Healthcare Policy Q & A with Rationales, Exams of Nursing

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HSAD 335

Health Care Policy

Q & A w/ Rationales

Which of the following is not a core principle of healthcare policy? a) Access b) Affordability c) Quality d) Profit maximization Answer: d) Profit maximization Rationale: Healthcare policy focuses on ensuring access, affordability, and quality of care for all individuals, rather than on profit maximization. What is the primary goal of the Affordable Care Act (ACA)? a) To decrease access to healthcare services b) To increase the cost of healthcare services c) To expand access to healthcare coverage d) To limit coverage for pre-existing conditions Answer: c) To expand access to healthcare coverage Rationale: The primary goal of the ACA is to expand access to healthcare coverage and improve the quality of care for Americans. Which of the following government programs provides healthcare coverage for individuals over the age of 65 in the United States? a) Medicaid b) CHIP c) Medicare d) TRICARE

information b) To limit access to healthcare for certain populations c) To increase administrative burden on healthcare providers d) To restrict access to emergency medical services Answer: a) To ensure the privacy and security of patient health information Rationale: HIPAA aims to safeguard the privacy and security of patient health information, while also ensuring individuals' right to maintain control over their healthcare data. Which of the following is a social determinant of health? a) Access to healthcare services b) Income level c) Health insurance coverage d) Availability of medical technology Answer: b) Income level Rationale: Income level is a social determinant of health, as it can significantly impact an individual's access to healthcare services and overall health outcomes. How does the Medicaid program differ from the Medicare program in the United States? a) Medicaid is a federal program, while Medicare is state- based b) Medicaid provides coverage for individuals over the age of 65, while Medicare provides coverage for low- income individuals c) Medicaid is means-tested, while Medicare is not

d) Medicaid is funded through payroll taxes, while Medicare is funded through general tax revenues Answer: c) Medicaid is means-tested, while Medicare is not Rationale: Unlike Medicare, Medicaid is a means-tested program, meaning that eligibility is based on income and other criteria. What is the role of the Centers for Medicare & Medicaid Services (CMS) in healthcare policy? a) To regulate health insurance companies b) To administer the Medicare and Medicaid programs c) To develop clinical practice guidelines d) To oversee medical licensing boards Answer: b) To administer the Medicare and Medicaid programs Rationale: CMS is responsible for administering the Medicare and Medicaid programs, as well as for overseeing various aspects of healthcare policy and regulation. What is the purpose of the Children's Health Insurance Program (CHIP)? a) To provide coverage for low-income, uninsured children b) To fund pediatric medical research c) To regulate children's access to healthcare services d) To provide coverage for children with pre-existing conditions Answer: a) To provide coverage for low-income, uninsured children

What is the role of the Agency for Healthcare Research and Quality (AHRQ) in shaping healthcare policy? a) To fund medical education programs b) To conduct research on healthcare quality and safety c) To regulate healthcare facilities d) To set reimbursement rates for healthcare services Answer: b) To conduct research on healthcare quality and safety Rationale: AHRQ plays a key role in shaping healthcare policy by conducting research on healthcare quality and safety, and by developing evidence-based guidelines for healthcare delivery. Which of the following is a key objective of population health management? a) Maximizing healthcare costs b) Improving health outcomes for specific patient populations c) Minimizing access to healthcare services d) Focusing on individual patient care Answer: b) Improving health outcomes for specific patient populations Rationale: Population health management aims to improve health outcomes for specific patient populations by addressing social determinants of health and implementing targeted interventions. How does the concept of health equity differ from health equality?

a) Health equity focuses on providing the same resources to all individuals b) Health equity aims to address disparities and barriers to optimal health c) Health equity emphasizes individual responsibility for health outcomes d) Health equity disregards social determinants of health Answer: b) Health equity aims to address disparities and barriers to optimal health Rationale: Health equity seeks to address disparities and barriers to optimal health, recognizing that individuals may require different resources to achieve equitable health outcomes. B:

1. A nurse is working in a public health clinic that serves a low-income and uninsured population. The nurse is aware that many of the patients have difficulty accessing health care services due to financial and social barriers. Which of the following health-care policies would most likely improve the access and quality of care for this population? a) A policy that expands Medicaid eligibility and coverage for preventive and primary care services. b) A policy that reduces Medicare reimbursement rates for hospitals that have high readmission rates. c) A policy that mandates employers to provide health insurance benefits to their employees.

