Review ATI Community Health (Policy Systems, Dr löwe) Exam

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ATI Community Health (Policy Systems, Dr löwe) Exam

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Total Questions : 50

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Question 1:

Who has the primary responsibility of cost containment in the United States?

A. The patients B. Both physicians and patients C. The private sector D. The nursing unions

Answer and Explanation

Choice A:

The patients: While patients play a role in cost containment through their healthcare choices and behaviors, they do not have the primary responsibility.

Choice B:

Both physicians and patients: Physicians and patients contribute to cost containment efforts, but they are not primarily responsible for it.

Choice C:

The private sector: The primary responsibility of cost containment in the United States lies with the private sector, including insurance companies, employers, and healthcare providers, who implement policies and practices to manage and reduce healthcare costs.

Choice D:

The nursing unions: Nursing unions advocate for better working conditions and patient care but do not have primary responsibility for cost containment.

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Question 2:

Which of the following is attributed to the rising cost of healthcare?

A. Hospital downsizing in the United States B. Transition from primarily government institutions to community institutions C. Advanced sanitation, nursing and medical services D. Third-party payment

Answer and Explanation

Choice A:

Hospital downsizing in the United States: Hospital downsizing generally aims to reduce costs and improve efficiency, not increase healthcare costs.

Choice B:

Transition from primarily government institutions to community institutions: This transition often seeks to improve accessibility and cost-effectiveness in healthcare delivery rather than causing rising costs.

Choice C:

Advanced sanitation, nursing, and medical services: While these contribute to better health outcomes and possibly higher initial investments, they are not the primary driver of rising healthcare costs.

Choice D:

Third-party payment: Third-party payment systems, such as insurance companies, contributeto rising healthcare costs due to factors like administrative expenses, profit margins, and complex billing processes.

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Question 3:

How did managed care organizations (MCOs) garner enormous buying power?

A. By integration of several organizations under the same ownership or contractual arrangements B. By shared savings program under the ACA C. By providing an array of health care services to a large community D. By enrolling a large segment of the insured population

Answer and Explanation

Choice A:

By integration of several organizations under the same ownership or contractualarrangements: MCOs garner enormous buying power by integrating various healthcare providers and services under one ownership or through contractual agreements, which allows them to negotiate better rates with suppliers and providers.

Choice B:

By shared savings program under the ACA: While the shared savings program under the ACA aims to reduce healthcare costs, it is not the primary method through which MCOs gained their buying power.

Choice C:

By providing an array of health care services to a large community: Providing a wide range of services enhances the value offered by MCOs but does not directly lead to significant buying power.

Choice D:

By enrolling a large segment of the insured population: Enrolling a large number of insuredindividuals helps MCOs spread risk but is not the main factor that provides them with enormous buying power.

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Question 4:

What is referred to as a community hospital?

A. A nonfederal short-stay hospital whose services are available to the general public B. Nongovernment and privately owned C. Government ownership (federal, state, or local) D. Often located in large urban areas

Answer and Explanation

Choice A:

A nonfederal short-stay hospital whose services are available to the general public: Community hospitals are defined as nonfederal short-stay hospitals that provide a range of services to the general public and are accessible to all members of the community.

Choice B:

Nongovernment and privately owned: While many community hospitals may be privately owned, this option does not encompass the full definition as it excludes government-owned hospitals that serve the community.

Choice C:

Government ownership (federal, state, or local): Community hospitals can be government- owned, but this answer does not capture the full scope of what defines a community hospital.

Choice D:

Often located in large urban areas: Community hospitals can be found in both urban and rural areas, so this answer is not sufficiently inclusive.

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Question 5:

Monitoring a patient's prognosis for recovery becomes important in which type of utilization review?

A. Concurrent B. Preauthorization C. Retrospective D. Prospective

Answer and Explanation

Choice 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.

Choice 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.

Choice 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.

Choice 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.

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Question 6:

Which of the following does adult foster care facilities mostly provide?

A. Part-time or intermittent skilled nursing care. B. Nursing care, psychosocial therapies, and rehabilitation. C. A social setting. D. Room, board, and personal care.

