D391 exam questions with answers
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healthcare ecosystem - CORRECT ANSWERS ✔✔a system
|\ |\ |\ |\ |\ |\ |\
composed of elements that create a community|\ |\ |\ |\ |\ |\
healthcare system - CORRECT ANSWERS ✔✔an |\ |\ |\ |\ |\ |\
organization of individuals, institutions, and resources |\ |\ |\ |\ |\ |\
that deliver services to clients
|\ |\ |\ |\
stakeholders - CORRECT ANSWERS ✔✔a group of people |\ |\ |\ |\ |\ |\ |\ |\
with a common interest, especially in a business
|\ |\ |\ |\ |\ |\ |\
provider - CORRECT ANSWERS ✔✔a person or institution
|\ |\ |\ |\ |\ |\ |\ |\
that performs a service; for example, a healthcare worker
|\ |\ |\ |\ |\ |\ |\ |\ |\
performs health services. |\ |\
healthcare producers - CORRECT ANSWERS ✔✔diverse
|\ |\ |\ |\ |\ |\
individuals with various skills and knowledge who provide
|\ |\ |\ |\ |\ |\ |\ |\
services to patients |\ |\
product - CORRECT ANSWERS ✔✔multiple client services
|\ |\ |\ |\ |\ |\ |\
and treatment in the healthcare system
|\ |\ |\ |\ |\
,licensure - CORRECT ANSWERS ✔✔education and
|\ |\ |\ |\ |\ |\
qualifications for healthcare providers |\ |\ |\
payers - CORRECT ANSWERS ✔✔individuals or
|\ |\ |\ |\ |\ |\
organizations who cover the costs of healthcare services,|\ |\ |\ |\ |\ |\ |\ |\
either through self-pay or insurance companies
|\ |\ |\ |\ |\
purchasers - CORRECT ANSWERS ✔✔an individual or|\ |\ |\ |\ |\ |\ |\
organization that purchases healthcare coverage on |\ |\ |\ |\ |\ |\
behalf of their employees
|\ |\ |\
investors - CORRECT ANSWERS ✔✔individuals or
|\ |\ |\ |\ |\ |\
organizations who invest in healthcare services |\ |\ |\ |\ |\
National Committee for Quality Assurance (NCQA) -
|\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔monitors payer organizations
|\ |\ |\ |\
Joint Commission on Accreditation of Healthcare
|\ |\ |\ |\ |\ |\
Organizations (JCAHO) - CORRECT ANSWERS ✔✔helps |\ |\ |\ |\ |\ |\
improve and monitor providers' quality of care
|\ |\ |\ |\ |\ |\
U.S. Department of Health and Human Services -
|\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔government organization that
|\ |\ |\ |\ |\
protects consumers from harm
|\ |\ |\
,government regulations - CORRECT ANSWERS ✔✔helps |\ |\ |\ |\ |\ |\
reduce harm to healthcare patients and employees
|\ |\ |\ |\ |\ |\
health insurance - CORRECT ANSWERS ✔✔payment for
|\ |\ |\ |\ |\ |\ |\
health services |\
fee-for-service - CORRECT ANSWERS ✔✔providers receive |\ |\ |\ |\ |\
payment for services performed
|\ |\ |\ |\
health maintenance organizations - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\
✔✔a model in which providers are paid capitation
|\ |\ |\ |\ |\ |\ |\ |\
payments, restricting patients to a preferred list of
|\ |\ |\ |\ |\ |\ |\ |\
providers and controlling access to care
|\ |\ |\ |\ |\
insurance risk - CORRECT ANSWERS ✔✔an event covered
|\ |\ |\ |\ |\ |\ |\ |\
by insurance; the risk of payment is borne by the insurer,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
