WGU C425 Review Finals Exam Questions and Answers with Complete Solutions 2023/2024 Universal Access - Correct Answer Developed countries have national health insurance programs.It provides routine and basic health care.It is ran by the government and financed-through general taxes.All Americans are not "entitled" to routine and basic health care services. - Correct Answer Access also requires an adequate health delivery infrastructure.There is a shortage of primary care physicians mostly in the southern and mountains region.Obesity, chronic disease and aging population will create a much greater demand for medical services and the size of physician workforce will decline.50 % of PCP accept Medicaid and Participation in Medicare by PCP 36% why PCP are reluctant to accept Medicaid insured patients because of low reimbursement to providers and delays to receive payments after the services.Health Care Reform - Correct Answer Is the extension of health insurance to the uninsured.For system to remain solvent, it must be accompanied by control costs measures.
To control costs:
· Manage utilization · Limit reimbursement to providers · Employ some sort of rationing for supply of health care services Only the government can control costs in a single payer system because they finance the healthcare system for all citizens.In a single payer system, - Correct Answer Medicare, Medicaid, CHIP and VA are no longer needed.The government will have the right to over the availability of services, utilization and payments to providers.This will be opposed by many Americans and it is not seen as an alternative for the future.ACA proposed interventions to control costs but few provisions on addressing control of health care expenditures. - Correct Answer If the US does not cut expenses in the 1 / 4
bloated government, US may be left with no choice except to take drastic "austerity measure" a term used to describe spending cuts, including cuts in social program.To save Medicare from bankruptcy, changes to reduce costs are proposed in the ACA.Medicare benefits and allow a government panel to make decisions about end of life care.Medicaid, the push to enroll beneficiaries to managed care and paying MCO capitated monthly fees to cover all health care expenses for Medicaid beneficiaries. Taxes will increase for Americans to pay for the health care programs to be expanded.
If ACA fails:
Patient choice act, Health Care Freedom Plan, Empowering Patients First Act were proposed by republican legislatures and the main features for these plans are. - Correct Answer 1. Established state-based health care exchanges to facilitate individuals to buy private health insurance and create a market where private health plans compete for enrollees based on price and quality.
- Create a national market for health insurance to allow individuals to purchase health
- Allow automatic enrollment in employer plans and create tax incentives for small
- Give tax credit or vouchers to individuals to purchase health insurance.
insurance plans across state lines which are currently prohibited.
business for auto enrollment.
High risk pools that enable hard to insure people to purchase subsidized covered.
• . Replace Medicaid with a program to provide grants to state for:
a) Acute Medical Care Assistance to the blind, foster care children, low income women
with breast cancer or cervical cancer, TB infected individuals;
- long term care services and support disabled and elderly populations
6). Establish and implement a bidding mechanism to promise competition among Medicare Advantage plans (Part C).7) Prevent Medicare fraud and abuse.8) Supplement the costs of Private health insurance for low income families by distributing debit cards which may be used for costs and accessing health care.9). Repeal CHIP because options for this program may not be necessary.10) Reform the Tort System by developing mechanism for the resolution of disputes concerning injuries allegedly caused by health care providers. Reduce frivolous lawsuits.11) Assure consumers have access to price information prior to treatment so that they can make their own decisions about the care.What issues exists in this system which is driven by medical model of health are unresolved? - Correct Answer 1) inadequate emphasis on wellness, disease prevention and health promotion 2 / 4
2) a rise of chronic conditions and ensuing disabilities, the current health care system focuses on acute illnesses.3) Inadequate access to primary care resulting in patients overutilizing the ER 4) increases the costs of health care w/o any improvement in health care 5) The delivery of care is fragmented instead of continuous and coordinated.
- emerging models of health care delivery - Correct Answer 1) Medical Home Model
2) Community Oriented Primary Care Model 3) Accountable Care Organizations.Teamlet Model - Correct Answer 1) refers to two-person team consisting of a PCP, nurse practitioners or physician assistant and an allied health professional who will function as a health coach.
The main function of health coach:
· is to assist patient in gaining the knowledge and skills, confidence to self manage their chronic conditions.· Assist in coordinating appts · Help patients adopt a healthy lifestyle · Help patients understand and adhere to medication regimen Connected Health Care Model - Correct Answer 1) uses communication technology 2) patient self management and distant home monitoring Main objective is to keep chronically ill patients connected to necessary clinical expertise in between office visits Future work force challenges - Correct Answer · Shortage of health care professionals · To have a successful model of health care delivery system to be highly effective must have trained professionals.· Nurses should practice to their full extent through education and training.· Licensing requirements rules governing scope of practice should be allowed across states for nurses who have masters or doctoral degrees · Residency programs for nurses need to incorporate training in community health, public health and geriatrics Future workforce challenges - Correct Answer PCP need to be trained to function as a comprehensivist to address the needs of growing number of people with chronic conditions.PCP must be prepared to manage complex pharmacology to address end of life issues and medical ethics and lead health care teams PCP need to be trained to function as a comprehensivist to address the needs of growing number of people with chronic conditions. 3 / 4
PCP must be prepared to manage complex pharmacology to address end of life issues and medical ethics and lead health care teams.There is a shortage of health professionals trained in geriatrics which is a challenge because of shortage of faculty in colleges and universities who are trained in geriatrics.The elderly uses most home health care services and nursing homes, accounts for hospital inpatient days and ambulatory care visits.Elderlies suffer from chronic conditions complicated by comorbidities, the use of many prescriptions and increased in mental conditions and dementia.These trends demand will have shortage of MD, nurses, therapist, social workers and pharmacists who are trained in geriatrics.Integration of a racially and culturally diverse workforce will be a challenge as the U.S.Healthcare System itself becomes more complex in taxing both patients and workers.Cultural Competence: - Correct Answer refers to knowledge, skills, attitudes and behavior required of a practitioner to provide optima health care services to persons from a wide range of cultural and ethnic backgrounds.Health care providers need to understand the different belief systems, cultural biases, ethnic origins, family structures and many other culture-based factors that influence people who have illnesses in compliance with medical advice and respond to treatment.refers to knowledge, skills, attitudes and behavior required of a practitioner to provide optima health care services to persons from a wide range of cultural and ethnic backgrounds.Health care providers need to understand the different belief systems, cultural biases, ethnic origins, family structures and many other culture-based factors that influence people who have illnesses in compliance with medical advice and respond to treatment.GLOBAL THREATS AND INTERNATIONAL COOPERATION - Correct Answer Early identification of infectious threats and rapid response to prevent further spread of disease - a goal that is often difficult to achieve without international cooperation.Efforts to strengthen global health security includes disease surveillance of outbreaks of international importance and urgency, exchange of technical information on new pathogens and control animal disease.IHR (International Health Regulations) - Correct Answer Aim is to help prevent and respond to acute public health risk that can potentially cross borders.·Apply to other public health emergencies such as chemical spills, leaks and dumping or nuclear melt downs.
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