Accountable Care Organizations (ACOs) are built on the premise that:
groups of providers come together and take responsibility for delivering care to a defined patient population.
Bad debt in health care finance is defined as:
when health care organizations bill for services but receives no payments.
CMI is an acronym that stands for:
Center for Medicare and Medicaid Innovation.
Capital budgets may include all of the following:
routine capital equipment used in clinical areas,
information technology infrastructure and upgrades
acquisition of staff physicians
Charge setting is controlled by:
Charity care is:
Community service, the not-for-profit organization provides care who is unable to pay.
Current assets may include:
cash on hand,
and other such items that can be converted into cash in LESS than one year.
For-profit health care organizations are usually owned by:
or others who have an interest in making a profit from the services provided
Health care financial management involves:
Working to increase the revenues and decrease the cost of the organization.
In the wake of health care reform, most health care executives believe that the new reform policies will:
have a negative financial impact on their facilities.
Physician reimbursement through Medicare will eventually be:
or focused on quality, value and accountability
Primary sources of working capital include all of the following:
current assets and liabilities
Setting prices in health care organizations involves consideration of all the following:
state/federal law and regulations,
the joint commission,
The Balanced Budget Act of 1997 implemented cost controls for Medicare expenditures in all of the following health care sectors:
skilled nursing facilities, home health agencies, outpatient hospitals, and clinics.
The Medicare prospective payment system for reimbursing hospitals utilizes:
All of the following are examples of family practice core privileges for care of infants and children, adolescents, and adults for most illnesses, disorders, and injuries:
treatment, and management.
All of the following are midlevel practitioners:
include APN’S such as NP’S, CNS, Nurse anesthetists, Nurse midwives, and PA’s ( Answer on test is “Except EMT” )
Home Health Aides who work for agencies reimbursed by Medicare and Medicaid must:
get a minimum level of training and pass a competency evaluation or receive state certification.
Physician resistance to acknowledge nurses as colleagues can lead to:
poor teamwork and interpersonal conflict which can result in poor patient outcomes.
Nurses quit jobs when they:
feel overworked, underpaid, and disrespected by co-workers and managers.
Residency training lasts from ______ depending on the specialty
The Sunshine Act requires:
medical device manufacturers and group purchasing organizations to report any payments and transfers of value to physicians.
or teaching hospitals as well as any ownership of investment interest physicians or immediate family members have in a company
The largest category of health care workers is:
Which of the following items should be on a work life analysis?
fairness of pay, opportunities for promotion,
relationships with co-workers and supervisors, level of job burnout, overall job satisfaction.
True or False: There are no shortages of allied health professionals
Behavioral-based interviews are helpful to the hiring organization in understanding a candidate’s:
Attitudes, behavior, and experience.
Best practices of high-performing organizations include all of the following focal areas:
staff acquisition and development,
staff front line empowerment,
leadership alignment and development
Human resources decisions need to be strategic because of:
increasing competition among HSOs
Incentive compensation is believed to have what effect on employee performance?
positive motivational effect which leads to higher performance.
Major federal law affecting human resources primarily addresses:
protecting employee rights and ensures nondiscrimination.
Predictive analytics or Human Resource Analytics are used by Human Resources managers to identify:
needs and better manage their human resources.
Recent information from the literature concerning employee perceptions suggests that:
benefits are more important than compensation.
The National Labor Relations Board provides guidance for HR in addressing:
union organization and collective bargaining.
The low supply of some health care workers (e.g nurses) has led to which of the following impacts on HSOs?
Understaffed, lower levels of staff satisfaction, higher rates of staff turnover and an increase human resources costs
Which of the following is a typical measure used by senior management to directly assess performance of HR efforts?
Contribution to recruitment, training and development for staff, as well as staff satisfaction and retention
A wicked problem DOES have which of the following features
10 key features:
non-enumerable and non-immediate solutions,
good/bad solutions, symptom of another problem,
planner has no right to be wrong, and discrepancy can be explained in numerous ways.