so insurance companies work hard to manage risk for
|\ |\ |\ |\ |\ |\ |\ |\ |\
both individuals and groups
|\ |\ |\
insurance expenses - CORRECT ANSWERS ✔✔payments
|\ |\ |\ |\ |\ |\
such as deductibles, premiums, and co-pays
|\ |\ |\ |\ |\
Moral hazards - CORRECT ANSWERS ✔✔situation in which
|\ |\ |\ |\ |\ |\ |\ |\
individual incurs no consequence for a decision, allowing
|\ |\ |\ |\ |\ |\ |\ |\
, for extravagant choices such as using more medical
|\ |\ |\ |\ |\ |\ |\ |\
services than are necessary
|\ |\ |\
adverse selection - CORRECT ANSWERS ✔✔in insurance
|\ |\ |\ |\ |\ |\ |\
terms, a situation in which the insured person has
|\ |\ |\ |\ |\ |\ |\ |\ |\
information that the insurer does not have, gaining
|\ |\ |\ |\ |\ |\ |\ |\
coverage at a cost below the true level of risk
|\ |\ |\ |\ |\ |\ |\ |\ |\
value-based care - CORRECT ANSWERS ✔✔provider of |\ |\ |\ |\ |\ |\ |\
service awards for quality patient care
|\ |\ |\ |\ |\
wellness and prevention - CORRECT ANSWERS ✔✔reduce
|\ |\ |\ |\ |\ |\ |\
cost and improve patient outcomes
|\ |\ |\ |\
legislation - CORRECT ANSWERS ✔✔standardizes care
|\ |\ |\ |\ |\ |\
and protects patients
|\ |\
Affordable Care Act - CORRECT ANSWERS ✔✔a law that
|\ |\ |\ |\ |\ |\ |\ |\ |\
states everyone in the United States can receive
|\ |\ |\ |\ |\ |\ |\ |\
affordable, accessible, quality care |\ |\ |\
Medicare - CORRECT ANSWERS ✔✔health insurance for
|\ |\ |\ |\ |\ |\ |\
people over age 65 and people on social security
|\ |\ |\ |\ |\ |\ |\ |\ |\
disability
|\ |\ |\ |\
healthcare ecosystem - CORRECT ANSWERS ✔✔a system
|\ |\ |\ |\ |\ |\ |\
composed of elements that create a community|\ |\ |\ |\ |\ |\
healthcare system - CORRECT ANSWERS ✔✔an |\ |\ |\ |\ |\ |\
organization of individuals, institutions, and resources |\ |\ |\ |\ |\ |\
that deliver services to clients
|\ |\ |\ |\
stakeholders - CORRECT ANSWERS ✔✔a group of people |\ |\ |\ |\ |\ |\ |\ |\
with a common interest, especially in a business
|\ |\ |\ |\ |\ |\ |\
provider - CORRECT ANSWERS ✔✔a person or institution
|\ |\ |\ |\ |\ |\ |\ |\
that performs a service; for example, a healthcare worker
|\ |\ |\ |\ |\ |\ |\ |\ |\
performs health services. |\ |\
healthcare producers - CORRECT ANSWERS ✔✔diverse
|\ |\ |\ |\ |\ |\
individuals with various skills and knowledge who provide
|\ |\ |\ |\ |\ |\ |\ |\
services to patients |\ |\
product - CORRECT ANSWERS ✔✔multiple client services
|\ |\ |\ |\ |\ |\ |\
and treatment in the healthcare system
|\ |\ |\ |\ |\
,licensure - CORRECT ANSWERS ✔✔education and
|\ |\ |\ |\ |\ |\
qualifications for healthcare providers |\ |\ |\
payers - CORRECT ANSWERS ✔✔individuals or
|\ |\ |\ |\ |\ |\
organizations who cover the costs of healthcare services,|\ |\ |\ |\ |\ |\ |\ |\
either through self-pay or insurance companies
|\ |\ |\ |\ |\
purchasers - CORRECT ANSWERS ✔✔an individual or|\ |\ |\ |\ |\ |\ |\
organization that purchases healthcare coverage on |\ |\ |\ |\ |\ |\
behalf of their employees
|\ |\ |\
