Final Exam US Healthcare Systems

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Which of the following is an area of special focus in the Affordable Care Act?
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Which of the following is the largest health care occupation in the U.S.?Registered nursesWhich of the following is a major influence that causes medical students to choose a specialized field of medicine over primary care?Greater earning potentialThe proportion of the U.S. population over age 65 is expected to reach which of the following by the year 2030?20%Which health profession is becoming obsolete due to the increasing prevalence of electronic medical records?Medical transcriptionistPerformance-based payment, as incorporated in the Affordable Care Act, may encourage hospitals to increase staffing of which of the following professions?NursesWhich model of care, included in the Affordable Care Act, engages a team of providers in the delivery of care to the patient that typically includes physicians, nurse practitioners, registered nurses, medical assistants, health educators, and pharmacists?Patient-centered medical homeWhich of the following innovations is increasing access to specialists for patients in rural areas?TelemedicineWhat percentage of nurse practitioners provide primary care services?65%To fully leverage the capacity of the health workforce and align care processes to emerging financial incentives, scope-of-practice regulations for which health care profession may need to be reconsidered?Nurse practitionersWhich of the following are innovations that create financial incentives for health care providers to improve efficiency of health care delivery while quality is maintained or improved?Bundled payments & accountable care organizationsWhich of the following parties are NOT responsible for paying for an individual's health insurance?Individual's physicianWhich of the following are negative outcomes that economists fear will occur when people do not directly and fully pay for their health services?Consumer overuse of health care servicesWhich of the following sources of revenue for hospitals is known for paying the lowest rates for each day of hospital care?MedicaidThe government health insurance program known as CHIP covers which group?Children not eligible for MedicaidWhich of the following effects is the Affordable Care Act expected to have on state Medicaid programs?It will drastically expand themAlthough Medicare was originally intended to cover people 65 years and older, it was soon expanded to cover which other groups?The disabilitedTravis, a 45-year-old construction worker and Iraq war veteran, was severely injured on the job site when a steel girder fell on him. He is now in the hospital and has undergone extensive operations and treatment for his injuries. He has health insurance provided by his employer. Which public program would most likely assist Travis in paying his medical bills in this situation?Workers' compensationThe Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 accomplishes which of the following?Requires employers to extend health insurance benefits to former employees for up to 18 monthsWhich payment approach, established in the Affordable Care Act, is a new version of managed care in which consumers trade freedom of provider choice for more coordination of care and lower copayments?Accountable care organizationWhich system involves the government setting rates of Medicare reimbursement up front so that Medicare pays a fixed amount for a hospital stay of a patient with a specific diagnosis and no more, regardless of the actual cost of care?Diagnosis-related groupsApproximately how much did the average household in the U.S. spend out of pocket on health care in 2012, not including health insurance premiums?$3500Which nation spends more on health care as a percentage of its gross domestic product than any other?United StatesAccording to the Commonwealth Fund (2013), what percentage of the total population is responsible for 80% of total spending on health care?20%Who makes most of the decisions about which health care services an individual consumes?PhysicianObese patients are estimated to cost the health care system how much more than patients of normal weight?42%Which approach to controlling health care costs are most Americans uncomfortable with, although it is commonly used in other nations with a "Universal Healthcare System"?Rationing health care servicesTo help reduce health care costs and ensure healthier employees, the Cleveland Clinic will no longer hire workers who are which of the following?SmokersIncreased use of which of the following could help reduce the cost of end-of-life care?HospicesWhich of the following is not an example of a medical service focused on a key determinant of population health?Rehabilitation programs for stroke patientsTo increase the ratio of value-to-costs in medical care delivery, which of the following should NOT be focused on?Increasing investment in researchWhich term is defined as "the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge"?QualityWhich term refers to facilities and health care professionals providing care?StructureProcess, one of the dimensions of quality, may be defined as which of the following?Set of services providedOutcomes, one of the dimensions of quality, may be defined as which of the following?End results that people experience and care aboutIn terms of health care quality, a 2014 Commonwealth Fund study found that the United States ranked in which position out of 11 countries?11thWhich of the following is an example of a process measure of quality of care?Percentage of patients who received a serviceToday, patients can and do reliably report on their experience of care through