WGU D391 HEALTHCARE ECOSYSTEMS OBJECTIVE ASSESSMENT 2025/2026 – UPDATED PRACTICE QUESTIONS AND COMPREHENSIVE ANSWER EXPLANATIONS

Healthcare system - - ANSWER an organization of individuals, institutions and resources that deliver services to clients Healthcare providers - - ANSWER diverse individuals with various skills and knowldge who provide services to patients product - - ANSWER multiple client services and treatment in the healthcare system healthcare ecosystem - - ANSWER a system composed of elements that create a community Licensure - - ANSWER education and qualifcations for healthcare providers stakeholders - - ANSWER a group of people with a common interest especially in a buisness payers - - ANSWER Individuals or organizations who cover the costs of healthcare services; either self pay or insurance companies Purchasors - - ANSWER An individual or organization that purchases healthcare coverage on behalf of their employees US DEPT OF HHS - - ANSWER Government organization that protects consumers from harm National committee for quality assurance - - ANSWER monitors payer organizations Government regulations - - ANSWER helps reduce harm to healthcare patients and employees Joint commission on accreditation of healthcare organization. - - ANSWER Helps improve and monitor providers quality of care Programmatic community services - - ANSWER HHS program or method that is marketed to and meets the needs of a community Quadruple Aim - - ANSWER concepts to optimize the performance of the healthcare system including reducing costs and improving population health Health insurance - - ANSWER payment for health services micro hospital - - ANSWER provides service to people in smaller rural areas Moral Hazard - - ANSWER when you get more medical services than you need at no cost Adverse selection - - ANSWER When the buyer and seller do not have the same information and you get cost below true cost of need. Reimbursement - - ANSWER When insurance companies pay provider High risk plan - - ANSWER a high premium plan for preexisting conditions Healthcare quality improvement act - - ANSWER weeds out bad providers and allows for no repurcussions patient safety and quality improvement act of 2005 - - ANSWER improves how they treat patients Point of service - - ANSWER you pay less when using in network providers. will need referrals for specialists STEEEP - - ANSWER making changes for better quality care. this can also stop a change to try something else. Plan do study act - - ANSWER used when making changes or when wanting to Lean - - ANSWER used to eliminate waste SHARE - - ANSWER allows provider and patient to explore all options. Goes over benefits and risk. DECIDE - - ANSWER a decision making approach Concierge - - ANSWER direct access to care. smaller patient loads and smaller number of providers Progmattic community service - - ANSWER a bundle of healthcare services stark law aka physician self referral law - - ANSWER Cant refer to family Bismark - - ANSWER Used in germany and is covered by a sick fund Beveridge - - ANSWER government tightly controls cost and is sole owner National Health insurance - - ANSWER providers private and gvt pays