Additional paperwork for specialists to complete and the filing of treatment and discharge plans EPOS are regulated by _______ (unlike HMOS, which are regulated by either the _____ or __________, depending on state requirements). Find answers to the next exam here: FEMA IS-120.C: An Introduction to Exercises Answers. 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). B) The care of the patient is carefully planned and monitored by the primary care provider. A) decreasing diversity C) uneducated consumers B) lower costs of healthcare D) current nursing shortage, 22. Consumers also benefit from HEDIS data through the _________, a comprehensive look at the performance of the nation's health care system. Fixed-price reimbursement is a feature of managed care. 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). b. June 29, 2022. The following are examples of hospital joint ventures that are unlikely to raise significant antitrust concerns. Select all that apply. (The catastrophic limit is usually higher than those common in other plans.) 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. Under emergency conditions,animal healthservices should always be provided by the person who is closest to the scene. Money must be used for qualified health care expenses and allows individuals to accumulate unspent money for future years. Which of the following statements characterizes effective disaster preparedness plans? f. Provide quality health care while containing costs. 14. a. Which of the following statements iscorrectregarding the disposal ofcarcasses? An elderly woman has total care of her husband with Alzheimer's disease. Continuing Healthcare Funding issues - why isn't it simple to apply? Individuals have greater freedom in spending health care dollars, up to a designated amount, and receive full coverage for in-network preventive care. C) Short- and long-term results of cost-containment measures are undetermined. It has. Which of the following accurately describes relationship between disasters and the economic impact on livestock farmers? 53. immunizations and screenings included in benefits 54. trevor lawrence 225 bench press; new internal medicine residency; what channel does maury come on xfinity. Then, identify the type of clause by writing one of the following abbreviations above it: ADJ for adjective clause, ADV for adverb clause, or N for noun clause. 22. Which of the following statements describe effective operations in disasters? prestar mucha atencin. "Don't drop out of school." b. A "health care system which attempts clinically and financially to control primary health care services in a medical group practice through elimination of redundant facilities and services for the purpose of reducing costs" describes which of the following health care financing systems? Unique and permanent identification for all animals would be of little help in reuniting animals with their correct owner in disasters. POS enrollees pay less if they use the plan's in-network providers. withdrawn to cover qualified medical expenses is tax-free. Question 10 options: A) Risk management is controlled and managed by HIPAA regulations. John Rawles suggested that in making decisions of distributive justice, one should examine the situation behind a "veil of ignorance" so that no one would be able to design principles to favor his or her particular condition. managed care. State disaster declarations can only be made when more than one community is affected. Typically, it is an illegal seizure of power by a political faction, politician, cult, rebel group, military, or a dictator. 2.7) How many years of a residency program is required for newly graduated M.D.s choosing to specialize in family practice, internal medicine, or pediatrics? Federal agencies are usually activated directly in response to requests from local emergency managers. results. When disasters affect many livestock farms in a county it is unlikely that this will represent a significant loss to the countys tax base. 3. A) Managed care systems control the cost of care with a lower quality of care. D) Medicare and Medicaid will pay most of the costs. Then, identify each adjective clause as essential (E) or nonessential (N). C. Veterinarians dont know much about the clinical aspects of food animals exposed to hazardous chemicals. all of the above. C. Housing animals so that heavy objects do not fall on them in earthquakes is an important preparedness activity for earthquakes. Which of the following is a natural consequence of utilitarian forms of health care financing? c. B) genetics and income. Which of the following statements would be most appropriate for the nurse to make? 51) Which of the following statements about managed care plans is (are) true? Step-by-step explanation A pregnant teenager has approached a nurse asking about ways to improve the health outcomes for her and her unborn child. In large-scale disasters, the Director of Emergency Management is responsible for declaring a disaster. All parties should foster an ethical environment for the delivery of effective and efficient quality health care. 5. B. Livestock agricultures reliance on machines and technology has increased the need for evacuation procedures. In Canada, almost all people are insured against the cost of all hospital and physician expenses through a government health insurance program. Many scholars consider a coup successful when the usurpers seize and hold power for at least . I. 1 . Included in HEDIS is the________, which measures members' satisfaction with their care in areas such as claims processing, customer service, and getting needed care quickly. D. All of the above. [The work functions are Ta (6.811019J)\left(6.81 \times 10^{-19} \mathrm{~J}\right)(6.811019J), Ba(4.301019J)\mathrm{Ba}\left(4.30 \times 10^{-19} \mathrm{~J}\right)Ba(4.301019J), and W (7.161019J)\left(7.16 \times 10^{-19} \mathrm{~J}\right)(7.161019J); work function is explained . 11. Documentation of ownership may be needed to reclaim a lost animal. Which of the following statements are considerations for managed care organizations? 