b) Write an op-ed article for a local newspaper and post it on social media platforms. c) Contact the local legislators and advocate for funding and support for the intervention. d) Develop a brochure and distribute it to the patients and providers who participated in the study. Answer: a) Publish the study results in a peer-reviewed journal and present them at a national conference. Rationale: Publishing the study results in a peer-reviewed journal and presenting them at a national conference are effective ways to disseminate research evidence to a wide audience of researchers, policymakers, practitioners, and stakeholders who are interested in health-care policy and practice. These strategies can also enhance the credibility and validity of the study findings, as they undergo rigorous peer-review and feedback processes. Option b) is a strategy that could raise public awareness and interest in the study topic, but it may not reach or influence the decision-makers who are responsible for health-care policy and practice. Option c) is a strategy that could directly advocate for policy change, but it may not be sufficient or persuasive without providing scientific evidence to support the intervention. Option d) is a strategy that could inform and educate the patients and providers who participated in the study, but it may not have an impact on the broader health- care system or population.

3. A nurse is working as a consultant for a health-care organization that is planning to implement a new electronic health record (EHR) system. The nurse is responsible for

evaluating the impact of the EHR system on patient safety, quality of care, and cost-effectiveness. Which of the following health-care policies would be most relevant for the nurse to consider in the evaluation process? a) The Health Insurance Portability and Accountability Act (HIPAA), which protects the privacy and security of patient health information. b) The Patient Protection and Affordable Care Act (ACA), which aims to increase access, quality, and affordability of health care. c) The Health Information Technology for Economic and Clinical Health (HITECH) Act, which provides incentives and support for the adoption and meaningful use of EHRs. d) The Medicare Access and CHIP Reauthorization Act (MACRA), which establishes a new payment system for Medicare providers based on quality and value. Answer: c) The Health Information Technology for Economic and Clinical Health (HITECH) Act, which provides incentives and support for the adoption and meaningful use of EHRs. Rationale: The HITECH Act is a federal law that was enacted in 2009 as part of the American Recovery and Reinvestment Act (ARRA). The HITECH Act aims to promote the adoption and meaningful use of EHRs by providing financial incentives, technical assistance, standards, certification, privacy, security, enforcement, research, evaluation, education, workforce development, innovation, infrastructure, governance, coordination, collaboration, outreach, public health, and quality improvement. The HITECH Act is directly related to the

a) A policy that allows nurse practitioners to practice independently and prescribe medications without physician supervision. b) A policy that requires health care organizations to report quality indicators and outcomes to public databases. c) A policy that creates accountable care organizations (ACOs), which are networks of providers who share responsibility and accountability for the care and costs of a defined population. d) A policy that implements value-based purchasing (VBP), which is a payment model that rewards or penalizes providers based on their performance on quality and efficiency measures. Answer: c) A policy that creates accountable care organizations (ACOs), which are networks of providers who share responsibility and accountability for the care and costs of a defined population. Rationale: Accountable care organizations (ACOs) are a type of health-care delivery system reform that was introduced by the ACA in 2010. ACOs are voluntary groups of providers who agree to work together to coordinate the care and services for a specific population of patients, usually Medicare beneficiaries. ACOs aim to improve the quality, efficiency, and patient satisfaction of health care, while reducing unnecessary costs and duplication. ACOs also receive financial incentives or penalties based on their performance on quality and cost measures. ACOs are relevant for the nurse's role as a case manager, as they facilitate the collaboration and communication among different providers who are

involved in the care of the same patients. ACOs also support the integration and continuity of care across different settings and levels of care. Option a) is a policy that expands the scope of practice and authority of nurse practitioners, which could enhance their autonomy and accessibility as primary care providers. However, this policy does not directly address the coordination and integration of care among multiple providers. Option b) is a policy that promotes transparency and accountability in health care quality by requiring health-care organizations to report quality indicators and outcomes to public databases, such as Hospital Compare or Nursing Home Compare. This policy could help consumers make informed choices about their health-care providers, but it does not necessarily improve the coordination and integration of care among different providers. Option d) is a policy that implements value-based purchasing (VBP), which is a payment model that rewards or penalizes providers based on their performance on quality and efficiency measures. VBP is similar to ACOs in that it aims to improve the value of health care by aligning payment with outcomes. However, VBP does not necessarily involve collaboration or coordination among different providers.

