Questions and 100% Verified Correct Answers
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3rd party payer - CORRECT ANSWERS: Agent of the patient (the 1st party) who
contracts with providers (the 2nd party) to pay all or a portion of the bill to the patient
Accountable care organizations (ACOs) - CORRECT ANSWERS: created by ACA. Set
of healthcare providers, PCP, specialists, and hospitals - work collaboratively and
accept collective accountability for the cost and quality of care delivered to a population
of patients. The patient-centered medical home is an accepted model for achieving ACO
goals
Associates - CORRECT ANSWERS: People who give their time and energy to the
organization. They can be employees, trustees and other volunteers and medical staff
members.
Boundary Spanning - CORRECT ANSWERS: Establishing and maintaining effective
relationships with all stakeholders, and adapting the HCO to the needs of its community
Capital analysis - CORRECT ANSWERS: A process to determine how much a capital
expenditure will cost and what return it will generate
Capitated price - CORRECT ANSWERS: A price per head or subscriber. And, a
healthcare payment system that an organization accepts a monthly payment from a 3rd
party payer for each individual covered by that payer's plan, whether a given individual
is treated in a given month. Provides a financial incentive to an HCO to keep its
population from using more healthcare services than necessary because the
organization only profits if the total cost of treating the specified population falls below
the total capitation provided by the 3rd party payer
, Caregiving/Clinical/Logistic/Strategic Teams - CORRECT ANSWERS: Caregiving
Teams: Provide care to patients with similar needs (PCP, ACUTE, rehab)
Clinical Support Teams: provide specific clinical services to Caregiving Teams (clinical
laboratory, pharmacy, imaging, cardiopulmonary)
Logistic Support Teams - provide trained personnel, information, facilities, accounting,
cash, management and supplies
Strategic Support Teams: provide marketing, governance, internal consulting, finance,
stakeholder relations management and strategic positioning
Certificate-of-need laws - CORRECT ANSWERS: Certificate or approval of new
services and construction and renovation of hospitals or related facilities; issued in
many states. Require that HCOs seek permission for construction or expansion.
Community Benefit - CORRECT ANSWERS: Requires hospitals to satisfy the
community benefit standard in order to qualify as tax-exempt charities under 501c3 of
the IRS code. The standard addresses charitable care, educational services, and other
benefits HCOs provide to their communities
Conflicts of interest - CORRECT ANSWERS: An individual owes duties to two or more
persons or organizations and when meeting a duty to one somehow harms the other
Construct validity - CORRECT ANSWERS: Degree to which a selection tool actually
measures the construct it intends to measure; this concept ultimately determines the
conclusions that can be legitimately drawn from the tool's use.
Content Validity - CORRECT ANSWERS: Extent to which a selection tool
representatively samples the content of the job for which the measure will be used.
Criterion-related validity - CORRECT ANSWERS: Extent to which a selection tool is
associated with or predicts actual job performance