Eisenhardt, Kahwajy & Bourgeois (1997) found that teams with minimal interpersonal conflict DO INVOLVE:
6 Strategies: Worked with more information, debated facts; developed multiple alternatives to enrich the level of debate; shared commonly agreed upon goals; injected humour into decision process; maintained a balanced power structure; and, 6th–, –resolved issues without forcing consensus
Guidelines for teamwork cannot:
they CAN improve communication, establish goals, and delineate responsibilities (pg 387)
One of the critical questions to ask when assessing a potential team member is:
Have the knowledge, skills, and disposition to do the job at hand
Teams go through the following stages, in the following order:
forming, storming, norming, performing, adjourning
To convince higher-level management that teamwork is worth the effort, one SHOULD point to:
increased productivity, increased job satisfaction and decreased nursing turnover.
the agency for health care research and quality (AHRQ), a team system designed for healthcare professionals that is evidenced based and intended to improve communication and teamwork skills
Which of the following is NOT a benefit of effective health care teams?
Improved coordination of care. More efficient use of health care services. Increased job satisfaction among team members. Higher patient satisfaction.
Which of the following is correct about Cross Functional Teams (CFTs)?
(question will ask what is NOT correct)
Address specific organizational needs,ie.service excellence, environmental sustainability,green initiatives and clinical services marketing
◦Carry out performance improvement activities/service enhancements
Which of the following is NOT correct about emotions?
a.Emotions are communicated in nanoseconds.
b.Women and people in helping professions are more sensitive to emotions.
c.Emotions are contagious.
d.None of the above.
d.none of the above.
A hospital can demonstrate inclusivity by community engagement through:
All of the above.
Benefits of a diverse health care workforce include
All of the above? Greater access for the underserved.
Health disparities have been identified based on the following criteria:
Lack of transport to healthcare providers, inability to obtain convenient appointment times and lengthy waiting room times reduce the likelihood of a person successfully making and keeping their healthcare appointment.
Select all the terms that can be used interchangeably with cultural competency
Culturally effective care,
cultural conditioning, cultural sensitivity, cultural humility, cultural excellence training.
Social determinants that contribute to health disparities include
Complex, integrated and overlapping social structures and economic systems
Structural barriers may impede patient care and increase disparities; for example
Having a 9-5 schedule and not being able to attend doctor’s appts.
The National Standards on Culturally and Linguistically Appropriate Services provide for
effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.
True or False: Cancer is the leading cause of death in the United States
True or False : Health disparities represent significant differences between one population and another.
Vulnerable populations are more exposed to risks from:
illness and injury
(Substance abuse, infant mortality, birth defects, asthma, cancer, diabetes, store, heart disease, sexual diseases, mental disease.
True or False : There is one specific destination or goal for health care organization to achieve in terms of cultural competence
True or False : The health care workforce matches the U.S. population in terms of diversity
A wrong against society as a whole, even if a particular individual is harmed, is considered a violation of which type of law?
Contract violations are generally considered to be part of which type of law?
49.For a health provider’s action to be considered negligent, which of the following factors is NOT necessary?
C. Injury or damages
D. Duty toward the harmed party
E. Breach of duty
Nonmaleficence is a concept that states that you should
“do no harm” or at least don’t make it worse.
The Patient Self – Determination Act-
is a law that requires healthcare organizations to inform patients of their rights as they pertain to their ability to determine their own health care
True or False : Any Willing Provider laws seek to enable patients to see whichever providers they want
True or False : Administrative agencies dictate many of the ways in which health care workers and organizations must function
True or False: Ethics does nothing to help form the laws and legal system of the U.S.
True or False : Generally speaking, laws govern the relationships between private individuals and organizations and between both of these and the government
What are some of the ways in which health care organizations protect the rights of their patients?
HIPPA, EMTALA, Fiduciary Duty.
