WGU D391 HEALTHCARE ECOSYSTEM| OA|
OBJECTIVE ASSESSMENT| 64 ACTUAL
QUESTIONS AND ANSWERS LATEST
UPDATED 2026 (GRADED A+)
1. Providers receive payment for services performed under which
reimbursement model?
A. Capitation
B. Prospective reimbursement
C. Fee-for-service
D. Coinsurance
✅ Correct Answer: Fee-for-service
Rationale:
Fee-for-service reimburses providers based on each individual service or procedure
delivered. The more services provided, the more payment the provider receives, which
can incentivize volume rather than outcomes. Capitation pays a fixed amount per
patient, while prospective reimbursement pays a predetermined amount for a
diagnosis. Coinsurance refers to patient cost-sharing, not provider payment.
2. In 1973, to address rising healthcare costs, the Nixon
Administration promoted which model?
A. Centers for Medicare & Medicaid Services (CMS)
B. National Committee for Quality Assurance (NCQA)
C. Advance health care directives
D. Health Maintenance Organizations (HMOs)
,✅ Correct Answer: Health Maintenance Organizations (HMOs)
Rationale:
HMOs were introduced to control healthcare costs by emphasizing preventive care and
limiting unnecessary services. Patients receive care through a network of providers,
which helps manage utilization and spending. CMS and NCQA are regulatory and
quality organizations, not care delivery models. Advance directives relate to end-of-life
planning, not cost containment.
3. Who is responsible for enforcing regulations related to Medicare
and Medicaid?
A. CDC and NIH
B. FDA
C. Centers for Medicare & Medicaid Services (CMS)
D. Joint Commission
✅ Correct Answer: Centers for Medicare & Medicaid Services (CMS)
Rationale:
CMS administers and enforces policies for Medicare, Medicaid, and other federal
health programs. It establishes reimbursement rules, compliance standards, and
quality initiatives. The CDC focuses on public health, the FDA regulates drugs and
devices, and The Joint Commission accredits healthcare organizations.
4. Which healthcare financing model is considered a social health
insurance model?
A. Market-driven healthcare
B. Out-of-pocket model
C. Beveridge Model
D. Bismarck Model
✅ Correct Answer: Bismarck Model
,Rationale:
The Bismarck Model is funded through mandatory payroll contributions shared by
employers and employees. Insurance is provided through non-profit insurers, and
coverage is universal. Unlike market-driven models, access does not depend on ability
to pay. The Beveridge Model is government-funded and government-owned, making it
different from social insurance.
5. Which model provides healthcare funded through general
taxation and delivered by government-owned facilities?
A. National Health Insurance Model
B. Bismarck Model
C. Beveridge Model
D. Market-driven model
✅ Correct Answer: Beveridge Model
Rationale:
The Beveridge Model uses tax revenue to fund healthcare services that are often
delivered by government-employed providers. This model emphasizes universal
access and cost control. Countries like the UK use this approach. The Bismarck Model
relies on insurance funds, not taxes, while market-driven systems depend on private
payment.
6. Which payment model provides a fixed amount per patient
regardless of the number of services provided?
A. Fee-for-service
B. Capitation
C. Prospective reimbursement
D. Coinsurance
, ✅ Correct Answer: Capitation
Rationale:
Capitation pays providers a predetermined amount per patient for a specific time
period. This model encourages cost control and preventive care because providers do
not receive additional payment for extra services. Fee-for-service rewards volume,
while prospective reimbursement is diagnosis-based. Coinsurance is a patient cost-
sharing mechanism, not a payment model.
7. What is the primary goal of the STEEEP framework in healthcare
quality?
A. Increase profitability
B. Reduce provider workload
C. Improve healthcare quality and patient outcomes
D. Eliminate private insurance
✅ Correct Answer: Improve healthcare quality and patient outcomes
Rationale:
STEEEP stands for Safe, Timely, Effective, Efficient, Equitable, and Patient-centered
care. It provides a framework to assess and improve healthcare delivery across
multiple dimensions. The focus is on quality and safety rather than cost or insurance
structures. It guides healthcare organizations in delivering value-based care.
8. Which STEEEP principle focuses on reducing delays in care
delivery?
