IAHCSMM Healthcare Systems, Regulations, and Compliance 2024 Exam Review, Exams of Community Health

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IAHCSMM Healthcare Systems, Regulations,

and Compliance 2024 Exam Review Questions

and Answers 100% Pass | Graded A+

David Mungai [Date] [Course title]

IAHCSMM Healthcare Systems,

Regulations, and Compliance 2024 Exam

Review Questions and Answers 100%

Pass | Graded A+

Supply-Side Rationing is used by universal healthcare, HMO's and ACO's to cut down on all of these except: A) Duplication of Effort B) Access to specialists C) Decrease Provider Communication D) Cost - Answer>> Decrease provider communication. An ACO (Accountable Care Organization) earns additional money by: A) Setting a flexible Fee Schedule B) Getting a share of money it saves Medicare C) Producing better patient results D) Both B&C - Answer>> Both B&C (Getting a share of money it saves Medicare, Producing better patient results) All Americans have the right to __________ under the Affordable Healthcare Act. A)Basic Care B) Purchase Care C) Low Cost Medications D) None of the Above - Answer>> B) Purchase Care Which is not a type of universal care utilized in Europe? A) National Health System B) National HMO C)National Health Insurance D) Socialized Health Insurance System - Answer>> B) National HMO

Holistic Medicine strives to: A)Lower Health Cost B) Treat the whole Person C) Use alternative medicine D)None of the above - Answer>> B) Treat the Whole Person What kind of Disease Classification is defined by a severe, short duration episode though typically treatable: A) Acute B) Sub-Acute C) Chronic D) All of the above - Answer>> A) Acute What is not one of the determinate of a population or personal health: A) Genetics B)Medical Practice C) Political Affiliation D) Individual Behaviors - Answer>> c) Political Affiliation What organization is responsible for the safety of medical devices and medications? A) FEMA B) OSHA C) CDC D) FDA - Answer>> D) FDA Market Justice holds that people are best served if the : A) Services are prepaid B) Services are Single payer based C) Patient Demand is primary D) Health Need is Primary - Answer>> C) Patient Demand is primary

Inpatient care continues to decline because of all these reasons except: A) Outpatient Competition B) Expensive inpatient care C) Doctors wishes D) New less invasive procedures - Answer>> C) Doctors wishes Primary care includes all but: A) Diagnostics B) Counseling C) Inpatient care D) Minor Surgery - Answer>> C) Inpatient Care Which one is not true- Tertiary Care is: A) Highly technical B) Interdisciplinary C) Not in teaching hospitals D) None of the Above - Answer>> D) None of the above In the future Primary care should be: A) The usual Route of entry B) Provide integrated health services C) Partnering with patients and the community D) All of the Above - Answer>> D) All of the Above What is not a product of increased preventive care: A) Lower costs B) Longer Life Expectancies C)Better technologies D) Do not Publish Medical Findings - Answer>> C) Better technologies To deter patients from utilizing Health Tourism the United States should:

B) Medicare C) Workman's Comp D) Medicaid - Answer>> C) Workman's Comp Telemedicine allows for greater sharing of needed information by: A) Allowing experts to give opinions from far away B) Cutting costs in on duty personnel C) Decreasing on call times D) All the above - Answer>> D) All the above Which organization was instrumental in beginning the blue Cross Network: A) Centers of Disease Control (CDC) B) The Joint Commission/JCAHO (TJC) C) American Hospital Association (AHA) D) None of the above - Answer>> C) American Hospital Association (AHA) Medicare part A covers: A) Physician fees B) Hospital Fees C) Both A&B D) None of the above - Answer>> B) Hospital Fees Medicare Covers those who are _____, and those who are ___? A) Impoverished, Disabled B) Disabled, 65 and Over C) 65 and over, Impoverished D) All the Above - Answer>> B) Disabled, 65 and Over What type of Billing Fraud is being used when the organization falsely reports the illness or injury as being more serious than it is? A) Price Fixing B) Conflict of interest

C) Up-coding D) All the above - Answer>> C) Up-coding A patient that stays overnight is an _______, a patient that receives care but does not stay overnight is an _____. A) Impatient, Dependent B) Outpatient, Dependent C) Inpatient, Outpatient D) None of the Above - Answer>> C) Inpatient, Outpatient Adjusting the utilization of care while active treating the patient is what type of review?: A)Prospective Utilization B) Concurrent Utilization C) Both A&B D) None of the Above - Answer>> B) Concurrent Utilization The organization leads the effort to improve the quality of healthcare, reduce costs and provide resourced for biomedical research and testing. A) WHO B) FDA C) AHRQ D) CDC - Answer>> C) AHRQ Organizational integration gave rise to which of the following: A) Medical Systems B) Physician/Hospital Partnerships C) Integrated Delivery System D) All the Above - Answer>> D) All the Above MCOs are accredited by the: A) National Committee for Quality Assurance (NCQA) B) Centers for Disease Control (CDC) C) Department of Health and Human Resources (DHHS)

