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Match the following Key Term(s) or italicized words from your text with the correct description: Third-party payer
- A. The federal government's health insurance program for people older than 65 years or those with certain disabilities or conditions
- 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: D
Rationale: A third-party payer is the insurance company that covers the cost of health care for a beneficiary.
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Match the following Key Term(s) or italicized words from your text with the correct description: Medicare
- A. The federal government's health insurance program for people older than 65 years or those with certain disabilities or conditions
- 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: C
Rationale: Medicare is defined as the federal government's health insurance program for people older than 65 years or those with certain disabilities or conditions.
Collaboration and teamwork are closely associated with patient safety.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Collaboration and teamwork enhance patient safety through coordinated care.
The nurse case manager usually provides direct, hands-on care.
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: Nurse case managers coordinate care rather than provide direct hands-on care.
Which of the following is the major difference between an assisted living facility and an independent living facility?
- A. There is no major difference.
- B. Independent living facilities do not provide nursing care.
- C. Residents must have medical needs to be placed in an assisted living facility.
- D. Assisted living facilities provide activities, but independent living facilities do not.
Correct Answer: B,C
Rationale: Assisted living facilities provide nursing care for residents with medical needs, unlike independent living facilities.
A primary care physician acting as a gatekeeper to eliminate unnecessary testing and procedures is a feature of a
- A. Health maintenance organization (HMO)
- B. Preferred provider organization (PPO)
- C. Point of service (POS)
- D. Medicaid
Correct Answer: A
Rationale: HMOs use primary care physicians as gatekeepers to control costs.