( reviews)
HEALTHCARE DELIVERY EXAM 1
2026 QUESTIONS AND ANSWERS
VERIFIED A+
Terms in this set (150 terms)
,1. Define a HEALTH People, institutions, resources in accordance with established policies, protecting
CARE SYSTEM against cost of ill-health and whose primary intent is to improve, promote, main-
tain, and restore health
2. Define the core State of complete physical, mental, and social well-being. Not merely the absence
component of of disease or infirmity
the health care State where individual can function routinely, daily in a normal capacity
system: HEALTH
3. Define the core Ettorts to maintain/restore physical, mental, emotional well-being by trained
component of licensed professionals
the health care
system: CARE
4. What are the lev- Primary, Secondary, Tertiary care
els of care?
5. What is PRIMARY Medical care provided by clinician of first contact for the pt
CARE? GP, NP, RPh, Dentist, Optician
Priority: preventive, diagnostic, health education, minor surgery
6. What is SEC- Care provided to a patient who has been referred to the specialist for an identified
ONDARY CARE? condition
Hospital clinic, Specialist Doctor, Dietician, Physiotherapist
Priority: curative, advanced interventions
7. What is TERTIARY Specific care for rare/uncommon conditions or diseases. Highly specialized, in-
CARE? stitution based. Receives referrals from both 1° and 2° care
Examples: National or regional specialist services
8. What is a SYS- Whole composed of several interdependent parts with ditterentiated roles that
TEM? are interconnected by 3 processes (input, throughput, outcomes)
1° purpose is to promote, restore and/or maintain health
, 9. Healthcare Value
Chain diagram
10. What are the Payers: where funding originates
KEY COMPO- Insurers: finance healthcare
NENTS of the Providers: healthcare service delivery
VALUE CHAIN? Distributors/Wholesalers: supply chain management
Producers: product manufacturers & innovation sources
11. Describe the PAY- Role: initial source healthcare funding
ERS: The Finan- Includes both private and public sectors
cial Foundation
12. What are the Employers: employees enrolled in EBHI
three main cate- Government: groups receiving public insurance (Medicare, Medicaid, VA)
gories of PAYERS? Individuals: out-of-pocket payments
13. Describe the Function as fiscal intermediaries between payers and providers
INSURERS: Fi-
nancers of
Healthcare
14. What are SER- Premium collection, Provider contracting, Claims processing
VICES of INSUR-
ERS?
15. What are TYPES Traditional health insurers
of INSURERS? High-deductible health plans (HDHP)
Pharmacy benefit managers (PBM)
HEALTHCARE DELIVERY EXAM 1
2026 QUESTIONS AND ANSWERS
VERIFIED A+
Terms in this set (150 terms)
,1. Define a HEALTH People, institutions, resources in accordance with established policies, protecting
CARE SYSTEM against cost of ill-health and whose primary intent is to improve, promote, main-
tain, and restore health
2. Define the core State of complete physical, mental, and social well-being. Not merely the absence
component of of disease or infirmity
the health care State where individual can function routinely, daily in a normal capacity
system: HEALTH
3. Define the core Ettorts to maintain/restore physical, mental, emotional well-being by trained
component of licensed professionals
the health care
system: CARE
4. What are the lev- Primary, Secondary, Tertiary care
els of care?
5. What is PRIMARY Medical care provided by clinician of first contact for the pt
CARE? GP, NP, RPh, Dentist, Optician
Priority: preventive, diagnostic, health education, minor surgery
6. What is SEC- Care provided to a patient who has been referred to the specialist for an identified
ONDARY CARE? condition
Hospital clinic, Specialist Doctor, Dietician, Physiotherapist
Priority: curative, advanced interventions
7. What is TERTIARY Specific care for rare/uncommon conditions or diseases. Highly specialized, in-
CARE? stitution based. Receives referrals from both 1° and 2° care
Examples: National or regional specialist services
8. What is a SYS- Whole composed of several interdependent parts with ditterentiated roles that
TEM? are interconnected by 3 processes (input, throughput, outcomes)
1° purpose is to promote, restore and/or maintain health
, 9. Healthcare Value
Chain diagram
10. What are the Payers: where funding originates
KEY COMPO- Insurers: finance healthcare
NENTS of the Providers: healthcare service delivery
VALUE CHAIN? Distributors/Wholesalers: supply chain management
Producers: product manufacturers & innovation sources
11. Describe the PAY- Role: initial source healthcare funding
ERS: The Finan- Includes both private and public sectors
cial Foundation
12. What are the Employers: employees enrolled in EBHI
three main cate- Government: groups receiving public insurance (Medicare, Medicaid, VA)
gories of PAYERS? Individuals: out-of-pocket payments
13. Describe the Function as fiscal intermediaries between payers and providers
INSURERS: Fi-
nancers of
Healthcare
14. What are SER- Premium collection, Provider contracting, Claims processing
VICES of INSUR-
ERS?
15. What are TYPES Traditional health insurers
of INSURERS? High-deductible health plans (HDHP)
Pharmacy benefit managers (PBM)