5. A nurse is working as an educator for a nursing school that offers an online bachelor's degree completion program for registered nurses (RNs). The nurse is responsible for designing and delivering the curriculum for the courses on health-care policy and leadership. Which of the following health-care policies would be most important for the nurse

Answer: c) Requiring individuals to have health insurance coverage or pay a penalty Rationale: This policy, also known as the individual mandate, aims to improve access by ensuring that a larger pool of individuals has health insurance coverage, reducing the financial barriers to care.

2. Which of the following is an example of a healthcare policy aimed at cost containment? a) Increasing reimbursement rates for healthcare providers b) Expanding Medicaid eligibility to include more low- income individuals c) Implementing measures to reduce hospital readmissions d) Allowing importation of prescription drugs from other countries Answer: c) Implementing measures to reduce hospital readmissions Rationale: Hospital readmissions contribute significantly to healthcare costs. Policies that aim to reduce readmissions, such as improving transitional care services or implementing telehealth programs, help in cost containment by preventing unnecessary hospitalizations.
3. Which of the following is a key principle of evidence- based healthcare policy? a) Public opinion should be the sole determining factor in policy decisions b) Policies should align with the interests of healthcare industry stakeholders

c) Policy decisions should be informed by scientific research and best available evidence d) Policymaking should prioritize cost savings over improved patient outcomes Answer: c) Policy decisions should be informed by scientific research and best available evidence Rationale: Evidence-based healthcare policy refers to policies that are grounded in scientifically sound evidence and research. This ensures that policy decisions are based on valid information and have a higher likelihood of yielding positive outcomes.

4. Which of the following is an example of a healthcare policy aimed at improving healthcare quality? a) Implementing electronic health records across healthcare facilities b) Decreasing the funding for nursing education programs c) Restricting the scope of practice for nurse practitioners d) Increasing taxes on healthcare facilities Answer: a) Implementing electronic health records across healthcare facilities Rationale: Electronic health records (EHRs) improve healthcare quality by streamlining communication, reducing medical errors, and enhancing coordination of care among providers.
5. Which of the following policy approaches represents a market-based approach to healthcare delivery?

areas? a) Implementing loan forgiveness programs for medical students from rural backgrounds b) Reducing reimbursement rates for rural healthcare facilities c) Promoting medical tourism to urban areas d) Increasing the number of residency programs in urban areas Answer: a) Implementing loan forgiveness programs for medical students from rural backgrounds Rationale: Offering loan forgiveness programs specifically targeted at medical students from rural areas encourages them to practice in underserved regions, helping to address the shortage of healthcare professionals in these areas.

8. Which of the following is an example of a healthcare policy aimed at promoting preventive care? a) Establishing public subsidies for cosmetic surgeries b) Enforcing stricter regulations on healthcare advertising c) Implementing vaccination requirements for school entry d) Allowing healthcare professionals to sell prescription drugs directly to patients Answer: c) Implementing vaccination requirements for school entry Rationale: Requiring vaccinations for school enrollment promotes preventive care among children, protecting them from vaccine-preventable diseases and reducing overall healthcare costs.

9. Which of the following policy approaches is aimed at improving healthcare affordability? a) Expanding price transparency for healthcare services b) Increasing taxes on pharmaceutical companies c) Limiting insurance coverage for pre-existing conditions d) Implementing a fee-for-service payment system Answer: a) Expanding price transparency for healthcare services Rationale: Price transparency policies require healthcare providers to disclose the prices of their services, enabling patients to make more informed decisions and compare costs, thus promoting affordability.
10. Which of the following is an example of a healthcare policy aimed at reducing medical errors? a) Implementing standardized protocols for surgical procedures b) Decreasing funding for healthcare quality improvement initiatives c) Allowing direct-to-consumer advertising for prescription drugs d) Increasing the number of hospital beds in each facility Answer: a) Implementing standardized protocols for surgical procedures Rationale: Standardized protocols, such as surgical safety checklists, help to reduce medical errors by ensuring consistent and evidence-based practices are followed