A. Safe
B. Timely
C. Efficient
D. Equitable
✅ Correct Answer: Timely
OBJECTIVE ASSESSMENT| 64 ACTUAL
QUESTIONS AND ANSWERS LATEST
UPDATED 2026 (GRADED A+)
1. Providers receive payment for services performed under which
reimbursement model?
A. Capitation
B. Prospective reimbursement
C. Fee-for-service
D. Coinsurance
✅ Correct Answer: Fee-for-service
Rationale:
Fee-for-service reimburses providers based on each individual service or procedure
delivered. The more services provided, the more payment the provider receives, which
can incentivize volume rather than outcomes. Capitation pays a fixed amount per
patient, while prospective reimbursement pays a predetermined amount for a
diagnosis. Coinsurance refers to patient cost-sharing, not provider payment.
2. In 1973, to address rising healthcare costs, the Nixon
Administration promoted which model?
A. Centers for Medicare & Medicaid Services (CMS)
B. National Committee for Quality Assurance (NCQA)
C. Advance health care directives
D. Health Maintenance Organizations (HMOs)
,✅ Correct Answer: Health Maintenance Organizations (HMOs)
Rationale:
HMOs were introduced to control healthcare costs by emphasizing preventive care and
limiting unnecessary services. Patients receive care through a network of providers,
which helps manage utilization and spending. CMS and NCQA are regulatory and
quality organizations, not care delivery models. Advance directives relate to end-of-life
planning, not cost containment.
3. Who is responsible for enforcing regulations related to Medicare
and Medicaid?
A. CDC and NIH
B. FDA
C. Centers for Medicare & Medicaid Services (CMS)
D. Joint Commission
✅ Correct Answer: Centers for Medicare & Medicaid Services (CMS)
Rationale:
CMS administers and enforces policies for Medicare, Medicaid, and other federal
health programs. It establishes reimbursement rules, compliance standards, and
quality initiatives. The CDC focuses on public health, the FDA regulates drugs and
devices, and The Joint Commission accredits healthcare organizations.
4. Which healthcare financing model is considered a social health
insurance model?
A. Market-driven healthcare
B. Out-of-pocket model
C. Beveridge Model
D. Bismarck Model
✅ Correct Answer: Bismarck Model
,Rationale:
The Bismarck Model is funded through mandatory payroll contributions shared by
employers and employees. Insurance is provided through non-profit insurers, and
coverage is universal. Unlike market-driven models, access does not depend on ability
to pay. The Beveridge Model is government-funded and government-owned, making it
different from social insurance.
5. Which model provides healthcare funded through general
taxation and delivered by government-owned facilities?
A. National Health Insurance Model
B. Bismarck Model
C. Beveridge Model
D. Market-driven model
✅ Correct Answer: Beveridge Model
Rationale:
The Beveridge Model uses tax revenue to fund healthcare services that are often
delivered by government-employed providers. This model emphasizes universal
access and cost control. Countries like the UK use this approach. The Bismarck Model
relies on insurance funds, not taxes, while market-driven systems depend on private
payment.
6. Which payment model provides a fixed amount per patient
regardless of the number of services provided?
A. Fee-for-service
B. Capitation
C. Prospective reimbursement
D. Coinsurance
, ✅ Correct Answer: Capitation
Rationale:
Capitation pays providers a predetermined amount per patient for a specific time
period. This model encourages cost control and preventive care because providers do
not receive additional payment for extra services. Fee-for-service rewards volume,
while prospective reimbursement is diagnosis-based. Coinsurance is a patient cost-
sharing mechanism, not a payment model.
7. What is the primary goal of the STEEEP framework in healthcare
quality?
A. Increase profitability
B. Reduce provider workload
C. Improve healthcare quality and patient outcomes
D. Eliminate private insurance
✅ Correct Answer: Improve healthcare quality and patient outcomes
Rationale:
STEEEP stands for Safe, Timely, Effective, Efficient, Equitable, and Patient-centered
care. It provides a framework to assess and improve healthcare delivery across
multiple dimensions. The focus is on quality and safety rather than cost or insurance
structures. It guides healthcare organizations in delivering value-based care.
8. Which STEEEP principle focuses on reducing delays in care
delivery?
A. Safe
B. Timely
C. Efficient
D. Equitable
✅ Correct Answer: Timely