29. Although you will first check with her provider, you are sure she is to see which of the following? Which of the following statements will NOT reduce risks arising from wildfires? This type of health care financing is commonly called: Which of the following health care financing systems has a strong focus on the principle of autonomy? (2023 History ) - Pgrip, 15 best free Android apps available right now, How Do Free Apps Make Money in 2022? 2.6) Which of the following best describes the alternative medicine modality of homeopathy? True or false? B. Livestock agricultures reliance on machines and technology has increased the need for evacuation procedures. . 30. Providers are employees of the organization. D) There is only one supplier for all units of a particular product. Which of the following statements accurately describes disaster assistance? Despite this, the country has significantly worse healthcare outcomes when compared to peer nations. Patients should be well informed about care and treatment options. B. Patient care delivery 2. Countries or subunits often also impose wealth taxes, inheritance taxes, estate taxes, gift taxes, property taxes, sales taxes, use taxes, payroll taxes, duties and/or tariffs . es necesario el capitn hacerun anuncio is an organization of affiliated providers' sites (e.g., hospitals, ambulatory surgical centers, or physician groups) that offer joint health care services to subscribers. 4) Which of the following statements about retirement ages in pension plans is (are) true? D) Hospitals are the preferred setting for service delivery. The early retirement age is the earliest age at which an employee can. Usually, network providers sign exclusive contracts with the EPO, which means they cannot contract with other managed care plans. D. Large-scale disasters affecting livestock never have serious implications for State revenues. B. The marketing department is launching a new advertising campaign. A. B) Employers, insurance companies, and other health insurance benefit providers are typical groups that contract with PPOs. Why is this plan called a third-party payer? HMOS provide preventive care services to promote "wellness" or good health, thus reducing the overall cost of medical care. Costs from animal disease outbreaks include loss of production andreplacementof animals. Per the PPACA, employees are permitted to carry over up to $500 of unspent funds remaining in the FSA at the end of the year. 2. 10. A. 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). Nurse case managers coordinate patient care from the time of hospital admission to the time of discharge and often following discharge from an . Group Model HMO Premiums, deductibles, and copayments are usually higher than those paid for HMOS, but lower than those paid for regular fee-for-service plans. Health risk assessment instruments (surveys) and resources are also available to subscribers. Models include physician-hospital organizations, management service organizations, group practices without walls, integrated provider organizations, and medical foundations. Patients do not need to be well informed about the financial benefit issues that affect the provision of care. If a claim was filed and $7,200 in costs remained after Crystal met the $200 deductible: A. 7. universal health insurance. C. Annual property loss resulting from thunderstorms, including damage to farms and barns, is estimated in the hundreds of millions of dollars. Individual Practice Association (IPA) HMO Network Model HMO. Which of the following statements about the history of home healthcare nursing is most accurate? Which of the following statements iscorrectregarding the human food supply in disasters? Exclusive provider organization (EPO) patients must receive care from participating providers, which can include emergency departments at participating hospitals, or they pay for all costs incurred. Healthcare in the United States is far outspent than any other nation, measured both in per capita spending and as a percentage of GDP. C. Do not dress animals with vests, blankets, and othermaterialsthat would prevent them from sweating. The _______ is responsible for supervising and coordinating health care services for enrollees and approves referrals to specialists and inpatient hospital admissions (except in emergencies). The nurse in charge of the clinic asks herself, "Who needs this medicine most?" 1. Costs from animal disease outbreaks include loss of production andreplacementof animals. Health care is provided by individuals who are not employees of the HMO or who do not belong to a specially formed medical group that serves the HMO. Tax-exempt accounts that are offered by employers to any number of employees, which individuals use to pay health care bills. B. Exclusive provider organization (EPO) A. Managed care is categorized according to six models: exclusive provider organizations, integrated delivery systems, health maintenance organizations, point-of-service plans, preferred provider organizations, and triple option plans. If the enrollee sees a non-managed care panel specialist without a referral from the primary care physician, this is known as a self-referral. Healthcare Effectiveness Data and Information Set (HEDIS). If the physician provides services that cost less than the capitation amount, there is a profit (which the physician keeps). D. Many animals look sufficiently distinct for most persons other than the owner to be able to distinguish one animal from another. 2.10) Which of the following best describes how alternative health therapies are being perceived? It is the result of a joint venture between hospitals and members of their medical staff. Ice dams on roofs and large icicles are uncommon causes of building collapse. D. All of the above. Preauthorization and/or precertification for all hospitalizations and continued certification if the patient's condition requires extension of the number of authorized days . B. Composting is no longer used to dispose of any livestockcarcasses. a. B. 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. A) The contribution rate is. c. proximal carpals It lowers cost through the elimination of waste and excess. 