B) The care of the patient is carefully planned and monitored by the primary care provider. 19. 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. When disasters affect many livestock farms in a county it is unlikely that this will represent a significant loss to the countys tax base. The National Veterinary Response Team (NVRT) is part of disaster response through the Environmental Protection Agency (EPA). Which of the following statements accurately describe an aspect of managed care? Cambodia Crime. If services provided to subscribers cost more than the capitation amount, the physician loses money. Which of the following statements regarding thunderstorms is correct? 11. Utilitarian theories Which of the following statements describe effective operations in disasters? HSA stands for health savings account, and HSA-qualified plans can be HMOs, PPOs, EPOs, or POS plans. 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. Preauthorization and/or precertification for all hospitalizations and continued certification if the patient's condition requires extension of the number of authorized days Fixed-price reimbursement is a feature of managed care. f. E) In the past, healthcare focused primarily on prevention of illnesses since it was covered by insurance. Many scholars consider a coup successful when the usurpers seize and hold power for at least . 16. C) education and income. D. Intoxications of livestock are common in disasters, but there are no concerns over the safety of the human food supply. Disaster advice from the USDA is provided by the Cooperative Extension Service. C. Do not dress animals with vests, blankets, and othermaterialsthat would prevent them from sweating. A variety of measures can be used; measures may be simple or complex; it is recommended that measures be straightforward, understandable, and valid. D. Allowing people to smoke in barns. Select all that apply. B. It is the result of a joint venture between hospitals and members of their medical staff. C) Employer contributions are considered taxable income to employees but are taxed at capital gains rates. Which of the following statements accurately describe an aspect of managed care? In Canada, almost all people are insured against the cost of all hospital and physician expenses through a government health insurance program. 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). Never tie an animal up if floods are pending. Which of the following statements accurately describes an aspect of home healthcare? Group Model HMO Which of the following is a trend to watch in healthcare delivery? Which of the following statements about managed funds is NOT correct? C. Veterinarians dont know much about the clinical aspects of food animals exposed to hazardous chemicals. Which of the following describes one of the elements that the nurse practitioner has successfully met? Beginning in 2006, the Physician Quality Reporting System (formerly called Physician Quality Reporting Initiative or PQRI system) established a _____ incentive for eligible professionals who participate in a ________ quality reporting program. 1. Managed care programs have been successful in containing costs and limiting unnecessary services, resulting in the current trend for health care plans to offer the SSO as a benefit, not a requirement. Three patients arrive at the free clinic in need of the same medication, but there is only enough in stock for one person. Who would be most likely to teach the classes? 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 Tax-exempt account that is used to pay for health care expenses. HEDIS data also are the centerpiece of most health plan "report cards" that appear in national magazines and local newspapers. 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. 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. b.Health insurance payments and co-pays must be proportional to income. Which of the following statements iscorrectregarding snow fall? c.Health insurance must be This problem has been solved! Institutions vary in their level of formality and informality. Costs from animal disease outbreaks include loss of production andreplacementof animals. State disaster declarations can only be made when more than one community is affected. 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 usually owned by physicians or a hospital and provides practice management (administrative and support) services to individual physician practices. A. 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. Definition. B. Which of the following statements iscorrectregarding droughts? es dudoso los nios obedecer la seal de abrocharse el cinturn de seguridad which of the following statements describes managed care? Individual decides, in advance, how much money to deposit in the HCRA (unused funds are forfeited). b. Medicare and many states prohibit managed care contracts from containing_________, which prevent providers from discussing all treatment options with patients, whether or not the plan would provide reimbursement for services. horse hind leg tendon sheath. 1. True: Name 3 of the primary purposes of the health record. Health plans also use HEDIS results themselves to see where they need to focus their improvement efforts. Point-of-service plan (POS) A mutual fund is required to use the services of a mutual fund custodian. e. Staff model llegar a tiempo The owner of an escaped animal may be held liable for damages his/her animal creates. Describe the three levels of Sumerian society. Qu haces t? 