WGU D391 Healthcare Ecosystems OBJECTIVE
ASSESSMENT Comprehensive Resource To Help You Ace
2026-2027 Includes Frequently Tested Questions With
ELABORATED 100% Correct COMPLETE SOLUTIONS
Guaranteed Pass First Attempt!!
Current Update!!
1. What are the characteristics of the Beveridge Model of health care?
- Correct Answer: - Government-run healthcare in the UK, Spain, and
New Zealand
- Funded by taxes, public providers, and universal coverage
- No cost at point of service
- Longer wait times and limited choices
2. What are the characteristics of the Bismarck Model of health care? -
Correct Answer:
- Mandatory insurance system in Germany, France, and Japan
- Broad access with shorter waits
- Higher costs and complex administration
3. What are the characteristics of the National Health Insurance (NHI) Model
of health care? - Correct Answer:
- Single-payer system in Canada, Taiwan, and South Korea
- Government-funded, private providers, and universal coverage
- Lower costs and simple administration
- Wait times for some services and limited coverage for extras
4. What are the characteristics of the US Health system? - Correct Answer:
, - Mixed public and private care in the US
- Employers' insurance, Medicare and caid, self-pay options
- Choice of providers, cutting-edge care
- High costs and unequal access
5. What are the qualifications for Medicare?
- - Correct Answer: Over 65
- Under 65 with a qualifying disability (after a waiting period) OR not
income-based program
6. Where does the funding from Medicare come from?
- Correct Answer: Varies depending on which of the Parts (A-D)
you are talking about
- Basic Medicare is payroll taxes
7. What is CMS? - Correct Answer: Centers for Medicare and Medicaid
Services (administers Medicare)
8. What are the characteristics of Part A of Medicare? - Correct Answer:
◼ Hospital Insurance
• Hospital Care
• SNF Care
• In-patient rehab
• Hospice
• Limited home health
• Bundled, NOT CPT codes
- Free for those who paid in through payroll taxed. Basic Medicare
-
9. What are the characteristics of Part B of Medicare?
- Correct Answer: Medical Insurance
, • Outpatient PT
• Physician & OP services
• DME
• CPT codes, NOT bundled
• Preventative services
- Paid by monthly premiums. Must ensure enrollment. No PA for PT.
Monthly Premium, Annual deductible, Coinsurance (20%), NO OP PT
if decline
-
10.What are CPT codes?
- Correct Answer: What we bill to justify what we did with a patient. We
can only bill for specific things such as manual therapy, therapeutic exercise,
and therapeutic activity.
11.What are the characteristics of Part C of Medicare?
- Correct Answer: Advantage Plans
• Must already been enrolled in A&B
• Changes how you receive the A&Bbenefits
• Now private insurance (not Mcare)
- Lower premium,Uses copay networks,Prior Authorizations,
Utilization-driven (insurances want to be utalized less)
◼ Bad for PT
12.What are the characteristics of Part D of Medicare?
- Correct Answer: Prescription Drugs
• Buy a stand-alone plan
• OR might come with an Advantage Plan
• Monthly premium
• Copays vary by med.
13.What are the characteristics of original Medicare?
, - - Correct Answer: Direct, timely access
- No referral required
- Don't need prior authorization
- No visit limits
- PT-driven frequency
- Patients participate in co-insurance
- Biggest PT challenege is documentation
14.What are the characteristics of Medicare Advantage?
- - Correct Answer: - Network and authorization required
- Referral required
- Visit limits are common
- Insurance plan drives frequency
- Many copays
- Biggest PT challenge is utilization oversight
15.What does Medicare Part A cover?
- Correct Answer: SNF, Hospital stays, acute rehab, and home-bound home
health
16.What does Medicare Part B cover?
- Correct Answer: Sub-acute inpatient rehab, mobile PT, and outpatient PT
17.What are the qualifications for Medicaid?
- - Correct Answer: Varies by state, but typically similar.
• Low-income children, pregnant people, some parents/caretakers
(Individual coverage)
• Older adults and people with disabilities meeting financial/clinical
criteria.
• Income-based program
-- Federal matching and state-funded
18.What is habilitative care?
- Correct Answer: Habilitative care helps a person develop or learn skills
they have never had, rather than restoring skills they lost.
