Western Governors University (WGU) HLTH 2012 D391 Pre-Assessment Healthcare Ecosystems Practice Test

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• Which type of insurance covers patients who see physicians outside of their insurance company's network?
• In value-based care arrangements, who typically shares in savings when quality improves and costs are reduced?
• Which regulation governs privacy in healthcare in the United States?
• What is a bundled payment, and what is a potential advantage and a potential challenge?
• Which is a typical component of a healthcare organization's strategic plan in an ecosystem?
• What is consumer-directed care and what ecosystem factors influence its adoption?
• Which regulatory act is designed to protect employee benefit plans and sets fiduciary responsibilities?
• In a shared savings model, what happens when providers meet quality and cost targets?
• How does the healthcare supply chain influence patient outcomes and costs?
• What are the general benefits and challenges of implementing electronic health records in care settings?
• Which statement about market dynamics and collaboration is true?
• What is value-based purchasing and how does it affect provider behavior?
• Which of the following is an example of a social determinant of health?
• What is a common challenge for primary care clinics in the healthcare ecosystem?
• Which professional is most likely to specialize in health care for older adults?
• What is the role of data visualization in healthcare analytics?
• How does telehealth fit into the healthcare ecosystem, and what are typical barriers?
• Why is governance important in healthcare IT projects?
• What is the purpose of the American Medical Association (AMA)?
• How did the Affordable Care Act influence access, coverage, and care delivery in the U.S. healthcare system?
• What is the role of analytics in identifying at-risk populations and allocating resources accordingly?
• Which factors influence patient access to healthcare services?
• How do the revenue cycle and the care cycle differ in healthcare organizations?
• Which act expanded health insurance coverage and prohibits denying coverage for pre-existing conditions?
• What is risk stratification and how is it used in population health?
• Which statement compares HL7 v2 and FHIR in terms of interoperability and modern adoption?
• Which statement best distinguishes equity in care from equality in access?
• How do market dynamics influence competition and collaboration in healthcare ecosystems?
• Under HIPAA, what does 'minimum necessary' disclosure require?
• In the STEEEP framework, which step corresponds to using a treatment plan that is proven and scientifically accepted?
• Which activities exemplify care coordination?
• How should health and human service workers engage clients in decision-making activities?
• The STEEEP framework outlines six aims for health care. Which acronym represents those aims?
• Which professional is most directly involved in physical rehabilitation therapies, such as gait training and mobility exercises?
• How do patient privacy concerns influence data-sharing decisions within a healthcare ecosystem?
• What is a valid strategy to overcome vendor lock-in in interoperability efforts?
• What is a key consideration in reimbursing telemedicine services?
• Which level of care involves specialized services after referral from primary care, such as specialty clinics or surgeons?
• What are common barriers to healthcare interoperability and a typical strategy to overcome them?
• What new dimension is added to the Triple Aim to create the Quadruple Aim?
• What is the main purpose of mental health organizations?
• Which option grants patients the ability to review their medical records and request amendments?
• Which approach helps test a change that is implemented?
• What should healthcare providers do when communicating with their clients during decision-making processes?
• What is care equity?
• What is a risk associated with incremental IT upgrades in healthcare IT projects?
• How does telemedicine integration influence rural health disparities?
• Which law established incentives for meaningful use of electronic health records and expanded privacy protections?
• Which federal regulation mandates health insurance companies to provide preventive care at no cost?
• A client needs medical services from different specialists. Who should be in charge of organizing the services provided to the patient?
• In healthcare, value is defined as what, and which three dimensions are commonly used?
• What is capitation and its typical incentives and risks in healthcare delivery?
• Which statement lists the core HIPAA privacy and security principles that affect health information handling?
• What is the purpose of interoperability standards in healthcare IT?
• Which healthcare regulation prohibits discrimination by health insurance companies based on clients' genetics?
• Which of the following is NOT typically considered primary care?
• What is the primary goal of an Accountable Care Organization (ACO)?
• A client's pregnancy test was positive during their last physical exam with the primary care physician. Which healthcare provider does the client need to see?
• Which statement accurately reflects MACRA/MIPS performance areas?
• What is a health information exchange (HIE), and what barrier commonly hinders its effective use?
