What Is Managed Care?
Has an organized physician staff
Managed care is a mechanism of providing health care services
An institution with at least six beds and that delivers diagnostic and therapeutic services for medical conditions
Provide continuous nursing service under RNS
The Correct Answer is B
Rationale:
A. Has an organized physician staff: This describes one characteristic of managed care organizations (MCOs), but it does not fully define managed care itself.
B. Managed care is a mechanism of providing health care services: Managed care refers to a system or approach to healthcare delivery that aims to manage and coordinate healthcare services
to improve quality, control costs, and optimize outcomes. It involves mechanisms such as provider networks, utilization management, and financial incentives to achieve these goals.
C. An institution with at least six beds and that delivers diagnostic and therapeutic services for medical conditions: This describes a hospital rather than managed care.
D. Provide continuous nursing service under RNS: This describes a specific nursing service and is not a comprehensive definition of managed care.
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Related Questions
Correct Answer is D
Explanation
Rationale:
A. Technology: While technological advancements may have influenced healthcare delivery, they did not directly trigger hospital downsizing in the 1980s.
B. Hill-Burton Act (1946): The Hill-Burton Act provided federal funding for hospital construction and modernization, which typically led to expansion rather than downsizing of hospitals.
C. Covid-19: Covid-19 emerged long after the 1980s and is not related to the hospital downsizing trends of that decade.
D. Prospective Payment System (PPS): The implementation of the Prospective Payment System (PPS) in the 1980s, particularly for Medicare reimbursements, shifted hospital reimbursement from fee-for-service to a predetermined payment based on diagnosis-related groups (DRGs).
This change incentivized hospitals to become more efficient and led to downsizing, closure of underutilized facilities, and consolidation of services.
Correct Answer is C
Explanation
Rationale:
A. Promotes the use of performance measurements in health care: This answer describes the purpose of quality indicators in general but does not specifically address the macro perspective.
B. Focus on individual services at the point of delivery: This describes the micro perspective, which focuses on specific aspects of care delivery.
C. Reflect the performance of the entire health care delivery system: The macro perspective of quality indicators looks at the overall performance of the entire healthcare system, including factors such as access, effectiveness, and efficiency.
D. Look at the performance of an individual or organization: While this may be a component of quality measurement, it does not encompass the broader view of the macro perspective.
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