If Medicare expenditures totaled $523 Billion in 2010; the program's income amounted to $486 billion in the same year what does this mean? A) Medicare is producing strong profits B) Medicare is saving Billions in cost savings. C) Medicare has a financing shortfall D) Medicare is Bankrupt. - Answer>> C) Medicare has a financing shortfall What is not a future concern for healthcare? A) Inadequate wellness programs. B) Primary Care Services C) Too few physician specialists D) Healthcare tourism - Answer>> C) Too few Physician Specialists What is a Nephrologist? - Answer>> A physician who specializes in kidney health and kidney dieases. What is an Orthodontist? - Answer>> A health provider who specializes in the straightening of teeth. What is a Neurologist? - Answer>> A physician who treats physical disorders of the nervous system and the brain. What is a Cardiologist? - Answer>> A physician who specializes in the diagnosis and treated of conditions of the heart. What is a Periodontist? - Answer>> A healthcare provider who specializes in dental implants. What is an Optometrist? - Answer>> A physician who specializes in the eyes.

In-house training is being conducted on OSHA standards for all staff. What is being accomplished with this training? A) Regulatory Renewal B) Accreditation Renewal C) Regulatory Compliance D) None of the above. - Answer>> C) Regulatory Compliance Due to the rapid spread of diseases in our global economy the text supports the idea of: A) Isolationism B) International Cooperation C) Travel Health Screenings D) None of the above. - Answer>> B) International Cooperation EBP is baed on the premises of better outcomes and ________ A) Increased value B) Maximum use of services C) Empowering physician autonomy D) Tailoring patient care to the individual. - Answer>> A) Increased value Which historic healthcare facility type most closely resembles today's free clinics? A) Alms Houses B) Dispensaries C) Pest Houses D) Asylums - Answer>> B) Dispensaries Which historic healthcare facility type kept the poor, children and homeless we kept as inmates? A) Alms houses B)Dispensaries C) Pest houses D) Asylums - Answer>> A) Alms HOuses

A) Teach classes B) Evaluate the appropriateness of treatment C) treat patients independently of physician orders D) None of the above. - Answer>> B) Evaluate the appropriateness of treatment Which of the regulation safeguards the patient's right to privacy? A) Sarbanes-Oxley Ac B) HIPAA C) EHR D) All the above - Answer>> B) HIPAA Though the U.S. tends to surpass other countries in intervention medicine, much of our elective or banned surgeries/procuedures can be lost to low cost competition that has similar quality. The term for this loss is _____ A) Free market B) Medical tourism C) Monroe Doctrine D) None of the above - Answer>> B) Medical tourism Insurance cost sharing is meant to dissuade frivolous use of benefits typically this is achieved by requiring what? A) Pre-Authorization B) Co-Pay C) A referral D) All the above - Answer>> B) Co-Pay Which is not a requirement for healthcare financing under the ACA? A) Mandate to be covered B) Employers with 50 o more employees must offer insurance, an incentive is set for less than 25 C) Individuals with pre-existing conditions cannot be denied D) Medicaid decreases the number of people who qualify

E) States mandated to create HC exchanges so people can buy insurance - Answer>> D) States mandated to create HC exchanges so people can buy insurance To avoid having to go to a nursing home after back surgery, the patient has opted for ______ so that she can get help with the Activities of Daily Living (ADLs) until she heals. A) Skilled nursing facility B) Outpatient nursing facility C) Home health D) Hospice - Answer>> C) Home health Which is not associated with primary care? A) Point of entry B) Coordination of care C) Essential care D) Speciality care - Answer>> D) Speciality care Integrating and gatekeeping are the job of: A) Primary care B) Secondary care C) Insurance companies D) All the above - Answer>> A) Primary care Point of entry care is best handled by: A) A PCP B) An ER C) A specialist D) None of the above - Answer>> A) A PCP An APN consists of: A) LPN's B) RN's C) NP, CNS's, or NNP's

• Change health attitudes and practices with regulations The three main types of cost sharing are utilized in private health insurance includes all but: A) Premium cost sharing B) Deductibles C) Copayments D) Stipends - Answer>> D) Stipends Lifetime limits were common in health insurance before the ACA. Why did the ACA make this illegal? A) Reduce premiums B) Make insurance cover recurring conditions like cancer C) Align with Medicare D) None of the above - Answer>> B) Make insurance cover recurring conditions like cancer If we exclude Medicare and Medicaid from how we obtain insurance, how do most Americans get healthcare coverage? A) Through their employer B) Through state programs C) Independent contracts D) None of the above - Answer>> A) Through their employer