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1. What best describes an Accountable Care Organization (ACO)?
A. A single-provider insurance model
B. A network of providers collaborating to deliver coordinated care and improve
outcomes
C. A government-funded hospital system
D. A fee-for-service reimbursement structure
Correct Answer: B. A network of providers collaborating to deliver
coordinated care and improve outcomes
2. In a functional organizational structure, departments are organized based on:
A. Patient populations
B. Geographic regions
C. Professional expertise
D. Financial performance
Correct Answer: C. Professional expertise
3. Which feature defines a matrix organizational structure?
A. Centralized authority
B. Departments working independently
C. Two or more organizational structures operating simultaneously
,D. Flat leadership hierarchy
Correct Answer: C. Two or more organizational structures operating
simultaneously
4. The biomedical model of health primarily views illness as:
A. Influenced by spiritual beliefs
B. A result of social determinants
C. Primarily biological in nature
D. Caused by emotional imbalance
Correct Answer: C. Primarily biological in nature
5. Which statement best reflects the concept of holistic health?
A. Focuses solely on disease treatment
B. Emphasizes physical health only
C. Addresses physical, mental, emotional, social, and spiritual well-being
D. Excludes cultural considerations
Correct Answer: C. Addresses physical, mental, emotional, social, and
spiritual well-being
6. Holistic medicine incorporates which of the following approaches?
A. Only evidence-based pharmaceuticals
B. Diverse disciplines, religious philosophies, and cultural healing practices
C. Surgical intervention only
D. Acute care treatment models
Correct Answer: B. Diverse disciplines, religious philosophies, and cultural
healing practices
7. What is the primary goal of a Managed Care Organization (MCO)?
A. Increase provider autonomy
,B. Manage cost, quality, and accessibility of care
C. Eliminate preventive services
D. Provide unrestricted access to specialists
Correct Answer: B. Manage cost, quality, and accessibility of care
8. A Health Maintenance Organization (HMO) is best described as:
A. Insurance with unrestricted provider choice
B. Coverage through a defined network for a fixed fee
C. A fee-for-service insurance plan
D. A supplemental insurance option
Correct Answer: B. Coverage through a defined network for a fixed fee
9. Which feature distinguishes a Preferred Provider Organization (PPO)?
A. No out-of-network coverage
B. Mandatory primary care referrals
C. In-network and out-of-network options with greater flexibility
D. Government ownership
Correct Answer: C. In-network and out-of-network options with greater
flexibility
10. An Integrated Delivery System (IDS) is characterized by:
A. Single-specialty focus
B. Fragmented care delivery
C. A range of services accountable for population health outcomes
D. Outpatient-only care
Correct Answer: C. A range of services accountable for population health
outcomes
, 11. What is payer-provider integration?
A. Expansion of outpatient services
B. Merger between healthcare payers and providers
C. Federal oversight of insurance
D. Privatization of hospitals
Correct Answer: B. Merger between healthcare payers and providers
12. A Consumer-Driven Health Plan (CDHP) typically includes:
A. Low deductibles
B. No cost-sharing
C. High deductibles with increased consumer responsibility
D. Mandatory referrals
Correct Answer: C. High deductibles with increased consumer responsibility
13. Which insurance plan combines features of both HMO and PPO models?
A. Fee-for-service plan
B. Point-of-service (POS) plan
C. Medicare Advantage
D. Medicaid managed care
Correct Answer: B. Point-of-service (POS) plan
14. In a fee-for-service plan, healthcare reimbursement is based on:
A. Patient outcomes
B. Capitated payments
C. Individual units of service provided
D. Population health metrics
Correct Answer: C. Individual units of service provided