ASSESSMENT Comprehensive Resource To Help You Ace
2026-2027 Includes Frequently Tested Questions With
ELABORATED 100% Correct COMPLETE SOLUTIONS
Guaranteed Pass First Attempt!!
Current Update!!
1. What are the characteristics of the Beveridge Model of health care?
- Correct Answer: - Government-run healthcare in the UK, Spain, and
New Zealand
- Funded by taxes, public providers, and universal coverage
- No cost at point of service
- Longer wait times and limited choices
2. What are the characteristics of the Bismarck Model of health care? -
Correct Answer:
- Mandatory insurance system in Germany, France, and Japan
- Broad access with shorter waits
- Higher costs and complex administration
3. What are the characteristics of the National Health Insurance (NHI) Model
of health care? - Correct Answer:
- Single-payer system in Canada, Taiwan, and South Korea
- Government-funded, private providers, and universal coverage
- Lower costs and simple administration
- Wait times for some services and limited coverage for extras
4. What are the characteristics of the US Health system? - Correct Answer:
, - Mixed public and private care in the US
- Employers' insurance, Medicare and caid, self-pay options
- Choice of providers, cutting-edge care
- High costs and unequal access
5. What are the qualifications for Medicare?
- - Correct Answer: Over 65
- Under 65 with a qualifying disability (after a waiting period) OR not
income-based program
6. Where does the funding from Medicare come from?
- Correct Answer: Varies depending on which of the Parts (A-D)
you are talking about
- Basic Medicare is payroll taxes
7. What is CMS? - Correct Answer: Centers for Medicare and Medicaid
Services (administers Medicare)
8. What are the characteristics of Part A of Medicare? - Correct Answer:
◼ Hospital Insurance
• Hospital Care
• SNF Care
• In-patient rehab
• Hospice
• Limited home health
• Bundled, NOT CPT codes
- Free for those who paid in through payroll taxed. Basic Medicare
-
9. What are the characteristics of Part B of Medicare?
- Correct Answer: Medical Insurance
, • Outpatient PT
• Physician & OP services
• DME
• CPT codes, NOT bundled
• Preventative services
- Paid by monthly premiums. Must ensure enrollment. No PA for PT.
Monthly Premium, Annual deductible, Coinsurance (20%), NO OP PT
if decline
-
10.What are CPT codes?
- Correct Answer: What we bill to justify what we did with a patient. We
can only bill for specific things such as manual therapy, therapeutic exercise,
and therapeutic activity.
11.What are the characteristics of Part C of Medicare?
- Correct Answer: Advantage Plans
• Must already been enrolled in A&B
• Changes how you receive the A&Bbenefits
• Now private insurance (not Mcare)
- Lower premium,Uses copay networks,Prior Authorizations,
Utilization-driven (insurances want to be utalized less)
◼ Bad for PT
12.What are the characteristics of Part D of Medicare?
- Correct Answer: Prescription Drugs
• Buy a stand-alone plan
• OR might come with an Advantage Plan
• Monthly premium
• Copays vary by med.
13.What are the characteristics of original Medicare?
, - - Correct Answer: Direct, timely access
- No referral required
- Don't need prior authorization
- No visit limits
- PT-driven frequency
- Patients participate in co-insurance
- Biggest PT challenege is documentation
14.What are the characteristics of Medicare Advantage?
- - Correct Answer: - Network and authorization required
- Referral required
- Visit limits are common
- Insurance plan drives frequency
- Many copays
- Biggest PT challenge is utilization oversight
15.What does Medicare Part A cover?
- Correct Answer: SNF, Hospital stays, acute rehab, and home-bound home
health
16.What does Medicare Part B cover?
- Correct Answer: Sub-acute inpatient rehab, mobile PT, and outpatient PT
17.What are the qualifications for Medicaid?
- - Correct Answer: Varies by state, but typically similar.
• Low-income children, pregnant people, some parents/caretakers
(Individual coverage)
• Older adults and people with disabilities meeting financial/clinical
criteria.
• Income-based program
-- Federal matching and state-funded
18.What is habilitative care?
- Correct Answer: Habilitative care helps a person develop or learn skills
they have never had, rather than restoring skills they lost.
