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Match the following Key Term(s) or italicized words from your text with the correct description: Case management
- A. Patient care approach aimed at coordinating the care of patients who are vulnerable, at risk, or cost intensive so that their specific needs are met in the most cost-effective manner while still bringing them to optimum health
- B. A federally and state-funded health insurance program for individuals who are poor and medically indigent, pregnant women, individuals with disabilities, and children meeting income level requirements
- C. A system of health-care delivery aimed at managing the cost and quality of access to health care
- D. The insurance company that finances health care provided to a beneficiary
- E. A cost-containment program featuring a primary care physician (PCP) as the gatekeeper to eliminate unnecessary testing and procedures
- F. A classification of illnesses and diseases that is then used to determine the amount of money paid to a hospital by Medicare
- G. A group of health-care providers who contract with a health insurance company to provide services to a specific group of patients on a discounted basis
Correct Answer: A
Rationale: Case management coordinates care for vulnerable or high-cost patients to ensure cost-effectiveness and optimal health outcomes.
You may also like to solve these questions
A case manager's main function is to coordinate and facilitate the care of several different patients concurrently.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Case managers coordinate care for multiple patients to ensure efficiency and effectiveness.
___ is a government-run insurance plan for people older than a certain age.
- A. Medicare
- B. Medicaid
- C. Private insurance
- D. Managed care
Correct Answer: A
Rationale: Medicare is for people over 65 or with certain disabilities.
A 48-year-old male patient has been hospitalized for 6 weeks in an acute care facility after being involved in a car accident. He was driving while intoxicated and admitted to being an alcoholic. He went through alcohol withdrawal while he was recovering from his injuries and has received some information about alcoholism treatment from a psychologist. He has his own business, is married, has four children, and has adequate health insurance. What care options are best for this man at this time?
- A. Inpatient drug and alcohol rehabilitation facility
- B. Ambulatory care clinic
- C. Outpatient mental health services
- D. Home health care
Correct Answer: A,C
Rationale: Inpatient rehab addresses his alcoholism, and outpatient mental health services support ongoing recovery.
In client-centered care, patients are encouraged to have a voice in goal setting and in deciding how the goals will be met.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Client-centered care empowers patients to participate in their care decisions.
One important consideration in managing costs is making sure the patient is placed in which of the following?
- A. Appropriate level of care
- B. Managed care
- C. A health maintenance organization (HMO)
- D. Acute care hospital
Correct Answer: A
Rationale: Placing patients in the appropriate level of care ensures cost-effective treatment.