#1
Which of the following is a primary healthcare reimbursement model?
Fee-for-service
ExplanationProviders are paid for each service rendered, promoting quantity over quality of care.
#2
Which government program provides healthcare coverage for individuals aged 65 and older in the United States?
Medicare
ExplanationSpecifically addresses the healthcare needs of the elderly population.
#3
What is the purpose of the Health Maintenance Organization (HMO) model in healthcare?
To provide comprehensive and coordinated care with a focus on prevention
ExplanationEmphasizes preventive care and comprehensive services for enrolled individuals.
#4
What does DRG stand for in the context of healthcare reimbursement?
Diagnostic Related Groups
ExplanationPatients with similar diagnoses receive a fixed payment, encouraging cost containment.
#5
Which reimbursement model emphasizes quality over quantity of care provided?
Value-based care
ExplanationFocuses on delivering high-quality care to improve patient outcomes.
#6
What is the primary goal of the Accountable Care Organization (ACO) model?
Improving patient outcomes and reducing costs
ExplanationPromotes coordinated care to enhance patient well-being while minimizing expenses.
#7
Which entity administers the Medicaid program in the United States?
State governments
ExplanationManaged at the state level to address the unique needs of each region.
#8
In a bundled payments model, how are providers reimbursed?
With a single payment for all services related to a treatment or condition
ExplanationEncourages cost efficiency by consolidating payments for an entire episode of care.
#9
What is a characteristic feature of the capitation reimbursement model?
Providers receive a set amount per patient regardless of services provided
ExplanationPromotes cost control by providing a fixed payment per patient.
#10
In the context of healthcare reimbursement, what does the acronym RBRVS stand for?
Resource-Based Relative Value Scale
ExplanationAssigns values to medical services based on resources required, influencing reimbursement.
#11
Which reimbursement model is designed to address the social determinants of health and focus on holistic patient care?
Population health management
ExplanationAims to improve overall health by considering social and environmental factors.