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. C) Risk management is unique to the health care industry. Managed care can now be categorized according to six models: 1. A) There is minimal purchasing-oriented paperwork. B. Which of the following statements is correct regarding the identification of animals in disasters? It attempts to control costs by modifying the behavior of providers and patients. which of the following statements describes managed care? B. Mitigation of transportation accidents involves the use of properly designed trailers and regular trailer maintenance. She is receiving chemotherapy at a hospital and interacts with many other healthcare providers in the course of her treatment. Patients should be well informed about care and treatment options. Cash values are a result of the level premium method of purchasing life insurance. Which of the following statements accurately describes the activation of federal agencies in disasters? What is the minimum number of the 900 non, highly compensated employees who must be covered by the. B. Livestock agricultures reliance on machines and technology has increased the need for evacuation procedures. how has dissection been used in engineering; which of the following statements describes managed care? A. D. All of the above. What managed care means? D) Risk management is a spontaneous response to an unexpected incident. Select all that apply. A) decreasing diversity C) uneducated consumers B) lower costs of healthcare D) current nursing shortage, 22. What is the confusion that might arise concerning her treatment and care is a problem known as? Spreading livestock operations out among several states is effective mitigation against weather-related disasters. B. Designating access to barns and water for firefighters. Direct contract model Which of the following is a natural consequence of utilitarian forms of health care financing? In return, individuals assume significantly higher cost-sharing expenses after the designated amount has been expended. Marcos and his horse will lead the tyler fourth of july parade. C. Intensification of U.S. dairy production has manifested itself as lower productivity of individual cows. 4) Which of the following statements about retirement ages in pension plans is (are) true? d. D. The USDA responds to disasters that threaten national food production, processing and distribution. 9 ways Android and Windows 10 can work well together, We asked a leading cosmetic doctor for his top anti-ageing tips. A risk pool is created when a number of people are grouped for insurance purposes (e.g., employees of an organization); the cost of health care coverage is determined by employees' health status, age, sex, and occupation. C. Only if flowing water is above your waist is it too high to cross. A. B. FEMA helps States by reviewing and coordinating State emergency plans. Utilization management activities include: preadmission certification (PAC) or preadmission review, preauthorization, concurrent review, and discharge planning. Under the auspices of its Health Care Reform Program, established in July 1993, The Commonwealth Fund is focusing on the need to expand knowledge about managed care organizations. 2.3) Which of the following statements best describes a health maintenance organization (HMO)? C. Disasters are declared starting at the local, then state, then federal level. B. A nurse in a walk-in healthcare setting provides technical services, such as, administering medications, determines the priority of care needs, and provides patient teaching on all aspects of care. 2.9) Which of the following is an eye specialist? es importante los pasajeros seguir las instrucciones de seguridad of B. 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 . Which of the following statements arecorrect? Contracted health care services are delivered to subscribers by participating physicians who are members of an independent multispecialty group practice. Patient care . 3. 13. If there is a boil-water order in effect, do not drink or give animals tap water unless you know it is safe. Managed care plans implement _______ as a method of controlling health care costs and quality of care. Health Savings Account (HSA); Health Savings Security Account (HSSA). The nurse in charge of the clinic asks herself, "Who needs this medicine most?" An EOB is a statement from your health insurance plan describing what costs it will cover for medical care or products youve received. 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. What type of insurance is most likely involved? POS enrollees pay less if they use the plan's in-network providers. National Committee for Quality Assurance (NCQA). b. distal radius [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 . 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). A. D) profession and income. Some managed care organizations have discontinued __________ and have adopted ___________ payment plans. B. C. The disposal ofcarcassesmust require the permission of the State or Federal Environmental Protection Agency and Department of Natural Resources. Laws, rules, social conventions and norms are all examples of institutions. es mejor todo el mundo tomar su asiento en seguida Damage from mudflows cannot be covered by insurance. Healthcare Effectiveness Data and Information Set (HEDIS). A tracking system for preauthorization of specialty care and documented requests for receipt of the specialist's treatment plan or consultation report C. FEMA is a primary source of education on disaster management in the U.S. Contracted health care services are provided to subscribers by two or more physician multispecialty group practices. Healthcare in the United States is far outspent than any other nation, measured both in per capita spending and as a percentage of GDP. B. B. . What type of agency is this? B) The cost of healthcare in the United States has decreased dramatically. B. (sometimes called a participating provider organization) is a managed care network of physicians and hospitals that have joined together to contract with insurance companies, employers, or other organizations to provide health care to subscribers for a discounted fee. C. Pre-existing economic difficulties can exacerbate the impact of disasters on livestock farmers. B. C. Hurricanes frequently cause flooding along the coast, but not inland. C. Planting deep-rooted ground cover is an effective mitigation measure against landslides. 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. C) The patient gets the bill and pays out-of-pocket costs. A pregnant teenager has approached a nurse asking about ways to improve the health outcomes for her and her unborn child. A. Livestock are resistant to heat stress. Managed care plans also require the development of patient care plans for the coordination and provision of care for complicated cases in a cost-effective manner, which is called __________. Crop insurance to protect against the effects of summer storms. b. To create flexibility in managed care plans, some HMOS and preferred provider organizations have implemented a _______, under which patients have freedom to use the managed care panel of providers or to self-refer to out-of-network providers. C. Guidelines for proper methods for euthanasia for livestock are available from veterinary, producer, and humane groups. 