26. C) education and income. In insurance, the insurance policy is a contract (generally a standard form contract) between the insurer and the policyholder, which determines the claims which the insurer is legally required to pay. manages the delivery of health care services offered by hospitals, physicians (who are employees of the _____), and other health care organizations (e.g., an ambulatory surgery clinic and a nursing facility). . Institutions (singular: institution) are humanly devised structures of rules and norms that shape and constrain individual behavior. C. Reducing personal water usage helps reduce the impact of droughts. An important role of FEMA in disasters is coordination of response and recovery activities in declared major disasters. B. es dudoso los nios obedecer la seal de abrocharse el cinturn de seguridad F) Planning and monitoring are conducted to ensure standards are followed. Each provider is paid a fixed amount per month to provide only the care that an individual needs from that provider (sub-capitation payment). C. To prevent introduction of disease to farms, delivery and dispatch points on farms should be located away from livestock. F) Competition among hospitals has further fueled the increase in health costs. 2.12) Which of the following does not apply to the role of a medical assistant? She explains that a reoccurring rash on her legs has been bothering her, and her provider wants the other doctor to examine the rash and treat her if possible. Es el medioda y t tienes hambre. Most employees are covered under some form of managed care plan. 1 I only 2) I only 3) both I and A neither non Question 70 (1 point . Which of the following best describes the connection between ethics and health care financing? Also write ELL above each elliptical clause. C. Do not tie animals to unhitched trailers, as many animals are strong enough to pull the trailer away. Unlike traditional fee-for-service. Which of the following statements is correct regarding disasters? d. Different methods of paying for health care in the United States seek to provide superior care, equality of access, and freedom of choice for all citizens, while promoting the public interest through cost-containment programs. A. Medicare was established in 1965 under Title XVIII of the Social Security Act as a federal health insurance program for individuals age 65 and older, regardless of income or health status. Tax-exempt accounts that are offered by employers with 50 or more employees, which individuals use to pay health care bills. If enrollees choose to receive all medical care from the managed network of health care providers, or obtain an authorization from their POS primary care provider for specialty care with an out-of-network provider, they pay only the regular copayment or a small charge for the visit and they pay no deductible or coinsurance costs. _______ were created to manage benefits and to develop participating provider networks. The IPA is an intermediary (e.g., physician association) that negotiates the HMO contract and receives and manages the capitation payment from the HMO, so that physicians are paid on either a fee-for-service or capitation basis. A Colles fracture occurs at the: Triple option plan. Yet, segments of the health care system maintain aspects of a free-market competition. a payment system based on Diagnosis related groups (DRGs). Managed care originally focused on cost reductions by restricting health care access through utilization management and availability of limited benefits. 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. 4. C) Reimbursement is usually based on fee-for-service. Select all that apply. 20. Managed care plans implement _______ as a method of controlling health care costs and quality of care. Participants enroll in a relatively inexpensive high- deductible insurance plan, and a tax-deductible savings account is opened to cover current and future medical expenses. Answer the following question choosing the stem-changing verb that makes the most sense in the sentence. b.Health insurance payments and co-pays must be proportional to income. Other plans contract with a _________, an organization that provides health benefits claims administration and other outsourced services for self-insured companies. D. All of the above. of 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. 28. 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 . A) locally supported healthcare financing, usually by donations B) a public assistance program for low-income individuals C) predetermined payment for services based on medical diagnoses D) a private insurance plan for subscribers who pay a copayment. B) Payment for services is integrated with delivery of services. a. 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. Copayments range from $1 to $35 per visit, and some services are exempt because coinsurance payments are required instead. B. A. 1) All of the following statements about tax implications of qualified pension plans are correct EXCEPT, A) Investment earnings on plan assets accumulate on a tax. is owned by hospital(s) and physician groups that obtain managed care plan contracts; physicians maintain their own practices and provide health care services to plan members. D. Allowing people to smoke in barns. 4. C. Annual property loss resulting from thunderstorms, including damage to farms and barns, is estimated in the hundreds of millions of dollars. b. Which of the following statements about managed care are true? Preferred provider organization (PPO) B. B. a. A) care of acute illnesses C) health promotion B) care of chronic illnesses D) health restoration. a. Smallville Mall's insurer knows the existence, Insurable interest may exist when Select one: a.Julia has insurance on a car she just sold, b.Wells Fargo bank lends Tien $300,000 to buy a house and buys insurance on the house, c.Anthony, a, Assume that the following probability distribution exists for automobile damages. 2.18) In 2007, how much of the world's population relied on alternative medicine? Most PPOS are open-ended plans allowing patients to use non-PPO providers in exchange for larger out-of-pocket expenses.