which of the following?Standardized surveysWhich organizational level is the easiest in which to improve health care quality?MicroThe interaction of surgeons, primary care clinicians, nurses, and nutritionists all working together to help provide high-quality care to a patient is an example of which organizational level of care?TeamWhich of the following is NOT among the drivers of quality care that influence provider behavior?CompetitionThe process that organizations use to make strategic decisions is which of the following?GovernanceThe agents of the governing board who create and maintain the environment that supports clinicians in their work are known as which of the following?ManagersAccountability means which of the following?Being answerable for decisions that affect health outcomesWhich of the following is NOT one of the principal functions of a Board of Directors for a nonprofit health care organization?Manage the day-to-day operations of the health care organizationIn their interactions with new hires, managers ideally should be spending most of their time doing which of the following?Removing obstaclesManagement decisions should be made based on which of the following?Best evidence availableAll of the following are benefits of having a governing board for a nonprofit organization EXCEPT:Coaching and mentoring of employeesAccording to Goleman, which of the following attributes is most important for effective managers?High emotional intelligenceWhich managerial function involves determination of goals and objectives?PlanningWhich managerial function involves structuring resources to accomplish the work required to meet the objectives?OrganizingA physician needs to order a computed tomography scan for a patient. Which of the following electronic health record tools would be appropriate for this task?Computerized physician order entryA patient is allergic to latex. Which of the following electronic health record tools could automatically alert the physician and nurses of this fact, thereby reducing the risk of using latex gloves when caring for this patient?Clinical decision supportA physician would like to set up patient portals so that her patients can schedule their own appointments online. Which of the following electronic health record tools would allow the physician to do this?Patient engagement toolWhich of the following allows physicians in a network to retrieve information about patients across providers and settings, in real time, creating coordinated or integrated care?Health information exchangeWhat one feature is essential for all electronic health records to share?InteroperabilityBy 2012, what percentage of acute care hospitals in the U.S. had an electronic health record system?44%Which law, passed in 2009, included $30 billion in incentives for hospitals and physician practices to adopt electronic health records?Health Information Technology for Economic Clinical Health ActA physician recently joined an integrated health care organization in which he and a group of other providers are assigned a group of patients for whom they are responsible to provide quality care and a quality patient experience while keeping the total costs of the care low. He is allowed to share in any savings generated by the group of providers. This model is known as which of the following?Accountable Care OrganizationCarla receives her health care from a team of caregivers including her primary care physician who, together, are responsible for meeting all of her physical and mental health care needs, including prevention and wellness, acute care, and chronic care. All of these caregivers are linked electronically and can view comments recorded in her electronic health record by all other members of the team. This model is known as which of the following?Patient-Centered Medical HomeMelissa has multiple significant health problems, including heart disease, diabetes, and hypertension. She also has a history of drug abuse and domestic violence. Given the complexity of her case, which of the following models of health care would best meet her needs?Health homeHealth care in the U.S. is relentlessly moving to a system that is which of the following?Outcomes-orientedWhich method of forecasting, developed by economists and statisticians, involves analyzing past data to predict future economic events by establishing the relationships between driving forces and outcomes and then predicting the future by assuming that the past relationships will continue going forward?QuantitativeWhich method of forecasting involves a more qualitative approach to forecasting and systematically obtains expert opinions, with an end goal of achieving consensus?DelphiWhich of the following, according to the authors, is the key driver of potential change in the health system?Emerging technology and medical know-howAt least how many states have refused to expand their Medicaid programs?21Which medical or scientific advancement holds the promise of allowing physicians to personalize each patient's treatment regimen?Human genome mappingWhich medical or scientific advancement may allow physicians to grow organs that would not be rejected by an individual when transplanted?Stem-cell technologiesNew finance approaches that focus on paying fixed amounts of money for taking care of a bundle of needs for patients are expected to have all of the following benefits EXCEPT:Patients will only have to pay for individual services instead of for an entire episode of careWhich of the following will likely become more prevalent and influential over the next 10 to 20 years?Large integrated networks of providers Previous NextWhich of the following is NOT an example of a health care system that has successfully created an integrated network of providers?Medicare