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

Question 1 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 2 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.

Question 3 of 5

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

A. Patient care approach aimed at coordinating the care of patients who are vulnerable, at risk, or cost intensive so that their specific needs are met in the most cost-effective manner while still bringing them to optimum healthB. 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: A

Rationale: Case management coordinates care for vulnerable or high-cost patients to ensure cost-effectiveness and optimal health outcomes.

Question 4 of 5

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

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: B

Rationale: Medicaid is a joint federal and state program for low-income individuals, pregnant women, those with disabilities, and children.

Question 5 of 5

Match the following Key Term(s) or italicized words from your text with the correct description: Third-party payer

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: D

Rationale: A third-party payer is the insurance company that covers the cost of health care for a beneficiary.

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

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