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Healthcare Administration Evolution, Systems,
and Leadership - D545 Questions and Answers
(100% Correct Answers) Already Graded A+
Patient Protection and Affordable Care Act (ACA) Ans: also known as
the Affordable Care Act and Obamacare; a U.S. federal statute
enacted in 2010 aimed at expanding health insurance coverage,
reducing healthcare costs, and improving healthcare system efficiency
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and quality
uninsured Ans: individuals who do not have health insurance coverage
through private companies, government programs, or other means, and
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therefore, may face difficulties in accessing healthcare services
health insurance marketplace Ans: system established to facilitate the
purchase of health insurance in organized markets (also referred to as
health insurance exchanges)
health care Ans: an act or deed between the healthcare provider and
the patient to maintain or improve the patient's healthcare status
biomedical model Ans: a theoretical framework in healthcare that views
illness and disease as primarily resulting from biological factors
holistic health Ans: an approach to wellness that simultaneously
addresses the physical, mental, emotional, social, and spiritual
components of health
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holistic medicine Ans: the practice of healthcare professionals using a
diverse range of disciplines, religious philosophies, and cultural practices
to heal individuals, communities, and the environment
accountable care organization (ACO) Ans: a network of doctors,
hospitals, and other healthcare providers that voluntarily come together
to provide coordinated, high-quality care to their patients
structure Ans: how specific activities are performed to ensure the mission
and vision of the organization are achieved
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functional organization structure Ans: splits the organization into
departments based on the expertise of employees (also referred to as
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bureaucratic organizational structure)
matrix organizational structure Ans: a type of organizational design that
combines two or more types of organizational structures, typically
functional and project-based
financing Ans: premiums established through negotiations between
employers and the MCO
insurance Ans: a financial arrangement that protects against financial
loss or liability, typically by allowing individuals or entities to pool the risk
of potential losses in exchange for regular payments known as premiums
managed care organization (MCO) Ans: a type of healthcare delivery
system that aims to manage the cost, quality, and accessibility of
healthcare services; MCOs are commonly associated with HMOs, PPOs,
and POS plans
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delivery Ans: the provision of healthcare services by various providers in
exchange for payment for services rendered
payment function Ans: to determine fees for services, how much a
provider should be paid for services rendered, and the actual payment
to the provider after services have been rendered
health maintenance organization (HMO) Ans: a type of managed care
organization that provides health insurance coverage through a network
of healthcare providers who offer services to members for a fixed fee
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preferred provider organization (PPO) Ans: a type of managed care
organization that provides health insurance coverage where members
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can receive care from both in-network and out-of-network providers,
with greater flexibility and higher coverage for in-network services
integrated delivery system (IDS) Ans: a network of organizations that
provides or arranges to provide an organized variety of services to
specific populations and is held accountable for the outcomes and
health status of those populations
payer-provider integration Ans: a system comprising a merger between
the payers of healthcare and the providers of healthcare to control
healthcare costs and improve the delivery of healthcare services
consumer-driven health plan (CDHP) Ans: (also known as a high-
deductible health plan) a type of health insurance plan that
encourages individuals to manage their healthcare costs
point-of-service plan Ans: a type of managed care health insurance that
combines features of HMOs and PPOs; it offers a blend of flexibility and
cost-efficiency, with an emphasis on coordinated care
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fee-for-service Ans: a system wherein healthcare is provided as individual
units of service, such as magnetic resonance imaging (MRI) or other X-
ray, medical examination, flu shot, or other service
preferred provider Ans: a type of organization that provides services
based on contracts with groups
magnetic resonance imaging (MRI) Ans: A medical imaging technique
used to visualize internal structures of the body.
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preferred provider Ans: A type of organization that provides services
based on contracts with groups of physicians and hospitals that are
referred to as preferred providers.
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healthcare reform Ans: The process of improving the efficiency,
accessibility, and quality of healthcare services, often involving changes
to policies, regulations, and practices within healthcare systems.
healthcare quality Ans: The degree to which health services for
individuals and populations increase the likelihood of desired health
outcomes and are consistent with current professional knowledge.
healthcare costs Ans: The monetary expenditures related to medical
care, including the costs of preventive, diagnostic, therapeutic, and
rehabilitative services, as well as health-related research and
administration.
consumerism Ans: The trend of patients increasingly acting as consumers
who make informed choices about their healthcare services based on
quality, cost, and other factors.