HCA 202 Exam Questions and Answers 100% Pass

HCA 202 Exam Questions and Answers 100% Pass managed care - ANSWER -seeks to achieve efficiency by integrating the basic functions of health care delivery, and it employs mechanisms to control (manage) utilization and cost of medical services. The dominant health care delivery system in the US today. Covers both private and public health insurance programs through contracts with a MCO. military - ANSWER -medical care system available mostly free of charge to active duty military personnel of the US army, navy, air force, and coast guard, as well as to members of certain uniformed nonmilitary services. Provides both preventive and treatment oriented services provided by salaried health care personnel. TriCare - ANSWER -a program that is financed by the US department of defense. This insurance plan permits the beneficiaries to receive care from both private and military medical care facilities. Veterans Administration - ANSWER -a health care system available to retired veterans who have previously served in the military, with priority given to those who are disabled. It focuses on hospital care, mental health services, and long-term care. One of the largest and oldest formally organized health care systems in the world, with a mission to provide medical care for the US department of defense medical care system. It is organized into 21 geographically distributed Veterans Integrated Service Networks. 2 | P a g e Created by Grace Amelia © 2025, All Rights Reserved. Veterans Integrated Service Network - ANSWER -organizes the VA system into 21 geographically distributed networks. Responsible for coordinating the activities of the hospital and other facilities located within its jurisdiction. Also responsible for improved efficiency and cost containment. special populations - ANSWER -vulnerable groups with health needs but inadequate resources to address those needs. Include poor and uninsured individuals, minorities, immigrants, or those in disadvantaged communities. Typically receive insurance through the nation's safety nets, Medicare and Medicaid, as well as community and migrant health centers, free clinics, and hospital emergency departments. Bureau of Primary Healthcare - ANSWER -located within the Health Resources and Services Administration in the Department of Health and Human Services, provides support for community based health centers that include programs for special populations medicare - ANSWER -one of the largest sources of public health insurance in the US, serving the elderly, disabled, and those with end stage renal disease. Offers coverage for hospital care, post-discharge nursing care, hospice, outpatient services, and prescription drugs. medicaid - ANSWER -the third largest source of health insurance in the US; provides coverage for low-income adults, children, the elderly, and individuals with disabilities Children's Health Insurance Program - ANSWER -aka CHIP; provides insurance to children in uninsured families as well as children in families with modest incomes that do not qualify for Medicare. Integrated Delivery Systems - ANSWER -a network of health care providers and organizations that provides or arranges to provide a coordinated continuum of services to a defined population and is willing to be held clinically and fiscally accountable for the clinical outcomes and health status of the population served 3 | P a g e Created by Grace Amelia © 2025, All Rights Reserved. most important principles specific to vulnerable populations: 1) emphasis on primary care 2) coordination of all care, including behavioral, social, and public health services 3) accountability for population health outcomes Long term care - ANSWER -consists of medical and nonmedical care that are provided to individuals who have chronic health issues and disabilities that prevent them from doing regular daily tasks. Delivered across various venues including patient's home, assisted living facilities, and nursing homes. public health system - ANSWER -mission is to improve and protect community health characteristics of the US health care system - ANSWER --no central or governing agency and little integration or coordination -technology driven delivery system focusing on acute care -high in cost, unequal in access, and average in outcome -delivery of health care under imperfect market conditions -government as subsidiary to the private sector -fusion of market injustice and social justice -multiple players and balance of power -quest for integration and accountability -access to health care services selectively based on insurance coverage -legal risks influence practice behaviors system - ANSWER -consists of a set of interrelated and interdependent components designed to achieve some common goals. The components are strategically coordinated. 4 | P a g e Created by Grace Amelia © 2025, All Rights Reserved. system resources - ANSWER -both human and nonhuman resources are essential for the delivery of health care services. human resources - ANSWER -consist of the various types and categories of workers directly engaged in the delivery of health care to patients. Includes physicians, nurses, dentists, pharmacists, and additional professionals that usually have direct contact with patients. Ancillary workers, those involved in billing and collection, marketing, PR, and building maintenance, often play indirect supportive roles in the delivery of health care. system processes - ANSWER -carried out mainly through the health care delivery infrastructure consisting of hospitals, clinics, long term care providers, etc. outpatient care-- HC services delivered in non-institutional settings institutional health services-- predominantly associated with acute care hospitals system outcomes - ANSWER -refers to the critical issues and concerns surrounding what the health services system is able to accomplish in terms of its primary objective primary objective of health care - ANSWER -to provide cost-effective health services that meet certain established standards of quality to an entire nation access, cost, and quality are the main outcome criteria for evaluating efficacy of a health care delivery system 5 | P a g e Created by Grace Amelia © 2025, All Rights Reserved. health - ANSWER -under the medical model, it is defined as the absence of illness or disease which emphasises clinical diagnosis and medical intervention to treat disease or its symptoms. further defined as the state of optimal capacity of an individual to perform his or her expected social roles and tasks. holistic medicine - ANSWER -seeks to treat the individual as a whole person; incorporates the spiritual dimension as a fourth element in addition to physic