What is one reason that cost-control efforts in the United States have not been successful?
Wastage at clinics
Global healthcare issues
Poor patient outcomes
Cost shifting
The Correct Answer is D
Rationale:
A. Wastage at clinics: While wastage at clinics may contribute to inefficiencies in the healthcare system, it is not a primary reason that cost-control efforts in the United States have not been successful.
B. Global healthcare issues: While global healthcare issues may impact the broader context of healthcare delivery, they are not a specific reason for the lack of success in cost-control efforts within the United States.
C. Poor patient outcomes: Poor patient outcomes may contribute to healthcare costs, but they are not the primary reason that cost-control efforts have not been successful.
D. Cost shifting: Cost shifting refers to the practice of shifting costs from one payer to another, such as from private insurers to public payers like Medicare and Medicaid. This practice can undermine efforts to control costs by redistributing financial burdens rather than addressing underlying cost drivers.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Chronic disease prevention and management: While chronic diseases can contribute to healthcare costs, they are not directly related to waste and abuse within the healthcare system.
B. Fraud: Fraudulent activities, such as billing for services not provided or submitting false
claims, contribute to waste and abuse in the healthcare system, leading to higher costs for payers and consumers.
C. Unequal access to health care: Unequal access to healthcare may lead to disparities in health outcomes and healthcare utilization but is not necessarily a direct cause of waste and abuse.
D. Competitive approaches: Competitive approaches may influence healthcare delivery models and pricing strategies but are not directly related to waste and abuse contributing to rising
healthcare costs.
Correct Answer is A
Explanation
A. Concurrent: Concurrent utilization review involves the ongoing monitoring of a patient's care and recovery while they are still receiving treatment. This type of review focuses on ensuring that the care provided is appropriate and that the patient is progressing as expected.
B. Preauthorization: Preauthorization involves obtaining approval from a health insurer before a service is provided to ensure it will be covered. It does not focus on monitoring a patient's recovery.
C. Retrospective: Retrospective review involves evaluating the care provided to a patient after the treatment has been completed. It looks at the appropriateness of care but does not monitor ongoing recovery.
D. Prospective: Prospective review involves evaluating the necessity of a treatment before it begins. It does not include ongoing monitoring of a patient's prognosis for recovery.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.