• Which statement best describes a health information exchange (HIE)?
• In DECIDE, how many alternatives must be considered before selecting the best approach?
• Which statement best describes the care cycle in a healthcare organization?
• Which statement best describes equality in health access?
• Which factor is a common barrier to successful EHR implementation?
• A 25-year-old client receives health insurance from their employer. This client wants to save some money for future medical expenses. What plan should this customer use?
• Which stakeholder is primarily responsible for cost control and risk management in a healthcare ecosystem?
• Which organizations are part of the healthcare ecosystem?
• Which level of care is associated with extremely specialized and cutting-edge medical services often delivered at a few advanced centers?
• How do quality measurement frameworks like HEDIS influence healthcare organizations?
• Bundled payments are best described as:
• What core principles differentiate a Patient-Centered Medical Home (PCMH) from traditional primary care?
• Which healthcare law reiterates protections for health information and includes health insurance reform?
• A 20-year-old client has been experiencing anxiety after their dad passed away six months ago. Which healthcare provider does the client need to see?
• A client suffered a fall from a ladder while painting outside their home. Their speech has become slurred and illogical. Which healthcare provider does the client need to see?
• How do organizations balance privacy with data sharing for population health?
• In DECIDE, which step involves establishing criteria to judge possible options?
• Which statement best defines value-based care in contrast to fee-for-service models?
• Which analytical approach is commonly used in population health analytics to target interventions?
• What is a common challenge for long-term care facilities in the healthcare ecosystem?
• Which three goals constitute the Triple Aim?
• How do care transitions contribute to patient safety and cost containment?
• Which setting typically provides highly specialized medical services and procedures often in specialized centers?
• What is a common challenge for hospitals within the healthcare ecosystem?
• What is the recommended sequence of actions after a PHI breach?
• What is the name of the comprehensive health care reform law enacted in March 2010?
• What is a health information exchange (HIE)?
• What describes privacy by design in healthcare information technology?
• A 25-year-old client with no medical problems is seeking new insurance coverage. They make minimum wage and don't want to spend too much money on coverage. Which type of health insurance is the client looking for?
• Identify and define two health insurance plan types: HMOs and PPOs.
• Which term describes a plan that blends features of HMO and PPO, allowing out-of-network coverage with higher costs?
• What is the role of public health within a healthcare ecosystem?
• Which data types are commonly used in population health analytics?
• What is the role of ongoing compliance monitoring in healthcare IT?
• Which is a goal of the Affordable Care Act?
• Which professional typically coordinates overall medical care for a patient and serves as a primary point of contact?
• To support analytics, data quality governance primarily ensures which of the following?
• A 25-year-old client found information about a new medication for anxiety on a social media post. What should the client's healthcare provider do about this information?
• Which act governs the privacy and security of health information?
• How do privacy rules balance patient confidentiality with data sharing for care coordination?
• Which statement best describes population health management compared with disease management?
• Which clinician should respond to acute neurologic symptoms after an injury?
• Which statement describes data provenance in health analytics?
• What was the role of the HITECH Act in promoting health information technology adoption?
• Which factor most directly affects the budget for data privacy initiatives in healthcare organizations?
• What best defines care coordination in a healthcare ecosystem?
• Which statement best describes the role of data sharing privacy safeguards in care coordination?
• Which statement best describes value-based care in the healthcare ecosystem?
• Which program provides continuation of coverage, allowing individuals to pay to keep their coverage after leaving a job?
• Which set best exemplifies social determinants of health?
• How do ecosystem-level interventions impact patient safety and care quality?
• Which statement best captures a patient-centered approach in a coordinated care environment?
• What is the capitation model of reimbursement?
• Which statement describes ACA provisions regarding Medicaid expansion and health insurance marketplaces?
• A client needs help navigating the healthcare system and scheduling appointments. Which professional should they see?
• Describe the Plan-Do-Study-Act (PDSA) cycle used in quality improvement.
• Under HIPAA, which statement best reflects patient rights regarding PHI?
• Describe the role of supply chain management in healthcare and its relevance to patient care.
• Name a common governance framework used in healthcare IT projects and its purpose?
• What is a key reason to assess online medical information critically, such as posts on social media?
