Chapter 2: Health-Care Delivery, Settings, and ECONOMICS

Question 1 of 5

Blue Cross/Blue Shield, Aetna, and Prudential are examples of ___ insurance programs.

A. MedicareB. MedicaidC. Private insuranceD. Managed care

Correct Answer: C

Rationale: These are examples of private insurance programs.

Question 2 of 5

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.

Question 3 of 5

TRICARE for retired military personnel and their families and CHAMPVA for veterans are examples of

A. preferred provider organizations (PPOs).B. point-of-service (POS) insurance plans.C. insurance for special populations.D. insurance through charitable organizations.

Correct Answer: C

Rationale: TRICARE and CHAMPVA are specialized insurance programs for military personnel and veterans.

Question 4 of 5

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 conditionsB. 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 requirementsC. A system of health-care delivery aimed at managing the cost and quality of access to health careD. The insurance company that finances health care provided to a beneficiaryE. A cost-containment program featuring a primary care physician (PCP) as the gatekeeper to eliminate unnecessary testing and proceduresF. A classification of illnesses and diseases that is then used to determine the amount of money paid to a hospital by MedicareG. 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.

Question 5 of 5

Match the following Key Term(s) or italicized words from your text with the correct description: Managed care

A. The federal government's health insurance program for people older than 65 years or those with certain disabilities or conditionsB. 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 requirementsC. A system of health-care delivery aimed at managing the cost and quality of access to health careD. The insurance company that finances health care provided to a beneficiaryE. A cost-containment program featuring a primary care physician (PCP) as the gatekeeper to eliminate unnecessary testing and proceduresF. A classification of illnesses and diseases that is then used to determine the amount of money paid to a hospital by MedicareG. 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: E

Rationale: Managed care focuses on controlling costs and quality of health care access.

Chapter 2: Health-Care Delivery, Settings, and ECONOMICS - Nurselytic

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