investors - CORRECT ANSWERS ✔✔individuals or
|\ |\ |\ |\ |\ |\
organizations who invest in healthcare services |\ |\ |\ |\ |\
National Committee for Quality Assurance (NCQA) -
|\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔monitors payer organizations
|\ |\ |\ |\
Joint Commission on Accreditation of Healthcare
|\ |\ |\ |\ |\ |\
Organizations (JCAHO) - CORRECT ANSWERS ✔✔helps |\ |\ |\ |\ |\ |\
improve and monitor providers' quality of care
|\ |\ |\ |\ |\ |\
U.S. Department of Health and Human Services -
|\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔government organization that
|\ |\ |\ |\ |\
protects consumers from harm
|\ |\ |\
,government regulations - CORRECT ANSWERS ✔✔helps |\ |\ |\ |\ |\ |\
reduce harm to healthcare patients and employees
|\ |\ |\ |\ |\ |\
health insurance - CORRECT ANSWERS ✔✔payment for
|\ |\ |\ |\ |\ |\ |\
health services |\
fee-for-service - CORRECT ANSWERS ✔✔providers receive |\ |\ |\ |\ |\
payment for services performed
|\ |\ |\ |\
health maintenance organizations - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\
✔✔a model in which providers are paid capitation
|\ |\ |\ |\ |\ |\ |\ |\
payments, restricting patients to a preferred list of
|\ |\ |\ |\ |\ |\ |\ |\
providers and controlling access to care
|\ |\ |\ |\ |\
insurance risk - CORRECT ANSWERS ✔✔an event covered
|\ |\ |\ |\ |\ |\ |\ |\
by insurance; the risk of payment is borne by the insurer,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
so insurance companies work hard to manage risk for
|\ |\ |\ |\ |\ |\ |\ |\ |\
both individuals and groups
|\ |\ |\
insurance expenses - CORRECT ANSWERS ✔✔payments
|\ |\ |\ |\ |\ |\
such as deductibles, premiums, and co-pays
|\ |\ |\ |\ |\
Moral hazards - CORRECT ANSWERS ✔✔situation in which
|\ |\ |\ |\ |\ |\ |\ |\
individual incurs no consequence for a decision, allowing
|\ |\ |\ |\ |\ |\ |\ |\
, for extravagant choices such as using more medical
|\ |\ |\ |\ |\ |\ |\ |\
services than are necessary
|\ |\ |\
adverse selection - CORRECT ANSWERS ✔✔in insurance
|\ |\ |\ |\ |\ |\ |\
terms, a situation in which the insured person has
|\ |\ |\ |\ |\ |\ |\ |\ |\
information that the insurer does not have, gaining
|\ |\ |\ |\ |\ |\ |\ |\
coverage at a cost below the true level of risk
|\ |\ |\ |\ |\ |\ |\ |\ |\
value-based care - CORRECT ANSWERS ✔✔provider of |\ |\ |\ |\ |\ |\ |\
service awards for quality patient care
|\ |\ |\ |\ |\
wellness and prevention - CORRECT ANSWERS ✔✔reduce
|\ |\ |\ |\ |\ |\ |\
cost and improve patient outcomes
|\ |\ |\ |\
legislation - CORRECT ANSWERS ✔✔standardizes care
|\ |\ |\ |\ |\ |\
and protects patients
|\ |\
Affordable Care Act - CORRECT ANSWERS ✔✔a law that
|\ |\ |\ |\ |\ |\ |\ |\ |\
states everyone in the United States can receive
|\ |\ |\ |\ |\ |\ |\ |\
affordable, accessible, quality care |\ |\ |\
Medicare - CORRECT ANSWERS ✔✔health insurance for
|\ |\ |\ |\ |\ |\ |\
people over age 65 and people on social security
|\ |\ |\ |\ |\ |\ |\ |\ |\
disability
