted to limited panel, except emergencies Deny for any service that does not meet established evidence-based guidelines

Accepted Answer

Health Maintenance Organization

Question 3

Medical Insurance Plan Patient can see providers outside network I need a referral Higher copays and deductible for out of network services

Accepted Answer

Point of Service

Question 4

Medical Insurance Plan Patient can see providers outside network I do not need a referral Higher copays and deductibles for all services

Accepted Answer

Preferred Provider Organization

Question 5

Medical Insurance Plan Providers voluntarily enroll Medicare

Accepted Answer

Accountable Care Organization

Question 6

Disease prevention, what type is this? Prevent disease before it occurs

Accepted Answer

Primary Disease Prevention

Question 7

Disease prevention, what type is this? Screen early for and manage existing but asymptomatic disease (Pap Smear)

Accepted Answer

Secondary Disease Prevention

Question 8

Disease prevention, what type is this? Treatment to reduce complications from disease that is ongoing or has long term effects

Accepted Answer

Tertiary Disease Prevention

Question 9

Disease prevention, what type is this? Identifying patients at risk of unnecessary treatment, protecting from the harm of new interventions?

Accepted Answer

Quaternary Disease Prevention

Question 10

Healthcare Payment Models Healthcare organization receives a set amount per service, regardless of ultimate cost, to be divided among all providers and facilities involved

Accepted Answer

Bundled Payment

Question 11

Healthcare Payment Models Physicians receive a set amount per patient assigned to them per period of time, regardless of how much the patient uses the healthcare system, used by HMO

Accepted Answer

Capitation

Question 12

Healthcare Payment Models Patient Pays for each individual service at a discounted rate predetermined by providers and payers

Accepted Answer

Discounted Fee for Service

Question 13

Healthcare Payment Models Patient pays for each individual service

Accepted Answer

Fee-for-Service

Question 14

Healthcare Payment Models

Patient pays for all expenses associated with a single incident of care with a single payment. Most commonly used during elective surgeries, as it covers the cost of surgery as well as the necessary pre and postoperative visits

Accepted Answer

Global Payment

Question 15

Who uses.... Medicare? Medicaid?

Accepted Answer

Medicare is Elderly Medicaid is Destitute

Public Health 2.0 Flashcards