WGU C425 Healthcare Delivery,
Regulation, and Compliance Questions
and Answers
Capitation A
covers all services an enrollee may need during an entire year
Market Justice
most equitably distributed through the market forces of supply and demand, rather than government
interventions. Distributed on the basis of willingness and ability to pay
Social Justice
An ideal that embraces all aspects of civilized life and that is linked to fundamental notions of fairness
and to cultural beliefs about right and wrong.
defensive medicine
Ordering more tests and procedures than are necessary in order to protect physicians from a lawsuit.
medical model
emphasizes clinical diagnosis and medical intervention in the treatment of diseases or symptoms. Health
is defined as lack of illness
,National Health Insurance
course of care delivered by providers (Canada)
National Health System
Great Britain taxes support the system, but government also manages the infrastructure for healthcare
delivery
Socialized Health Insurance
government mandated contributions by employers and employees finance health care (Germany)
Acute Care
relatively severe, short duration, often treatable. Ex. stroke
Chronic Care
continuing for a long time
, Planned Rationing
The government making deliberate attempts to limit the supply of health care services
Medicare
Benefit period = 60 days after admitted
Pt B: cover physicians bill, small premiums for elderly
Premiums are income based
Part D: Prescription Drug coverage
Voluntary, w monthly premium
1973- expanded to non elderly disabled, end stage renal disease patients. Financed by pay roll taxes
American Medical Association
protect the interests of physicians, organized medicine. Supported licensing discouraged employment by
hospitals and insurance companies
Globalization
various forms of cross border economic activities
Medicaid
Eligible poor, financed through federal matching funds to the states
Regulation, and Compliance Questions
and Answers
Capitation A
covers all services an enrollee may need during an entire year
Market Justice
most equitably distributed through the market forces of supply and demand, rather than government
interventions. Distributed on the basis of willingness and ability to pay
Social Justice
An ideal that embraces all aspects of civilized life and that is linked to fundamental notions of fairness
and to cultural beliefs about right and wrong.
defensive medicine
Ordering more tests and procedures than are necessary in order to protect physicians from a lawsuit.
medical model
emphasizes clinical diagnosis and medical intervention in the treatment of diseases or symptoms. Health
is defined as lack of illness
,National Health Insurance
course of care delivered by providers (Canada)
National Health System
Great Britain taxes support the system, but government also manages the infrastructure for healthcare
delivery
Socialized Health Insurance
government mandated contributions by employers and employees finance health care (Germany)
Acute Care
relatively severe, short duration, often treatable. Ex. stroke
Chronic Care
continuing for a long time
, Planned Rationing
The government making deliberate attempts to limit the supply of health care services
Medicare
Benefit period = 60 days after admitted
Pt B: cover physicians bill, small premiums for elderly
Premiums are income based
Part D: Prescription Drug coverage
Voluntary, w monthly premium
1973- expanded to non elderly disabled, end stage renal disease patients. Financed by pay roll taxes
American Medical Association
protect the interests of physicians, organized medicine. Supported licensing discouraged employment by
hospitals and insurance companies
Globalization
various forms of cross border economic activities
Medicaid
Eligible poor, financed through federal matching funds to the states
