Question 1

In a ______________ system the health care provider charges and is paid for each item of service provided.

Accepted Answer

In a fee-for-service system, the healthcare provider charges and is paid for each specific service they provide to a patient, rather than receiving a pre-set amount or payment based on the overall care of the patient.

Question 2

Which of the following is NOT one of the administrative simplification provisions of HIPAA?

Accepted Answer

PPS (Prospective Payment System) is not one of the administrative simplification provisions of HIPAA. HIPAA's administrative simplification provisions include EDI (Electronic Data Interchange), Privacy, and Security, which aim to improve the efficiency and effectiveness of the healthcare system.

Question 3

A(n) _________ links data provided by various health care providers.

Accepted Answer

A Health Information Exchange (HIE) organization or Regional Health Information Organization (RHIO) links data provided by various health care providers to facilitate access to and retrieval of clinical information to provide safer, more timely, efficient, patient-centered care.

Question 4

A longitudinal patient record documents a patient's health status, conditions, and treatments _____________________________.

Accepted Answer

A longitudinal patient record documents a patient's health status, conditions, and treatments throughout the patient's life.

Question 5

The State Children's Health Insurance Program (SCHIP or CHIP) is _________________.

Accepted Answer

The State Children's Health Insurance Program (SCHIP or CHIP) is a joint state-federal program designed to provide health insurance to children in families with incomes too high to qualify for Medicaid but too low to afford private health insurance.

Question 6

Under HIPAA, it is permissible to use or disclose PHI without a specific written authorization when it is necessary for ____________________.

Accepted Answer

Under HIPAA (Health Insurance Portability and Accountability Act), it is permissible to use or disclose Protected Health Information (PHI) without a specific written authorization for treatment, payment, and health care operations purposes. These are considered essential activities for the provision of healthcare services, the payment for these services, and the necessary operations to support treatment and payment.

Question 7

This part of Medicare is optional insurance coverage available to all Medicare beneficiaries designed to lower prescription drug costs.

Accepted Answer

Part D is the component of Medicare that offers prescription drug coverage to Medicare beneficiaries.

Question 8

This law, passed in 2010, expanded Medicaid eligibility requirements.

Accepted Answer

The answer of  This law, passed in 2010, expanded...

Question 9

A program designed by CMS to recover improper Medicare payments is named _______________.

Accepted Answer

The Recovery Audit Contractor (RAC) program is specifically designed by the Centers for Medicare & Medicaid Services (CMS) to identify and correct improper Medicare payments through the efficient detection and collection of overpayments made on claims of health care services provided to Medicare beneficiaries, and the identification of underpayments to providers so that CMS can implement actions that will prevent future improper payments.

Question 10

Under this type of program, reimbursement may be rewarded or penalized based upon the provider's ability to meet pre-established targets for delivery of health care services.

Accepted Answer

Pay-for-performance (P4P) programs incentivize healthcare providers to meet specific benchmarks in the quality and efficiency of the care they provide, often through financial rewards or penalties.

Question 11

This legislation amends the HIPAA privacy and security rules.

Accepted Answer

The Health Information Technology for Economic and Clinical Health Act (HITECH) amends the HIPAA privacy and security rules to strengthen the privacy and security protection for individuals' health information, primarily through increased enforcement and penalties for non-compliance.

Question 12

Under this care model, the primary care physician acts as a "gatekeeper" to coordinate the patient care across providers by addressing preventive, acute, and chronic care needs and by providing the patient with access to electronic tools.

Accepted Answer

The Patient-centered medical home model (PCMH) is designed around the concept of a primary care physician acting as a "gatekeeper" to coordinate all aspects of patient care, including preventive, acute, and chronic needs. This model emphasizes the use of electronic tools for better health management and communication among healthcare providers.

Question 13

This program was developed by The Joint Commission to help accredited health care institutions focus upon specific patient safety concerns.

Accepted Answer

The National Patient Safety Goals (NPSG) program was developed by The Joint Commission to help accredited health care institutions focus on specific patient safety concerns.

Question 14

This federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information was mandated in the Health Information Technology for Economic and Clinical Health Act (HITECH Act) of 2009.

Accepted Answer

The Office of the National Coordinator for Health Information Technology (ONC) was specifically established to lead national efforts in implementing and advancing health information technology and the electronic exchange of health information, as mandated by the HITECH Act of 2009.

Question 15

Americans have heavily depended on hospitals for lifesaving health care since the 1700s.

Accepted Answer

Hospitals in the 1700s were generally places for the poor and destitute, and most Americans relied on home care or local healers. The widespread dependence on hospitals for lifesaving health care did not begin until the late 19th and early 20th centuries, with advances in medical science and the establishment of more modern hospital facilities.

Question 16

The American College of Surgeons was one of the first organizations to establish standards for hospitals.

Accepted Answer

The American College of Surgeons, founded in 1913, established standards for hospitals in 1918 to improve the quality of surgical care, marking one of the first efforts to set nationwide hospital standards.

Question 17

The purpose of the Hill-Burton program in the mid-twentieth century was to decrease the number of hospital beds in over served areas

Accepted Answer

The Hill-Burton Act, passed in 1946, aimed to increase the number of hospital beds in underserved areas by providing federal grants and loans for the construction of hospitals and other healthcare facilities.

Question 18

Part A of Medicare pays for hospital inpatient care, home health care, skilled nursing care, and hospice care.

Accepted Answer

Part A of Medicare covers hospital inpatient care, skilled nursing facility care, hospice care, and some home health care services, providing essential coverage for these types of healthcare needs.

Question 19

Federal and state governments jointly fund the Medicaid program.

Accepted Answer

Medicaid is a joint federal and state program that helps with medical costs for some people with limited income and resources.

Question 20

In a prospective payment system, the health care provider charges and is paid for each item of service provided.

Accepted Answer

In a prospective payment system, the health care provider is paid a predetermined, fixed amount for each episode of care or service, regardless of the actual cost or number of services provided.

Quiz 1: Introduction to Health Care Systems