WGU D391 HEALTHCARE ECOSYSTEMS OA EXAM
ACTUAL QUESTIONS AND ANSWERS - LATEST AND
COMPLETE UPDATE WITH VERIFIED SOLUTIONS –
ASSURED PASS WITH INSTANT DOWNLOAD PDF.
Which type of insurance covers more than half of the U.S. population under 65
years old? - ANSWER: Employer-sponsored insurance plans cover more
Americans under 65 than any other type of coverage.
Which federal healthcare insurance will be a better fit for a 30-year-old client who
is currently receiving dialysis for permanent kidney failure? - ANSWER:
Medicare is available for people aged 65 or older, younger people with disabilities,
and people with end-stage renal disease.
A 69-year-old retired machinist who is widowed has one child that lives out of
state. The retiree has a history of congestive heart failure and is currently unable to
care for themselves. Their physician's office helped enroll them in a longterm
service and support program through Medicaid. While the original assessment
qualified the retiree to receive support from a home health aide for 30 hours per
week, a six-month reassessment reduced the support qualification to 15 hours per
week. According to the physician, the retiree's declining health necessitates 30
hours of support from a home health aide per week; however, Medicaid denied the
appeal.Which agency can the retiree make a complaint to? - ANSWER: State
Department of Health.This agency monitors and responds to complaints presented
by individuals that need assistance in ensuring they can receive necessary
assistance that is needed based on their situation.
Which organization accredits health insurance companies? - CORRECT
ANSWER - National Commission on Quality and Assurance,This commission is a
nonprofit accreditation agency for payer groups.
,A small rural community is facing a public health crisis during a particularly
virulent flu season. A Health and Human Services (HHS) professional is assigned
to work directly with the community to reinforce the importance of preventative
care and to ensure the members of the community have the resources and
knowledge they need to prevent the spread of flu.
Which HHS role is appropriate to serve this need? - ANSWER: Public health
educators
work directly with the public to spread awareness of preventative health measures.
Which component of the U.S. healthcare ecosystem is classified as a provider? -
CORRECT ANSWER - An urgent care facility
is a place that offers healthcare services, so it is classified as a provider in the
healthcare ecosystem.
A single mother of two young children who relies on public assistance is having
difficulty seeing due to an outdated eyeglass lens prescription. However, she has
no vision coverage and can't afford to pay out of pocket for an optometrist
appointment and new lenses and frames.Where should this client go to get an eye
exam and new glasses? - ANSWER: A free medical clinic (FMC)
FMCs are privately-funded non-profits that provide medical services not readily
unavailable elsewhere to those with health care access barriers such as poverty,
addiction, and homelessness.
What is a medical service that a nurse practitioner can provide, but a registered
nurse cannot? - ANSWER: A nurse practitioner (NP) is an advance practice
professional who may perform many duties of a physician, including prescribe
medication. While registered nurses may dispense prescribed medications, they
may not prescribe them.
What is a primary responsibility of long-term care administrators in a healthcare
organization? - ANSWER: Oversee assisted living facilities
,Long-term administrators oversee the operations of nursing homes and other
assisted living facilities.
A client had an accident, was cut deeply, and is bleeding heavily.Which type of
provider should treat this patient? - ANSWER: An acute care facility, such as a
hospital, provides short-term treatment for urgent medical conditions. Acute care is
appropriate for this patient's urgent medical need.
Which legislation created health insurance exchanges that allowed consumers to
compare and buy health insurance plans? - ANSWER: The Affordable Care Act
of 2010.
This act also expanded Medicaid and CHIP
What is a goal of the Health Insurance Portability and Accountability Act
(HIPPA) of 1996? - ANSWER: The Health Insurance Portability and
Accountability Act (HIPPA) of 1996 defines protected health information as "any
individually identifiable health information."
Which medical field contains the largest percentage of U.S. physicians by specialty
as of 2019? - ANSWER: General practice/Family medicine
As of 2019, general practice physicians represent 16% of all physicians in the U.S.,
more than any other medical field.
What is one of the five main funding models of the U.S. healthcare system? -
ANSWER: The national health insurance model is one of the five main funding
models of the U.S. healthcare system.
What is The equity model - ANSWER: The equity model is a component of the
ACA, not a payer model.
, Which model is a social health insurance model? - ANSWER: The Bismarck
Model reimburses for social needs in the plan of care.
Three defining features of the Beveridge model. - ANSWER: (1) Universal,
single-payer insurance - no enrollment necessary, all financed through taxes. (2)
Public health care provision - government runs hospitals and clinics + decides all
supply. (3) Free care - care is provided for free at government hospitals.
Which ins model is a hybrid and of what? - ANSWER: The National Health
Insurance model is a hybrid of the Beveridge and Bismarck models in which the
government is the single-payer for healthcare (Beveridge) and the providers are
private (Bismarck)
What is The Beveridge Model? - ANSWER: Is a single-payer national health
service that is provided and financed by the government s everyone has access.
Taxpayer money provided by health staff who are considered government
employees
What is The Bismarck Model - ANSWER: Social insurance model.
healthcare is jointly funded by 'sickness funds" employers and employees through
payroll taxes deducted directly from employee paychecks
Government regulates closely, and must include all citizens.
Functions like ins, but not -for -profit.
Relies on an insurance system known as sickness funds
Providers are mostly private!
Which is an example of fraud by a provider? - ANSWER:
Kickbacks.Providers are not allowed to take funds from vendors for referrals.