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. Some managed care plans contract out utilization management services to a _________ an entity that establishes a utilization management program and performs external utilization review services. Local plans allow communities to integrate with state and federal response to disasters. plans emphasize cost control, total health benefit costs continue to increase. B. B. A. Patients' needs are assessed and prioritized. (A) Give the symmetry number for each of the following molecules: C. Practice a fire drill every month throughout the fire season. 18. The _______ serves as a gatekeeper by providing essential health care services at the lowest possible cost, avoiding nonessential care, and referring patients to specialists. These include provider networks, provider oversight, prescription drug tiers, and more. Effective biosecurity on farms includes restricting access to feed storage bins to authorized persons only. A. Documentation of ownership may be needed to reclaim a lost animal. A. 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. You have three metal samples- A,B\mathrm{A}, \mathrm{B}A,B, and C\mathrm{C}C - that are tantalum (Ta), barium (Ba), and tungsten (W), but you don't know which is which. es necesario el capitn hacerun anuncio C. The disposal ofcarcassesmust require the permission of the State or Federal Environmental Protection Agency and Department of Natural Resources. Which of the following ethical theories of justice are based upon the rule that it is good to maximize the greatest good for the greatest number of people? Practicing veterinarians are the officials who must conduct the investigation of a suspected Foreign Animal Disease. Medical practice that treats disease, such as medications and surgery Allopathic Individual contributes to the injury or condition Contributory negligence A person under the age of 18 who has been legally separated from his/her parents Emancipated minor Discontinue medical care without proper notice after accepting a patient Abandonment 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. 8. 11. E) The managed care system may required approval for specialty care. 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). 2.16) Twenty-five percent of urgent care patients do not have which of the following? D. Intensification and consolidation has resulted in an increased number of animals living in a smaller space. The traditional health care system in the United States is: 12. Which of the following statements apply to the transportation of livestock? The local Department ofAnimal Controlis the legal entity in most communities to deal with abandoned and lost animals. A PPO is not an HMO, but it is similar to an HMO because it is a managed care plan that provides enrollees with discounted health care through a network of providers. 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. 51) Which of the following statements about managed care plans is (are) true? In the following sentences, circle each incorrectly used lowercase letter. D. All of the above. "Don't drop out of school." b. Most countries charge a tax on an individual's income as well as on corporate income. HMOS often require a copayment (or copay), which is a fee paid by the patient to the provider at the time health care services are rendered. a. which of the following statements describes managed care? For Australia, recent figures show that the statutory funds of life offices have the largest amounts of assets under management. June 29, 2022. prestar mucha atencin. Storing patient care information: All of the primary purposes of the health record are associated directly with the provision of patient care services. Some case managers employed by the MCO to monitor services provided to enrollees and to be notified if a patient fails to keep a preauthorized appointment D) The contribution rate is variable, but the, 6) Which of the following statements describes a defined, contribution pension plan? Which of the following correctly describes the role of the USDA in disasters? D. Floods are an uncommon cause of natural disaster in the United States. An important role of FEMA in disasters is coordination of response and recovery activities in declared major disasters. B. What is one way in which nurses can help shape healthcare reform? The term "managed care" is used to describe a type of health care focused on helping to reduce costs, while keeping quality of care high. D. All of the above. Which of the following statements accurately describes the clinical nurse leader (CNL)? 30. 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. The only loss in disasters is to affected farms. The response to transportation accidents often requires coordination among law enforcement, fire department, emergency management, the hauler and owner. Expert Help. The company has collected the following information on product sales: Total Polices Gender Location Female Male Northwest. Unlike traditional fee-for-service. arrangements to alter provider and patient behavior so that health care services are delivered and utilized in a more. B. 2. e. (B) Give the symmetry number for each of the following molecules: Although you will first check with her provider, you are sure she is to see which of the following? In each of the given sentences, underline the subordinate clause. 2.10) Which of the following best describes how alternative health therapies are being perceived? 92) Which of the following best describes vendor managed inventory? Responsible for reviewing health care provided by managed care organizations. 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? 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. A. 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. 5) Two parameters that usually result in an indication of excellent health are: A) genetics and education. Libertarian theories 16. B) Payment for services is integrated with delivery of services. B. Health maintenance organizations (HMOS) manage patient health care services by expending a monthly capitation amount paid by a third-party payer. c. The attachment of preauthorization documentation to health insurance claims submitted to some MCOS. The report card contains data regarding a managed care plan's quality, utilization, customer satisfaction, administrative effectiveness, financial stability, and cost control. 2. 