True or False : Patient advocates play a role in the navigating the health care system whether an individual is sick or no
Which of the following is not part of the definition of the health care malpractice?
the negligence or carelessness of a professional person; it can be either civil (tort) concern or a criminal one, depending on whether it involved “reckless disregard” for the safety of another (criminal) or simple carelessness (civil). “Malpractice is a professional’s improper or immoral conduct in the performance of duties, done either intentionally or through carelessness or ignorance.
Which of the following are obligations of a managed care organization to its patients?
Fiduciary duty, Using competent providers, Providing appropriate care, and Balancing cost-containment with good quality care
Examples of health care fraud and abuse include
Providers billing for services that were not provided or did not meet medical necessity criteria (false claims), submitting duplicate bills, upcoding services to receive higher reimbursement, and receiving kickbacks for referrals
HEAT is the President’s newest tool against
Safe Harbor regulations were put in place by
Seven essential elements of an effective compliance program include
1. written policies,
2. designation of compliance officer,
3. training and education,
4. effective lines of communication throughout the org,
5. enforcement procedures,
6. procedures for effective internal monitoring and auditing,
7. procedures for corrective action
The investigative and enforcement authority to deal with fraud and abuse violations was granted to the Department of Health and Human Services ( DHHS) through
49.True or False : A successful compliance plan requires buy – in from upper management
True or False : Fraud is an improper act that is unintentional and inconsistent with standard practices
True or False: As of 2015, Medicare RAC’s are returning more money than Medicaid Fraud Control Units
True or False : The Sherman Antitrust Act prohibits mergers and acquisitions that lessen competition
Violations of the Criminal Disclosure Provision of the Social Security Act include which of the following penalties?
Violations of this act are a felony and may include punishment of up to 5 years in prison and/or fines up to $25,000, imposes a requirement to disclose overpayment to the government regardless of the intent at the time the claim was submitted
Violations of the Emergency Medical Treatment and Active Labor Act ( EMTALA) include all of the following, EXCEPT…
Dumping a patient on another hospital because they are very sick
True or False: The Stark 1 laws apply to both Medicare and Medicaid
49.True or False: The health reform act that was passed in March 2010 will end health care fraud and abuse once and for all
is an inadvertent slip, lapse, or mistake
Medical Tourism includes
outbound: U.S. patients traveling to other countries for medical care. Inbound: foreign patients traveling to the U.S. for medical care and Intrabound: U.S. patients traveling domestically for medical care.
True or False : Bioterrorism was created for military uses in the 1980s
True or False : If a person has been exposed to Ebola, has no fever, and travels on an airplane, he can transmit the disease to other passengers
True or False : One – Third of woman killed in the U.S. workplaces were killed by a current or former intimate partner
True or False : Vaccines have only been around since the 1950s
True or False : There are no assurances of quality if you go for medical care in a country other than the United States
Which of the following is NOT an example of stalking
example of stalking includes unwanted phone calls, texts, letters, emails, social media posts, following or spying on the victim, showing up at places without a legitimate reason, waiting at places for the victim, leaving unwanted items, presents or flowers; posting information or spreading rumors about the victim
Disruptive behaviors include
overt actions such as verbal outburst and physical threats, as well as passive activities such as refusing to perform assigned task or quietly exhibiting uncooperative attitudes during routine activities
is required for physicians, nurses and others to practice and demonstrate competency to perform a scope of practice.
Physician resistance to acknowledge nurses as colleagues can lead to
Poor teamwork, Interpersonal Conflict, Poor Communication, Poor patient outcomes
Incentive compensation is believed to have what effect on employee performance ?
Higher level of organizational performance
Gainsharing or goal- sharing programs
A type of incentive compensation program where all staff share in receiving additional compensation in the form of a bonus as a result of meeting annual performance targets
Leadership Development Programs in HSOs
Serve as a recruitment tool for HSOs, focus primarily on filling middle-level manager positions
The perspective that HSO employees should be viewed as a strategic asset means
Organizational performance is based on individuals
Frequent, positive organizational communication does
(question asks NOT)
organizations that empower their employees
promote employee satisfaction
Virtual teams are being used for:
telemedicine and telecommuting