Answer and Explanation

Choice A:

Part-time or intermittent skilled nursing care: This type of care is more commonly provided by home health care agencies or skilled nursing facilities rather than adult foster care facilities.

Choice B:

Nursing care, psychosocial therapies, and rehabilitation: These services are typically offered in specialized healthcare facilities such as nursing homes or rehabilitation centers, not adult foster care facilities.

Choice C:

A social setting: While adult foster care facilities do provide a social environment, this is not their primary function.

Choice D:

Room, board, and personal care: Adult foster care facilities primarily provide room, board, and personal care services to individuals who need assistance with daily living activities but do not require intensive medical or nursing care.

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Question 7:

Which of the following groups of people pay for the benefits of Medicare?

A. Health insurance companies B. Only doctors and nurses C. Hospital employees D. Taxpayers

Answer and Explanation

Choice A:

Health insurance companies: While health insurance companies may play a role in administering Medicare plans, they do not directly pay for the benefits of Medicare. Medicare is primarily funded through taxpayer contributions.

Choice B:

Only doctors and nurses: Healthcare providers, including doctors and nurses, do not directly pay for the benefits of Medicare. They may receive reimbursements for services rendered to Medicare beneficiaries, but they are not the ones funding the program.

Choice C:

Hospital employees: Hospital employees do not directly pay for the benefits of Medicare.Like other taxpayers, they may contribute to Medicare funding through taxes deducted from their salaries.

Choice D:

Taxpayers: The benefits of Medicare, a federal health insurance program primarily for people age 65 and older, are funded by taxpayers through various revenue sources, including payrolltaxes, income taxes, and premiums paid by beneficiaries.

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Question 8:

Why is organizational integration important?

A. Pharmacy services available B. Provides food services to meet the nutritional and therapeutic requirements of the patients C. There is maintenance of medical records on each patient D. It is necessary for economic reasons

Answer and Explanation

Choice A:

Pharmacy services available: While having pharmacy services available may be beneficial for patient care, it does not directly address the importance of organizational integration.

Choice B:

Provides food services to meet the nutritional and therapeutic requirements of the patients: While important for patient care, providing food services does not fully capture the importance of organizational integration.

Choice C:

There is maintenance of medical records on each patient: Maintaining medical records is essential for patient care but does not address the broader importance of organizationalintegration.

Choice D:

It is necessary for economic reasons: Organizational integration refers to the coordination and alignment of different aspects of a healthcare organization, including clinical, administrative, and financial functions. Integration is crucial for optimizing efficiency, reducing duplication of services, improving communication, and ultimately achieving cost savings and better patient outcomes.

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Question 9:

What is Precision Medicine?

A. Medical model of health care delivery B. Variations in practice C. Increase in the elderly population D. Goes a step beyond personalized medicine by taking into account environmental and lifestyle factors.

Answer and Explanation

Choice A:

Medical model of health care delivery: Precision Medicine is not a medical model of healthcare delivery but rather an approach to medical treatment.

Choice B:

Variations in practice: While Precision Medicine may lead to variations in medical practice, it is not a definition of Precision Medicine.

Choice C:

Increase in the elderly population: The increase in the elderly population is not the definition of Precision Medicine.

Choice D:

Goes a step beyond personalized medicine by taking into account environmental and lifestyle factors: Precision Medicine involves tailoring medical treatment to the individual characteristics of each patient, including their genetic makeup, environment, and lifestyle factors. It goes beyond traditional personalized medicine by incorporating a more comprehensive understanding of the patient's unique circumstances.

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Question 10:

According to Shi and Singh "Essentials of the U.S. Healthcare System," what percentage of the healthcare workforce do hospitals employ?

A. 10% B. 39% C. 50% D. 75%

Answer and Explanation

Choice A:

10%: This percentage is too low; hospitals employ a larger portion of the healthcare workforce.

Choice B:

39%: Hospitals employ approximately 39% of the healthcare workforce, including various professionals such as physicians, nurses, allied health professionals, and administrative staff.

Choice C:

50%: While hospitals employ a significant portion of the healthcare workforce, it is not as high as 50%.

Choice D:

75%: This percentage is too high; hospitals do not employ three-quarters of the healthcare workforce.

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ATI Community Health (Policy Systems, Dr löwe) Exam

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