which of the following statements describes managed care?

QUESTION 1 Medicaid plans face several operational challenges, Accreditation is a voluntary process that a health care facility or organization (e.g., hospital or managed care plan) undergoes to demonstrate that it has met standards beyond those required by law. 2.17) Approximately how many boutique operations are there in the United States? Citizens discuss the ideal of equal access to health care for everyone, including care for indigents. A. C. The disposal ofcarcassesmust require the permission of the State or Federal Environmental Protection Agency and Department of Natural Resources. a. A. Patient care delivery 2. Funds in an FSA are exempt from both income tax and Social Security tax (employers may also contribute to FSAS). Select all that apply. The appropriateness, efficiency, and medical necessity of health care provided to patients is reviewed on a prospective and retrospective basis. The US is the only developed nation without a system of universal healthcare, with a large proportion of its population not carrying health insurance, a . D) Hospitals are the preferred setting for service delivery. do australian shepherds have a good sense of smell; matan adelson net worth; words that rhyme with crime; fattmerchant customers; shoulder holster for ruger lcrx 3 inch barrel You might think of a CDHP as a sort of "401(k) plan for health care" (recalling the shift from employer defined-benefit pension plans to employer defined-contribution 401(k) plans). The _______ is responsible for supervising and coordinating health care services for enrollees and approves referrals to specialists and inpatient hospital admissions (except in emergencies). Out-of-pocket payments for health care expenses, which are made after the tax-exempt account is expended and before the deductible for high-deductible insurance has been met; this tier actually represents a gap in coverage A) the healthcare institution itself C) American Medical Association B) Board of Healing Arts D) State Board of Nursing, 14. B. es posible nosotros permanecer sentado(s) a and b only. D. All of the above. Case managers do not use the nursing process. Health maintenance organizations (HMOS) manage patient health care services by expending a monthly capitation amount paid by a third-party payer. which of the following statements describes managed care? Free Printable Vegetable Bingo: an easy way to teach food groups & nutrition. B. Livestock that are adapted to cold can tolerate low temperatures if they have adequate feed intake. (B) Give the symmetry number for each of the following molecules: 1. b. Libertarianism, which espouses a free market system and freedom of choice, undergirds the basic principles of U.S. health care financing. The most common health plans available today often include features of managed care. He tells the nurse, "I don't know what that word, outpatient, means." Practicing veterinarians are the officials who must conduct the investigation of a suspected Foreign Animal Disease. The aftermath was first by the Bush administration - by George Bush's then secretary of Treasury, who had come right from Goldman Sachs, which was Hank Paulson. Which of the following are effective MITIGATION (reduction, prevention) activities for farms? C) Short- and long-term results of cost-containment measures are undetermined. Models include physician-hospital organizations, management service organizations, group practices without walls, integrated provider organizations, and medical foundations. c. Individual (or Independent) practice association (IPA) [Solved] Which of the following statements describes managed care organizations? Individuals have greater freedom in spending health care dollars, up to a designated amount, and receive full coverage for in-network preventive care. A triple option plan provides patients with more choices than a traditional managed care plan. which of the following statements describes managed care? horse hind leg tendon sheath. C) The contribution rate is, variable, and the retirement benefit is not known in advance. B) The cost of healthcare in the United States has decreased dramatically. PPO enrollees can also receive health care outside of the network if they are willing to pay higher costs. 5. Ms. A Chap 1-4 Flashcards - Cram.com A. b. The physician group can be owned or managed by the HMO, or it can simply contract with the HMO. HMO Unit 17 Quiz Flashcards | Quizlet Which of the following statements will NOT reduce risks arising from wildfires? 2. These include provider networks, provider oversight, prescription drug tiers, and more. What is the primary focus of healthcare today? The cash value of a policy, Which of the following is a regulatory approach to solving information problems in insurance markets? Point-of-service plan (POS) Health maintenance organization (HMO) B) The care of the patient is carefully planned and monitored by the primary care provider. 2.12) Which of the following does not apply to the role of a medical assistant? 7. Tax-exempt accounts that are offered by employers with 50 or more employees, which individuals use to pay health care bills. A. Which of the following is a characteristic of primary healthcare? Typically, it is an illegal seizure of power by a political faction, politician, cult, rebel group, military, or a dictator. A. precertification. Triple option plan. A. C. Annual property loss resulting from thunderstorms, including damage to farms and barns, is estimated in the hundreds of millions of dollars. 8. 2.11) Concierge care does not offer patients which of the following? A. Livestock agriculture is more widely dispersed than ever before. 2.4) Which of the following best describes the process of screening in the medical office setting? Select one: O a. Which of the following statements iscorrectregarding a Foreign Animal Disease outbreak? B. The group plan will pay depending on the employee's recovery C. The group plan will not pay because the employee was injured at work D. The group plan will pay C. Accreditation of Managed Care Organizations. 5) Which of the following statements describes a defined. is usually owned by physicians or a hospital and provides practice management (administrative and support) services to individual physician practices. 