Delivery Systems
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Questions and Answers

Which program recognizes health care organizations that achieve excellence in nursing practice?

  • Innovation Center
  • Medicare Part A
  • Magnet Recognition Program® (correct)
  • Quality Payment Program Advanced Alternative Payment Models

    • What is the focus of the Magnet® Model in hospitals?

  • Patient admission rates
  • Physician satisfaction
  • Nurse engagement and evidence-based practices (correct)
  • Cost management

    • What is the primary purpose of the CMS Innovation Center?

  • To reduce the quality of care
  • To support unnecessary costs
  • To test innovative payment and service delivery models (correct)
  • To increase program expenditures

    • What system categorizes each patient case into a diagnosis-related group (DRG)?

    <p>Inpatient Prospective Payment System (IPPS)</p> Signup and view all the answers

    What is the main focus of health care payers such as Medicare, Medicaid, and private insurers?

    <p>Managing and addressing health care costs</p> Signup and view all the answers

    What are ACOs in the context of health care?

    <p>Accountable Care Organizations</p> Signup and view all the answers

    What does the Affordable Care Act tie payment to for organizations offering Medicare Advantage plans?

    <p>Quality ratings of the coverage they offer</p> Signup and view all the answers

    What system established a payment for the operating costs of acute care hospital inpatient stays under Medicare Part A?

    <p>Social Security Act</p> Signup and view all the answers

    What does the Innovation Center support?

    <p>Testing new payment and service delivery models</p> Signup and view all the answers

    What is the primary purpose of ACOs in healthcare?

    <p>To reduce unnecessary costs and provide coordinated high-quality care</p> Signup and view all the answers

    What is the primary focus of primary health care?

    <p>Preventing diseases and promoting regular health care visits</p> Signup and view all the answers

    What distinguishes secondary health care from primary health care?

    <p>It is provided by a specialist on referral from a primary care provider</p> Signup and view all the answers

    What type of care does a patient with increasing shortness of breath with activity require?

    <p>Tertiary health care</p> Signup and view all the answers

    In what setting are more surgeons performing simple surgeries to reduce costs?

    <p>Outpatient surgical centers</p> Signup and view all the answers

    What is the goal of restorative care?

    <p>Helping individuals regain maximal functional status and enhance quality of life</p> Signup and view all the answers

    What do extended care facilities primarily provide?

    <p>Intermediate medical, nursing, or custodial care for patients recovering from acute illness or with chronic illnesses or disabilities</p> Signup and view all the answers

    When might a patient need tertiary health care?

    <p>When the primary health care provider is unable to treat their condition</p> Signup and view all the answers

    What is the traditional reason people use health care services?

    <p>For diagnosis and treatment of illness.</p> Signup and view all the answers

    What does restorative care aim to achieve?

    <p>To help individuals regain maximal functional status.</p> Signup and view all the answers

    What are the conditions in the environments that affect health, functioning, and quality-of-life outcomes and risks?

    <p>Social Determinants of Health</p> Signup and view all the answers

    Which initiative identifies five categories of social determinants of health?

    <p>Healthy People 2030</p> Signup and view all the answers

    What do disparities in health status affect in a population?

    <p>Productivity and vulnerability</p> Signup and view all the answers

    According to the National Quality Forum (2021b), what are health care disparities linked to?

    <p>Inadequate resources and poor patient-provider communication</p> Signup and view all the answers

    What is one strategy to reduce the effect of social determinants on patients' health?

    <p>Establishing and supporting policies</p> Signup and view all the answers

    What is one of the goals of Healthy People 2030?

    <p>Promote the nation's health and create a society for health equity</p> Signup and view all the answers

    Where do nurses practice that requires an awareness of the social determinants of health?

    <p>Settings with diverse populations</p> Signup and view all the answers

    What are examples of social determinants of health provided in BOX 2.7?

    <p>Safe housing, transportation, and neighborhoods</p> Signup and view all the answers

    Which factor is linked to disparities in health status according to the National Quality Forum (2021b)?

    <p>Inadequate resources</p> Signup and view all the answers

    What is a key goal of Healthy People 2030?

    <p>Attain health literacy to improve the nation's health and well-being</p> Signup and view all the answers

    Which type of health care service includes adult screenings for blood pressure, cholesterol, tobacco use, and cancer?

    <p>Preventive care</p> Signup and view all the answers

    What type of care involves the diagnosis and treatment of common illnesses, ongoing management of chronic health problems, and prenatal care?

    <p>Primary care (health promotion)</p> Signup and view all the answers

    What type of care includes urgent care, hospital emergency care, and radiological procedures?

    <p>Secondary (acute care)</p> Signup and view all the answers

    Which type of health care service is highly specialized and may include intensive care and specialty care like neurology, cardiology, and dermatology?

    <p>Tertiary care</p> Signup and view all the answers

    What type of care includes rehabilitation programs like cardiovascular and pulmonary rehabilitation?

    <p>Restorative care</p> Signup and view all the answers

    Which type of health care service involves pediatric screenings for hearing, vision, autism, and developmental disorders?

    <p>Preventive care</p> Signup and view all the answers

    What type of care includes mental health counseling and crisis prevention?

    <p>Preventive care</p> Signup and view all the answers

    Which type of health care service encompasses patient-centered medical home care and family planning?

    <p>Primary care (health promotion)</p> Signup and view all the answers

    Study Notes

    Health Care Systems and Services

    • The Magnet Recognition Program recognizes health care organizations that achieve excellence in nursing practice.

    Medicare and Payment Systems

    • The Centers for Medicare and Medicaid Services (CMS) Innovation Center focuses on improving health care through innovative strategies.
    • Diagnosis-Related Groups (DRGs) categorize each patient case for Medicare payment.
    • The Prospective Payment System (PPS) establishes payment for the operating costs of acute care hospital inpatient stays under Medicare Part A.

    Accountable Care Organizations (ACOs)

    • ACOs are groups of health care providers working together to provide coordinated care to Medicare patients.
    • The primary purpose of ACOs is to improve health outcomes, reduce costs, and enhance patient satisfaction.

    Primary, Secondary, and Tertiary Health Care

    • Primary health care focuses on preventive care, health promotion, and diagnosis and treatment of common illnesses.
    • Secondary health care involves specialized care, such as urgent care, hospital emergency care, and radiological procedures.
    • Tertiary health care is highly specialized and may include intensive care and specialty care like neurology, cardiology, and dermatology.
    • Restorative care aims to achieve maximum functioning and well-being for patients.

    Social Determinants of Health

    • The Affordable Care Act ties payment to quality measures, including social determinants of health.
    • The Health Resources and Services Administration (HRSA) identifies five categories of social determinants of health: economic stability, education, health and health care, neighborhood and environment, and social and community context.
    • Disparities in health status affect the overall health of a population.
    • Social determinants of health, such as housing, education, and access to healthy food, affect health outcomes.

    Healthy People 2030

    • One goal of Healthy People 2030 is to address social determinants of health and disparities in health care.
    • Nurses practice in various settings, requiring awareness of social determinants of health.

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    Test your knowledge about nursing expertise in extended care settings, including the principles of gerontological nursing and managing health care costs. Explore the similarities and differences between nursing in extended care facilities and acute care inpatient settings.

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