• How do network effects influence the adoption of health information exchanges?
• Why is data provenance important in health analytics?
• Which type of health services does the concierge model of healthcare provide?
• Which technologies are part of patient engagement technologies used in care management?
• Which is an example of tertiary healthcare service?
• Which healthcare plan is payable with out-of-network coverage?
• What is the primary purpose of establishing shared standards and governance in health information exchanges?
• Which statement best characterizes governance gaps as a barrier to interoperability?
• Which ethical consideration is commonly discussed in population health and data use?
• What does IT governance define in healthcare organizations and why is it important?
• In the healthcare ecosystem, what is the primary role of suppliers?
• Which scenario describes insider risk in healthcare data security?
• Which healthcare professional typically leads the diagnostic process and determines treatment plans in a hospital setting?
• Which individual is part of the healthcare ecosystem?
• Which savings mechanism pairs with a high-deductible plan to give individuals tax-advantaged funds for medical expenses?
• Which statement best differentiates EMR, EHR, and HIE?
• In evaluating improvements in care delivery, what is the primary purpose of the Plan-Do-Study-Act (PDSA) cycle?
• Identify two privacy/security controls required under HIPAA for health information systems.
• What practice best supports equitable and patient-centered care when designing care plans for diverse populations?
• In population health, what is the purpose of risk stratification?
• Why are dashboards used in healthcare quality measurement?
• What is a primary incentive for providers to participate in value-based purchasing?
• How did HITECH impact healthcare IT adoption?
• Which best distinguishes 'access' from 'availability' in healthcare?
• Which role specializes in coding, medical records, and health information management to support clinical and billing processes?
• Which statement best describes the benefit of interoperability standards like FHIR for patient data portability?
• A care coordinator works with a client with diverse health service needs and coordinates with multiple healthcare teams to provide personalized service. Which STEEEP step is demonstrated?
• Which of the following are components of the STEEEP framework?
• Explain the significance of interoperability standards like FHIR in enabling patient data portability.
• Which groups are typically considered primary participants in the healthcare ecosystem?
• A health coordinator and client demonstrate which DECIDE step when evaluating whether a quit-smoking plan succeeded after a month?
• Which is a component of the quadruple aim framework?
• Which groups are considered core stakeholders in the healthcare ecosystem?
• How does MACRA/MIPS influence clinician reimbursement?
• A client has been unable to stop taking opioid medication months after being discharged from their medical treatment. Which facility should the client visit?
• What is the typical lifecycle of healthcare analytics from data to action?
• Which act allows workers who were laid off to continue to purchase health insurance under their previous employer's plan?
• In health care reimbursement, which model is described by payment for each discrete service provided?
• Which organizations are responsible for providing health education campaigns and activities to prevent diseases in the community?
• Which combination best represents approaches to advancing care equity within healthcare ecosystems?
• Which statement about HL7 and FHIR is correct?
• Which environment is most likely to provide highly specialized, complex medical services such as organ transplantation?
• Which statement best describes how leaders should respond to changes in policy, regulations, or the market?
• Which level of care involves specialized services after referral from primary care, such as specialty clinics or surgeons?
• Which level of care typically includes hospital-based specialist services after referral from primary care?
• How do health equity and access issues impact the healthcare ecosystem?
• What is a key difference between US healthcare financing and many other high-income countries?
• What is a common challenge to achieving interoperability in healthcare IT?
• Which term best describes a plan commonly offered by employers that coordinates care through a primary physician?
• Within the DECIDE framework, which step involves selecting the best alternative after evaluating options?
• In Medicare, value-based purchasing primarily rewards providers based on which?
• A patient has recently been diagnosed with diabetes. Their healthcare provider showed them how to check their blood sugar levels daily. What should the provider do to help the patient adhere to their treatment plan?
• Which statement about HL7 is true?
• Which payment model involves a single bundled payment covering all services for a patient's episode?
• Which term describes a health plan that requires selecting a primary care physician and obtaining referrals for specialists?
• Which organization is primarily known for promoting public health and science among physicians?
• Which statement about privacy by design is most accurate?
• What is HIPAA's primary purpose and one key responsibility for healthcare organizations?
• What is care gaps closure and why is it important?