4. Contracted health care services are delivered to subscribers by participating physicians who are members of an independent multispecialty group practice. Hint and warning: Do not use lower limits on your integrals 1n2n3+1\sum_{1}^{\infty} \frac{n^{2}}{n^{3}+1}1n3+1n2. A. 2.6) Which of the following best describes the alternative medicine modality of homeopathy? It is the result of a joint venture between hospitals and members of their medical staff. plan in order for the plan to satisfy the ratio test? C. Do not tie animals to unhitched trailers, as many animals are strong enough to pull the trailer away. If livestock raised for human consumption are removed from a farm, care must be taken that the animals are not exposed to diseases or hazardousmaterialsthat could threaten the human food supply. Escriba lo que dice. Which of the following phrases is characteristic of case management as a method of healthcare delivery? Utilitarian theory is the sole basis for U.S. health care financing, forming the foundation of Medicare, Medicaid, and privately purchased health care insurance. C. Pre-existing economic difficulties can exacerbate the impact of disasters on livestock farmers. Which of the following statements best describes this system? A. C. Reducing personal water usage helps reduce the impact of droughts. 4) Which of the following statements about retirement ages in pension plans is (are) true? D. For a State to qualify for Federal disaster assistance from FEMA, it is best if the State has laws that are consistent with those of Federal emergency management law. B. Peer review organizations (PROs). which of the following statements describes managed care? C. The Department of Health and Human Services (DHHS) is responsible for overseeing the safety of the environment in the U.S. A) Managed care systems control the cost of care with a lower quality of care. Having fire tools handy at your home and in your barn: a ladder, garden hoses, fire extinguishers, gas-operated water pumps, shovels, rakes, and buckets. Exam 1 Review Questions Flashcards by Cam Bui | Brainscape Accreditation organizations, such as the NCQA, evaluate MCOS according to preestablished standards. b. The term used to describe sophisticated and highly complex medical care is. B. Most human injuries in earthquakes result from falling objects. Which of the following statements is correct regarding disasters? Prior to scheduling elective surgery, managed care plans often require a _______; that is, a second physician is asked to evaluate the necessity of surgery and recommend the most economical, appropriate facility in which to perform the surgery (e.g., outpatient clinic doctor's office versus inpatient hospitalization). Which of the following statements best describes an integrated delivery system? Freedom from a Foreign Animal Disease in a country (such as Foot and Mouth Disease) usually includes being free of clinical disease and vaccinating against the disease. Purchasing a generator as an alternative power supply. Which of the following organizations provides independent, impartial assistance in more than 60 countries to people whose survival is threatened by violence, neglect, or catastrophe, primarily due to armed conflict, epidemics, malnutrition, exclusion from health care, or natural disasters? Correctly identify disorders of the wrist. "Sign up for childbirth classes." c. "Sign up for the WIC program." d. "Take your prenatal vitamins daily." A gilead sciences canada jobs. ), State insurance departments, state commerce or departmenf of cooperations. Patients do not need to be well informed about the financial benefit issues that affect the provision of care. The owner of an escaped animal may be held liable for damages his/her animal creates. The intent was to replace conventional fee-for-service plans with more affordable quality care to health care consumers and providers who agreed to certain restrictions (e.g., patients would receive care only from providers who are members of a managed care organization). The report card contains data regarding a managed care plan's quality, utilization, customer satisfaction, administrative effectiveness, financial stability, and cost control. In large-scale disasters, the Director of Emergency Management is responsible for declaring a disaster. Costs from animal disease outbreaks include loss of production andreplacementof animals. b. C. Snow has to fall at rates of greater than 12 inches per hour to cause severe disruptions. D. All of the above. how has dissection been used in engineering; which of the following statements describes managed care? Institutions (singular: institution) are humanly devised structures of rules and norms that shape and constrain individual behavior. Which of the following statements accurately describe an aspect of managed care? which of the following statements describes managed care? A managed care organization (MCO) is responsible for the health of its enrollees, which can be administered by the MCO that serves as a health plan or contracts with a hospital, physician group, or health system. Only animals intended for human consumption require an official health permit signed by a veterinarian when moved across State lines. a. Which of the following statements iscorrectregarding droughts? Expert Help. C. Hurricanes frequently cause flooding along the coast, but not inland. And then, on the foreign policy front, obviously the most important event was the 2008 financial collapse, which was then managed. D. All of the above. D) Risk management is a spontaneous response to an unexpected incident. a. proximal radius C) Employer contributions are considered taxable income to employees but are taxed at capital gains rates. Premiums and other revenue are paid to the HMO. 13. A) There is minimal purchasing-oriented paperwork. This type of economic structure best describes which of the following? Ch. 3 Managed Health Care Flashcards | Quizlet but the retirement benefit is not known in advance. Up-to-date lists of patient copayments and fees for each managed care plan contract Special patient interviews to ensure preauthorization and to explain out-of-network requirements if the patient is self-referring Responsible for reviewing health care provided by managed care organizations. D) The contribution rate is variable, but the, 6) Which of the following statements describes a defined, contribution pension plan? Relate What evidence indicates that oceans formed early in Earth's geologic history? Accreditation organizations develop standards (requirements) that are reviewed during a survey (evaluation) process that is conducted both offsite (e.g., managed care plan submits an initial document for review) and onsite (at the managed care plan's facilities). 