U.S. Healthcare Systems

19 Questions | Total Attempts: 189

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U.S. Healthcare Systems

From the beginning health care systems existed in cultures across the globe. The purpose of this primer is to illustrate the structure and function of the most common types of health systems. This assessment is tracked and scored at the end to help us understand your knowledge retention and how to further provide insight in the Phase 2 training.


Questions and Answers
  • 1. 
    A heathcare system is the organization of people, institution, and resources to deliver heath care services to meet the heath needs of target populations.
    • A. 

      True

    • B. 

      False

  • 2. 
    There are 2 parts to a integrated system:
    • A. 

      Horizontal

    • B. 

      Structural

    • C. 

      Vertical

    • D. 

      Functional

  • 3. 
    Non-Integrated Systems include:
    • A. 

      Academic Medical Centers

    • B. 

      Concierge Medical Practice

    • C. 

      Cosmetic Procedure Groups

    • D. 

      Medical Spas

    • E. 

      Chiropractors

    • F. 

      "Alternative" Homeopathic Medicine

  • 4. 
    Non-Integrated Medicine: 
    • A. 

      Most of these businesses are not part of an integrated system because they do not want to be operationally or financially controlled by the health system or health insurance

    • B. 

      Integrated Systems are only driven by healthcare reform and do not cross into non-integrated medicine

    • C. 

      Is becoming more operationally and financially controlled by the health systems or health insurance provider

  • 5. 
    Define: Multi-Specialty Group Practice (MSGP) with Health Plan
    • A. 

      A Multi-Specialty Group Practice that includes a health plan is therefore both a provider and a payer

    • B. 

      A Multi-Specialty Group Practice that accepts government

    • C. 

      A Multi-Specialty Group that accepts only individual plans

  • 6. 
    Define: Multi-Specialty Group Practice Single-Entity Delivery System
    • A. 

      A Multi-Specialty Group Practice that is government coordinated

    • B. 

      A Multi-Specialty Group Practice that accepts commercial, individual, and government pay plans

    • C. 

      A Multi-Specialty Group Practice that is State level run

  • 7. 
    Examples of Private Networks of Independent Providers and Coordinated Services that Include:
    • A. 

      California Healthcare Foundation

    • B. 

      Molina Healthcare

    • C. 

      Mayo Clinic

    • D. 

      Geisinger Health System

  • 8. 
    Examples of Public Network of Independent Providers and Coordinated Services that Include:
    • A. 

      Community Care of North Carolina

    • B. 

      Department of Veterans Affairs

    • C. 

      Kiser Permanente

    • D. 

      Healthcare Partners

  • 9. 
    Integrated Care providers are concerned with shifting away from...
    • A. 

      Fee-For-Performance

    • B. 

      Fee-For-Service Payment

    • C. 

      Episode Payment

  • 10. 
    Fee-For-Service: This type of payment is blamed for increasing fragmentation and inhibiting integration. Many providers respond to payment systems more aggressively than they respond to regulation. Consequently, policymakers are looking for ways to entice payers and providers to move away from Fee-For-Service and volume driven healthcare to bundled payment systems that reward coordinated and value oriented care.
    • A. 

      True

    • B. 

      False

  • 11. 
    Fee-For-Performance (P4P): This type of payment program is designed to reward high-quality, patient-centered care and can stimulate greater integration. The greater the integration in delivery systems, the more feasible and effective these payment models become.
    • A. 

      True

    • B. 

      False

  • 12. 
    Healthcare Reforms are changing payment models to emphasize and include:
    • A. 

      Higher quality

    • B. 

      Lower costs

    • C. 

      Improved value

  • 13. 
    Integration can occur at the system level or across a patient population. 
    • A. 

      True

    • B. 

      False

  • 14. 
    There are two main types of integration used in Integrated Delivery System (IDS):
    • A. 

      Horizontal

    • B. 

      Structure

    • C. 

      Vertical

    • D. 

      Functional

  • 15. 
    Horizontal Integration-Operionaiiy excellent in one specific area
    • A. 

      True

    • B. 

      False

  • 16. 
    Examples of Horizontal Integration Include:
    • A. 

      Multi-hospital systems

    • B. 

      Mergers between doctors groups

    • C. 

      Strategic alliances with neighboring hospitals to form local networks

  • 17. 
    Vertical Integration attempts to maximize the value of the health system, not the profit of a particular participant group, e.g. hospitals or outpatient centers.
    • A. 

      True

    • B. 

      False

  • 18. 
    Vertically integrated systems are intended to address the following 
    • A. 

      Efficiency Goals

    • B. 

      Access Goals

    • C. 

      Quality Goals

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