RATIONALES
1. B — Payer
Payers (insurance companies, Medicare, Medicaid) reimburse providers for
services. Providers deliver care; patients receive care.
2. B — Primary care
Annual checkups and first-contact routine care are primary care functions.
3. C — CMS
Centers for Medicare & Medicaid Services administers Medicare and
oversees Medicaid rules with states.
4. B — Secondary
A cardiologist is a specialist, which is secondary care after referral.
5. C — Premium
A premium is the recurring monthly payment to maintain insurance
coverage.
6. B — Value-based care
This model ties reimbursement to quality, outcomes, and efficiency rather
than volume alone.
7. B — HIPAA
HIPAA protects patient health information privacy and security.
8. B — Housing stability
Housing is a classic social determinant affecting health outcomes and
access.
9. C — Improving population health
The Triple Aim = better patient experience, better population health, lower
cost.
10. B — Medicaid
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, Medicaid primarily supports eligible low-income individuals/families.
11. B — Root cause analysis
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