Healthcare Ecosystems (D391)

Healthcare Ecosystems (D391)

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Free Healthcare Ecosystems (D391) Questions

1. Which Medicare part pays for prescriptions?
  • Medicare Part D
  • Medicare Part B
  • Medicare Part C
  • Medicare Part A

Explanation

Medicare Part D is the portion of Medicare that covers prescription drugs. It was introduced in 2006 to help beneficiaries manage the cost of medications. Part D plans are offered by private insurance companies approved by Medicare and help reduce out-of-pocket expenses for both generic and brand-name drugs. This coverage is essential for ensuring medication adherence and improving health outcomes among Medicare enrollees.
2. Which statement about telemedicine is correct?
  • Telemedicine is for emergency visits only.
  • The patient cannot access their telehealth visit on their cell phone.
  • With telemedicine, patients only need enough time to interface with their healthcare provider.
  • Telemedicine has increased the number of infections among patients.

Explanation

The correct statement is that with telemedicine, patients only need enough time to interface with their healthcare provider. Telemedicine enables patients to consult healthcare professionals through virtual platforms, eliminating the need for travel and waiting-room time. It allows efficient, convenient interactions where patients can discuss symptoms, receive medical advice, and obtain prescriptions from home. It is not intended for emergency situations, and in fact, it has reduced rather than increased the number of infections by limiting in-person contact during healthcare visits.
3. Which medical field contains the largest percentage of U.S. physicians by specialty as of 2019?
  • General surgery
  • General pediatrics
  • General practice/Family medicine
  • General internal medicine

Explanation

General practice/family medicine contains the largest percentage of U.S. physicians by specialty. Family medicine physicians provide comprehensive, continuous care for individuals of all ages, managing a broad spectrum of health conditions. This specialty is essential for primary care, preventive services, and the coordination of care, making it one of the most common fields among physicians in the United States.
4. When did private health insurance coverage start?
  • In 1965, with the CHIPS program
  • In 1930, with the start of Blue Cross and Blue Shield
  • In 2010, with the Affordable Care Act
  • In 1920, when there was coverage for the hospital

Explanation

Private health insurance coverage in the United States began in 1930 with the establishment of Blue Cross and Blue Shield. These organizations were created to provide hospital and physician coverage to individuals and groups, marking the beginning of organized private health insurance. Over time, private insurance expanded to include employer-sponsored plans, individual policies, and various managed care models, forming a major component of the U.S. healthcare system.
5. A 75-year-old client who is recovering from knee surgery is ready to be discharged but is not yet ready to return home to resume independent living. Which type of facility is appropriate for this client's needs?
  • A long-term care facility
  • A post-acute short-term care facility
  • An ambulatory care facility
  • An inpatient acute care facility

Explanation

A post-acute short-term care facility is the most appropriate setting for a client who has been discharged from surgery but is not yet able to live independently. These facilities, often called rehabilitation or skilled nursing facilities, provide short-term medical care, physical therapy, and support services aimed at helping patients regain functional independence. They serve as a transitional step between hospital care and home, ensuring safety and continued recovery until the client can safely return to independent living.
6. A single mother of two young children who relies on public assistance is having difficulty seeing due to an outdated eyeglass lens prescription. However, she has no vision coverage and can't afford to pay out of pocket for an optometrist appointment and new lenses and frames. Where should this client go to get an eye exam and new glasses?
  • A federally qualified health center (FQHC)
  • A Women, Infants, and Children (WIC) facility
  • A Patient-Centered Medical Home (PCMH)
  • A free medical clinic (FMC)

Explanation

A federally qualified health center (FQHC) is the most appropriate place for this client to receive an eye exam and new glasses. FQHCs provide comprehensive primary and preventive care, including vision services, to underserved populations regardless of their ability to pay. They often offer sliding-scale fees and support programs to help low-income individuals access necessary healthcare services, including optometry. This ensures that the client and her children can receive care without facing financial barriers.
7. Tricare is what type of health insurance?
  • Self-pay
  • Medicare
  • Military
  • Commercial

Explanation

Tricare is a military health insurance program that provides coverage to active-duty service members, retirees, and their families. It offers comprehensive healthcare benefits, including medical, dental, and prescription coverage, through military treatment facilities and civilian providers. Tricare ensures that military personnel and their dependents have access to necessary healthcare services, reflecting its role as a specialized government-sponsored insurance program.
8. A ___ is an organization of individuals, institutions, and resources that deliver services to clients.
  • Stakeholders
  • In patient services
  • Healthcare ecosystem
  • Healthcare system

Explanation

A healthcare system refers to the organized structure of individuals, institutions, and resources that provide healthcare services to meet the health needs of a population. It includes hospitals, clinics, healthcare professionals, and governing bodies that coordinate care delivery, policy, and financing. The purpose of a healthcare system is to ensure efficient, equitable, and effective access to health services for clients across different levels of care.
9. Which of the following is NOT one of the 5 P’s of the healthcare ecosystem?
  • Professional administrators
  • Patients
  • Pharmaceutical companies
  • Providers

Explanation

The 5 P’s of the healthcare ecosystem include Patients, Providers, Payers, Policy makers, and Professional partners. Each plays a distinct role in maintaining and improving the healthcare system. Patients are the recipients of care, providers deliver medical services, payers (such as insurers) finance healthcare, policymakers create and enforce healthcare regulations, and professional partners support operational and administrative functions. Pharmaceutical companies, while influential, are not one of the defined “5 P’s” in the healthcare ecosystem—they are generally categorized under industry stakeholders rather than a core component.
10. What is one of the five main funding models of the U.S. healthcare system?
  • The private insurance model
  • The Medicare model
  • The Medicaid model
  • The national health insurance model

Explanation

The private insurance model is one of the five main funding models of the U.S. healthcare system. In this model, individuals or employers purchase health insurance plans from private companies to cover medical services. Private insurance plays a significant role in financing healthcare in the U.S., especially for working-age adults and their families, and operates alongside public programs like Medicare and Medicaid to support the overall healthcare system.

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