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. A triple option plan provides patients with more choices than a traditional managed care plan. e. D. The USDA responds to disasters that threaten national food production, processing and distribution. B) The care of the patient is carefully planned and monitored by the primary care provider. C. Annual property loss resulting from thunderstorms, including damage to farms and barns, is estimated in the hundreds of millions of dollars. D. Large-scale disasters affecting livestock never have serious implications for State revenues. Individual Practice Association (IPA) HMO. b. a condition in which the nasal septum strays from the midline of the nasal cavity, c. a chronic bacillus infection that usually affects the lung and is caused by a mycobacterium, d. an inflammation of the mucous lining of the larynx, e. a condition in which ruptured alveoli reduce the surface area of the lung, making breathing difficult, g. an obstructive disorder characterized by recurring spasms of the smooth muscles of the bronchi, i. an inflammation or infection of the pharynx, j. a disease characterized by a lack of surfactant in the alveoli; usually occurs in premature infants. They include many choices that provide individuals with an incentive to control the costs of health benefits and health care. Which of the following statements is/are correct regarding the humane care of animals in disasters? Which of the following is a characteristic of primary healthcare? managed care plans because of restrictions placed upon their freedom to treat patients. Individuals have greater freedom in spending health care dollars, up to a designated amount, and receive full coverage for in-network preventive care. The use of an out-of-area contact can be an effective way to coordinate in disasters. 1. Usually, network providers sign exclusive contracts with the EPO, which means they cannot contract with other managed care plans. 53. immunizations and screenings included in benefits 54. Employees contribute funds to the FSA through a salary reduction agreement and withdraw funds to pay medical bills. 2. B. c. perpetual motion ornaments; who plays elias in queen of the south; robert snodgrass net worth; pacific northwest volleyball association; C. If escaped livestock ingest toxic plants, their milk is likely to still be suitable for human consumption. I. Other plans contract with a _________, an organization that provides health benefits claims administration and other outsourced services for self-insured companies. D. All suspect findings of Foreign Animal Diseases have to be reported to State or Federal veterinarians. benefit pension plan? C) Short- and long-term results of cost-containment measures are undetermined. iwi galil ace rs regulate; pedestrian killed in london today; holly woodlawn biography; how to change icon size in samsung s21; houston marriott westchase D. All of the above. D. Landslides rarely affect agricultural property. (The catastrophic limit is usually higher than those common in other plans.) ayudar a los otros pasajeros Nurse case managers coordinate patient care from the time of hospital admission to the time of discharge and often following discharge from an . Which of the following statements describes cyberwarfare? Which of the following phrases is characteristic of case management as a method of healthcare delivery? a. information disclosure regulation b. establishing minimum standards and monitoring compliance, The Smallville Mall has assumed the responsibility for payment of liability losses caused by Chuck's Famous Pizza to attract the pizza chain to the mall. external quality review organization (EQRO). 8. Managed care plans emphasize cost controls and preventative care. Proper watershed, forest, and rangeland management is effective mitigation against droughts. B. Thunderstorms and their consequences are common, but rarely create problems. C. Planting deep-rooted ground cover is an effective mitigation measure against landslides. Select all that apply. 14. is a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of care and service, makes it possible to compare the performance of health plans on an "apples-to-apples" basis. 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. retire without receiving actuarially reduced benefits. In abreva commercial girl or guy the elizabethan poor laws of 1601 quizletabreva commercial girl or guy the elizabethan poor laws of 1601 quizlet B) The contribution rate is fixed, and the retirement benefit is known in advance. True or false? C. The number of animals that need to be evacuated from a farm is an important factor in determining how quickly a farm can be evacuated. combines health care delivery with the financing of services provided. The Incident Command System provides a consistent method to respond to all types of emergencies. A) The contribution rate is fixed. 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. (a) CO\mathrm{CO}CO, (b) O2\mathrm{O}_2O2, (c) H2S\mathrm{H}_2 \mathrm{~S}H2S, (d) SiH4\mathrm{SiH}_4SiH4, and (e) CHCl3\mathrm{CHCl}_3CHCl3. 2.17) Approximately how many boutique operations are there in the United States? b. C. Each responding agency and group should operate independently and separately from the others, in order to cover more ground. A) physical therapist C) social worker B) speech therapist D) respiratory therapist, 15. 2.4) Which of the following best describes the process of screening in the medical office setting? In exchange for an initial payment, known as the premium, the insurer promises to pay for loss caused by perils covered under the policy . They are intended to prevent the problem of covering members who are sicker than the general population (called adverse selection). Select all that apply. Which of the following ethical theories place the community, rather than the individual, the state, the nation, or any other entity, at the center of the value system? A primary care provider (PCP) assigned to each subscriber is responsible for coordinating health care services and referring subscribers to other health care providers. A) The U.S. healthcare system has been experiencing a financial crisis. usually offered either by a single insurance plan or as a joint venture among two or more insurance payers, provides subscribers employees with a choice of HMO, PPO, or traditional health insurance plans. Never tie an animal up if floods are pending. A) Managed care systems control the cost of care with a lower quality of care. If the physician provides services that cost less than the capitation amount, there is a profit (which the physician keeps).