• Which healthcare professional is primarily responsible for managing and coding patient health information for records and billing?
• A 40-year-old client thinks that the pharmacy made a mistake with the instructions for their medication. Which resource should the client consult to verify the instructions for their medication?
• Which statement illustrates how social determinants influence a health outcome?
• What is the basic idea of supply and demand in healthcare markets, and how do externalities affect it?
• Which statement best describes data interoperability?
• How does the Affordable Care Act influence health insurance coverage rates among populations?
• How is risk stratification used in population health?
• A client pays $100 on each doctor's visit before their insurance starts to pay. Which term describes this type of payment?
• Which types of measures are commonly used in healthcare quality dashboards?
• What is data governance and why is it critical in healthcare ecosystems?
• What is data interoperability and why is it critical for care coordination?
• Which describes how ecosystem-level interventions enhance patient safety?
• Which individual is an example of an advanced practice professional?
• Which combination best balances privacy with data sharing for population health?
• For ongoing obstetric care, which provider should be involved?
• Which statement best describes a typical barrier to telehealth adoption?
• What is an interoperability fracture and how can ecosystems mitigate it?
• Which of the following is NOT one of the three commonly used dimensions of value in healthcare?
• What is fee-for-service reimbursement?
• Which statement best describes FHIR?
• Which statement correctly distinguishes a payer from a provider in healthcare financing?
• Which role ensures integration across multiple specialists?
• Which regulation requires employers to provide information to employees about funding for pensions and group-sponsored welfare benefits provided by the employer?
• Which factor is essential to the successful deployment of telemedicine in rural areas?
• Why is patient engagement important in a healthcare ecosystem, and which strategy is commonly used?
• Which statement correctly describes the roles of SNOMED CT and CPT in clinical documentation and coding?
• An 80-year-old client has many healthcare problems. Which healthcare provider does the client need to see?
• What is population health analytics and what data sources are commonly used?
• Which cost-sharing arrangement means you pay a percentage of costs after meeting the deductible?
• What best describes interdisciplinary team-based care and its role in chronic disease management?
• According to the DECIDE approach, what is the next step after developing and implementing a plan of action?
• Which combination of technologies best supports patient engagement in care management?
• What does data provenance mean in the context of health data quality?
• In Medicare, value-based purchasing is best described as:
• Which plan is often referred to as a 'consumer-directed plan'?
• A client from Greece changed dieticians because they did not believe their U.S. dietician understood their dietary preferences. Which approach should the new dietitian use?
• Which healthcare professional is primarily responsible for diagnosing diseases?
• What does coverage parity mean in telemedicine reimbursement?
• Which of the following is NOT a common data security measure used in healthcare IT systems?
• Which STEEEP step is demonstrated when a local health department provides the same service to all clients regardless of gender, income, or ethnicity?
• Population health management aims to improve outcomes for defined groups by addressing clinical and social determinants, prevention, and care coordination to reduce disparities.
• What is telehealth and how has it affected care delivery in modern ecosystems?
• Which type of insurance will cover a 40-year-old client who is an uninsured, disabled non-veteran?
• Which statement best describes how Medicare's payment reform supports value-based care?
• In the SHARE approach, which step is demonstrated when a social worker helps a client compare treatment options?
• What strategic capabilities should healthcare leaders develop to succeed in a complex ecosystem?
• What is the main purpose of a mental healthcare organization?
• A high-income 20-year-old client with pre-existing conditions is looking for a new healthcare plan. Which healthcare plan will fit the needs of the client?
• Which of the following is not typically listed as a health data quality dimension?
• What role does data governance play in healthcare ecosystems?
• Which level of care is typically the first point of contact for a patient seeking medical care?
• How should a physician respond when someone other than a family member is designated as the surrogate decision maker for a patient who lacks decision-making capacity?
• Which description best captures the essence of an Accountable Care Organization (ACO) as a payment and care model?
• Which term describes the type of health plan an employer offers its employees?
• In health data sharing, consent is typically required for which scenario?
• Which governance framework is described as IT governance for aligning IT with strategy and defining decision rights?
• Which statement accurately describes the relationship among SNOMED CT, CPT, and ICD-10-CM codes in documentation and coding?