1. d. withdrawn to cover qualified medical expenses is tax-free. After a stroke, a patient is having difficulty swallowing. What managed care means? B. Livestock agricultures reliance on machines and technology has increased the need for evacuation procedures. What population do hospice nurses provide with care? 10. Which of the following statements would be most appropriate for the nurse to make? 6) All of the following are types of health care facilities except: A) physicians' office. I. Managed care plans are a type of health insurance. Which of the following statements about the nursing process is true. 1 . Health care can be purchased or given freely in Country A, but there is no entitlement program to ensure basic health care to vulnerable people. is a nonprofit organization that contracts with and acquires the clinical and business assets of physician practices; the _____ is assigned a provider number and manages the practice's business. managed care. A) The U.S. healthcare system has been experiencing a financial crisis. A. The group plan will pay a portion of the employee's expenses B. 8-10 - 1. Which of the following statements accurately describe an Select all that apply. retire without receiving actuarially reduced benefits. D) Medicare and Medicaid will pay most of the costs. A) those requiring care to improve health B) children with chronic illnesses C) dying persons and their loved ones D) older adults requiring long-term care, 13. Who provides physicians with the authority to admit and provide care to patients requiring hospitalization? Although you will first check with her provider, you are sure she is to see which of the following? A. Managed care organizations (MCOS) impact a practice's administrative procedures by requiring: Separate bookkeeping systems for each capitated plan to ensure financial viability of the contract The use of remedies made from naturally occurring plant, animal, or mineral substances. A. Which of the following statements is/are correct regarding the humane care of animals in disasters? D. All of the above. State disaster declarations can only be made when more than one community is affected. Managed care plans emphasize cost controls and preventative care. The economics of Country A support the rights of property and liberty for each person and allow each citizen to improve life circumstances by his or her own effort. All definitions of institutions generally entail that there is a level of persistence and continuity. results. 3. (b) What range of wavelengths would distinguish B\mathrm{B}B and C\mathrm{C}C ? Study Resources. E) In the past, healthcare focused primarily on prevention of illnesses since it was covered by insurance. I. Essay: Managed Care: Promise and Concerns | Health Affairs FEMA IS 111.A: Livestock in Disasters Answers A Colles fracture occurs at the: Note In managed care, the primary care provider usually receives capitation payment and is responsible for managing all of an individual's health care, which includes reimbursing other caregivers (e.g., specialists). This question suggests which of the following? Which of the following statements accurately describe an aspect of managed care? Then, identify each adjective clause as essential (E) or nonessential (N). Ch. 9: Other Health Insurance Concepts Flashcards | Chegg.com What is one way in which nurses can help shape healthcare reform? managed care plans because of restrictions placed upon their freedom to treat patients. Brace anchor all tall or top-heavy objects. Utilization management activities include: preadmission certification (PAC) or preadmission review, preauthorization, concurrent review, and discharge planning. Select all that apply. 5) Two parameters that usually result in an indication of excellent health are: A) genetics and education. A patient has a private insurance policy that pays for most healthcare costs and services. perpetual motion ornaments; who plays elias in queen of the south; robert snodgrass net worth; pacific northwest volleyball association; Quality Compass users benefit from the largest database of comparative health plan performance information to conduct competitor analysis, examine quality improvement and benchmark plan performance. 3) What are the minimum age and service requirements that can be imposed on employees eligible to participate, A) age 18 and 6 months of service B) age 21 and 1 year of service, C) age 21 and 3 years of service D) age 25 and 4 years of service. An integrated delivery system may also be referred to by any of the following names: integrated service network (ISN), delivery system, vertically integrated plan (VIP), vertically integrated system, horizontally integrated system, health delivery network, or accountable health plan. Which of the following statements arecorrect? The NCQA began accrediting managed care programs in 1991 when a need for consistent, independent information about the quality of care provided to patients was originally identified. gilead sciences canada jobs. 14. 2.3) Which of the following statements best describes a health maintenance organization (HMO)? The federal _________ plan requires managed care plans that contract with Medicare or Medicaid to disclose information about ________ plans to CMS or state Medicaid agencies before a new or renewed contract receives final approval. B) epidemiology. 2.19) Who best knows the patient's body and financial situation? In large-scale disasters, the Director of Emergency Management is responsible for declaring a disaster. A) The contribution rate is fixed. B) genetics and income. 2.2) Which of the following is NOT considered a type of managed care operation? Nurses who are employed in home care have a variety of responsibilities. Relationships are not critical in the delivery of health services. llegar a tiempo It is necessary for it to be raining to be struck by lightning. A) cost containment C) healthcare rationing B) fragmentation of care D) knowledgeable consumers, 21. 24 A primary care provider (PCP) assigned to each subscriber is responsible for coordinating health care services and referring subscribers to other health care providers.

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