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med 149 rev 3
| Question | Answer |
|---|---|
| Which of the following is mandatory for certain health professionals to practice in their field? | licensure |
| Licensure to practice medicine is done by | each individual state. |
| Which of the following processes lets licensed health care practitioners transfer their license to a new state after moving without repeating an examination? | Reciprocity |
| A licensed advanced registered nurse practitioner might be accused of scope of practice violations if he | Prescribes controlled substances without a supervising physician’s knowledge or permission |
| Which of the following is not true of accrediting agencies? | They never charge a fee. |
| Which of the following indicates a health care facility, education program, or managed care organization is credible and maintains high standards? | Accreditation |
| Which of the following is an advantage that might apply to individuals attending an accredited health care education program? | Transfer of credits more easily accepted if one changes schools, More likely to obtain a license after graduating, More likely to be selected for a federal student aid program |
| Which of the following statements is not true of accreditation? | State law says it must be renewed every year. |
| Which of the following is not a purpose of practice acts? | To be sure health care professionals are adequately compensated for their services |
| Each state’s practice acts also provide for the establishment of | Professional boards |
| Laws vary from state to state, but unprofessional conduct for medical professionals usually includes | Physical abuse of a patient, Inadequate record keeping, Failure to meet continuing education requirements ,All of these are unprofessional conduct |
| Health care practitioners’ actions generally classified as fraud include | Falsifying medical diplomas and other credentials, Falsifying medical reports, Promising a patient “secret cures” or other special ways to cure an ailment |
| The authority that governs the practice of medicine is called | Medical practice act |
| A health care business that is publicly held is also known as | A company where stock is bought and sold on the stock market. |
| The most well-known form of a not-for-profit health care organization is | A company owned by a city or state government |
| The largest integrated health care system in the country is | The VA system |
| Which of the following best defines a managed care health plan? | A corporation that pays for and delivers care to subscribers |
| What is a copayment? | A set amount that each patient pays for each office visit |
| Under this type of plan, insured patients must designate a primary care physician (PCP). | Point-of-service plan |
| A patient-centered medical home is | A primary care practice that focuses on coordinated care and quality of care |
| An ACO is | An organization that has a designated patient population and a predetermined payment if quality goals are met |
| A mandatory credentialing process established by law, usually at the state level, that grants the right to practice certain skills and endeavors | licensure |
| The process by which a professional license obtained in one state may be accepted as valid in other states by prior agreement without reexamination | reciprocity |
| Revoking licenses for health care professionals to practice | revocation |
| Temporarily recalling licenses for health care professionals to practice | suspension |
| A voluntary credentialing process whereby applicants who meet specific requirements may receive a certificate | certification |
| A credentialing process whereby one’s name is listed on a register after having met certain educational criteria within a profession. | registration |
| The determination of the duties/procedures that a person may or may not perform under the auspices of a specific health care professional’s license | scope of practice |
| Official authorization or approval for conforming to a specified standard for health care education programs, health care facilities, and managed care facilities | accreditation |
| A type of HMO where a patient’s primary care needs are supported with a primary care provider developing a team-based approach to health care with an emphasis on preventive services, care coordination, and access to care | Primary Care Medical Home (PCMH) |
| A corporation that links health care financing, administration, and service delivery | managed care organization (MCO) |
| A health plan that combines coverage of health care costs and delivery of health care for a specific payment | health maintenance organization (HMO) |
| A system in which financing, administration, and delivery of health care are combined to provide medical services to subscribers for a prepaid fee | managed care |
| A network of independent physicians, hospitals, and other health care providers who contract with an insurance carrier to provide medical care at a discount rate to patients who are part of the insurer’s plan; also called preferred provider association (P | preferred provider organization (PPO) |
| A health care plan in which physicians join with hospitals to provide a medical care delivery system and then contract for insurance with a commercial carrier or an HMO | physician-hospital organization (PHO) |
| A managed care plan that pays for health care services only within the plan’s network of physicians, specialists, and hospitals (except in emergencies) | exclusive provider organization (EPO) |
| Offered to individuals covered by high-deductible health plans, these accounts let these individuals save money, tax free, to pay for medical expenses | health savings account (HSA) |
| A type of HMO that contracts with groups of physicians who practice in their own offices and receive a per-member payment (capitation) from participating HMOs to provide a full range of health services for members | independent practice association (IPA) |
| The physician responsible for directing all of a patient’s medical care and determining whether the patient should be referred for specialty care | primary care physician (PCP |
| A type of HMO that requires coordination and affiliation among multiple practices to lower costs and improve outcomes and receives a predetermined payment to care for a designated patient population | Accountable Care Organization (ACO) |
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