ACTUAL QUESTIONS AND ANSWERS - LATEST AND
COMPLETE UPDATE WITH VERIFIED SOLUTIONS –
ASSURED PASS WITH INSTANT DOWNLOAD PDF.
Which type of insurance covers more than half of the U.S. population under 65
years old? - ANSWER: Employer-sponsored insurance plans cover more
Americans under 65 than any other type of coverage.
Which federal healthcare insurance will be a better fit for a 30-year-old client who
is currently receiving dialysis for permanent kidney failure? - ANSWER:
Medicare is available for people aged 65 or older, younger people with disabilities,
and people with end-stage renal disease.
A 69-year-old retired machinist who is widowed has one child that lives out of
state. The retiree has a history of congestive heart failure and is currently unable to
care for themselves. Their physician's office helped enroll them in a longterm
service and support program through Medicaid. While the original assessment
qualified the retiree to receive support from a home health aide for 30 hours per
week, a six-month reassessment reduced the support qualification to 15 hours per
week. According to the physician, the retiree's declining health necessitates 30
hours of support from a home health aide per week; however, Medicaid denied the
appeal.Which agency can the retiree make a complaint to? - ANSWER: State
Department of Health.This agency monitors and responds to complaints presented
by individuals that need assistance in ensuring they can receive necessary
assistance that is needed based on their situation.
Which organization accredits health insurance companies? - CORRECT
ANSWER - National Commission on Quality and Assurance,This commission is a
nonprofit accreditation agency for payer groups.
,A small rural community is facing a public health crisis during a particularly
virulent flu season. A Health and Human Services (HHS) professional is assigned
to work directly with the community to reinforce the importance of preventative
care and to ensure the members of the community have the resources and
knowledge they need to prevent the spread of flu.
Which HHS role is appropriate to serve this need? - ANSWER: Public health
educators
work directly with the public to spread awareness of preventative health measures.
Which component of the U.S. healthcare ecosystem is classified as a provider? -
CORRECT ANSWER - An urgent care facility
is a place that offers healthcare services, so it is classified as a provider in the
healthcare ecosystem.
A single mother of two young children who relies on public assistance is having
difficulty seeing due to an outdated eyeglass lens prescription. However, she has
no vision coverage and can't afford to pay out of pocket for an optometrist
appointment and new lenses and frames.Where should this client go to get an eye
exam and new glasses? - ANSWER: A free medical clinic (FMC)
FMCs are privately-funded non-profits that provide medical services not readily
unavailable elsewhere to those with health care access barriers such as poverty,
addiction, and homelessness.
What is a medical service that a nurse practitioner can provide, but a registered
nurse cannot? - ANSWER: A nurse practitioner (NP) is an advance practice
professional who may perform many duties of a physician, including prescribe
medication. While registered nurses may dispense prescribed medications, they
may not prescribe them.
What is a primary responsibility of long-term care administrators in a healthcare
organization? - ANSWER: Oversee assisted living facilities
,Long-term administrators oversee the operations of nursing homes and other
assisted living facilities.
A client had an accident, was cut deeply, and is bleeding heavily.Which type of
provider should treat this patient? - ANSWER: An acute care facility, such as a
hospital, provides short-term treatment for urgent medical conditions. Acute care is
appropriate for this patient's urgent medical need.
Which legislation created health insurance exchanges that allowed consumers to
compare and buy health insurance plans? - ANSWER: The Affordable Care Act
of 2010.
This act also expanded Medicaid and CHIP
What is a goal of the Health Insurance Portability and Accountability Act
(HIPPA) of 1996? - ANSWER: The Health Insurance Portability and
Accountability Act (HIPPA) of 1996 defines protected health information as "any
individually identifiable health information."
Which medical field contains the largest percentage of U.S. physicians by specialty
as of 2019? - ANSWER: General practice/Family medicine
As of 2019, general practice physicians represent 16% of all physicians in the U.S.,
more than any other medical field.
What is one of the five main funding models of the U.S. healthcare system? -
ANSWER: The national health insurance model is one of the five main funding
models of the U.S. healthcare system.
What is The equity model - ANSWER: The equity model is a component of the
ACA, not a payer model.
, Which model is a social health insurance model? - ANSWER: The Bismarck
Model reimburses for social needs in the plan of care.
Three defining features of the Beveridge model. - ANSWER: (1) Universal,
single-payer insurance - no enrollment necessary, all financed through taxes. (2)
Public health care provision - government runs hospitals and clinics + decides all
supply. (3) Free care - care is provided for free at government hospitals.
Which ins model is a hybrid and of what? - ANSWER: The National Health
Insurance model is a hybrid of the Beveridge and Bismarck models in which the
government is the single-payer for healthcare (Beveridge) and the providers are
private (Bismarck)
What is The Beveridge Model? - ANSWER: Is a single-payer national health
service that is provided and financed by the government s everyone has access.
Taxpayer money provided by health staff who are considered government
employees
What is The Bismarck Model - ANSWER: Social insurance model.
healthcare is jointly funded by 'sickness funds" employers and employees through
payroll taxes deducted directly from employee paychecks
Government regulates closely, and must include all citizens.
Functions like ins, but not -for -profit.
Relies on an insurance system known as sickness funds
Providers are mostly private!
Which is an example of fraud by a provider? - ANSWER:
Kickbacks.Providers are not allowed to take funds from vendors for referrals.
