Question

1.33 pts Question 9 When Charlotte's ACL was torn, she visited her physician at an outpatient care facility. Her doctor's decision to not recommend surgery for Charlotte and 10 other patients with similar conditions is under review by the Board of the outpatient facility. Charlotte and other patients complained that they still struggled to walk after the recovery period. What type of utilization review would identify this delivery of service? (Level 3) Oa. Prospective Utilization Review (the doctor used this to identify that surgery was an unnecessary medical procedure for his patients) Ob. Concurrent Utilization Review (Charlotte's physician employed discharge planning by deciding that Charlotte did not need to be hospitalized) O C.Retrospective Utilization Control, the board is identifying a pattern of underutilization d. None of the above

1.33 Question 8 Which type of payment method provides incentives for providers for efficiency? (Level 1) a. Capitation b. Discounted fees c. Salaries (physicians can earn bonuses for efficiency) O d. Per member per month

Question 7 1.33 pts Kat was concerned when she woke up one morning and saw that she had a red, itchy area on her left arm. She didn't think much of it but thought that maybe it was just a patch of dry skin. A few days went by, and she looked again at her arm, and it was now getting white dots around it. She decided it was best to go to her general physician. Once at the doctor, Dr. Betty decided it was best to send Kat to a dermatologist to get proper care. What type of utilization review would Dr. Betty's decision be? (Level 3) O a. Concurrent Utilization Review Ob.Gatekeeping OCManaged Care d. Prospective Utilization Review Oe. Retrospective Utilization Review

D Question 6 1.33 pts In Chapter 9, the author talks about Managed Care Organizations (MCOS). What are the three main approaches that MCOS use to monitor and control utilization? (Level 2) O a. Gatekeeping and utilization review b. Expert evaluation of which services are medically necessary c.Determination of how services can be provided most inexpensively while maintaining standards of quality d. Review of the process of care and changes in the patient's condition to revise the course of medical treatment if necessary O e.a, b, and c O fb,c, and d g. None of the above O h. All of the above

1.33 pts Question 5 A close friend of Verna's had an accident while hiking and fell 5 feet, hitting her head. She was admitted to UMC trauma and cannot be cared for at home at this time. Verna's friend is 35 years old very healthy, without any illness or pre-existing diseases, has a 10-month-old child and is married with spousal support. Verna needed some direction and asked Dr. Betty for her recommendation regarding Long-Term Care Services for the injuries sustained that also required short-term ventilator support, a fractured hip that needed replacing and some wound care. Based on these injuries and the circumstances, what long-term care institution would Dr. Betty most likely recommend for Verna's close friend? (Level 3) O a. Retirement facility O b. Skilled nursing facility O c. Personal care facility d. Sub-acute facility e. All of the above OE None of the above

Memy is an older individual and has 2 ADLS. She has no family and is lonely. She would like feeling a part of a family again. Which type of senior care listed below would be most appropriate for Memy? (Level 2) O a. Senior Center O b.Adult Day Care O c. Adult Foster Care O d. Home Health Care O e. None of the above 1.33 pts Question 4 Based upon the report from (CDC, 2013) data in Chapter 11, Exhibit 11.2, motor-vehicle death rates in American Indians and Alaska Natives are two to five times higher than that for Hispanic Americans. (Level 3) True False

Question 1 1.33 pts Critical pathways refer to the specific manner in which care is provided. (Level 1) O True O False Question 2 1.33 pts Which National Survey collects health care information and data from persons between ages 1-10? (Level 2) a a. National Health and Nutrition Examination b. b. Longitudinal Survey on Aging c. Area Recourse File d. All of the above e. None of the above

Answer 1

1.

a. Prospective utilisation

2.

c. Salaries

3.

a.concurrent review

4. b. Expert evaluation

5.b. skilled nursing faculty

6.d.home health care

7.true

8.false

9.a.