Healthy Aging and Community Programs Lecture 3
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Questions and Answers

What is a key characteristic of an Accountable Care Organization (ACO)?

  • Focus on fee-for-service payments
  • Unlimited access to out-of-network providers
  • A value-based care model (correct)
  • Mandatory participation in managed care plans

    • Which insurance model provides a wider network while allowing out-of-network providers at a higher cost?

  • Preferred Provider Organization (PPO) (correct)
  • Health Maintenance Organization (HMO)
  • Accountable Care Organization (ACO)
  • Exclusive Provider Organization (EPO)

    • Which program is designed to support efficient care by providing resources for non-visit-based care?

  • Comprehensive Primary Care Plus (CPC+) (correct)
  • Medicare Advantage Plan
  • National Family Caregiver Support Program
  • Managed Care Organization (MCO)

    • What does the Quintuple Aim in healthcare focus on?

    <p>Health equity and improving care experience</p> Signup and view all the answers

    What is the primary benefit of the HITECH Act concerning healthcare providers?

    <p>Incentives for meaningful use of electronic health records</p> Signup and view all the answers

    Which of the following statements about evidence-based practice is true?

    <p>It recognizes the role of all disciplines in service delivery.</p> Signup and view all the answers

    What is a potential limitation of self-funded/employer-based health insurance plans?

    <p>They may have limits on what is covered.</p> Signup and view all the answers

    What is the primary purpose of the National Committee for Quality Assurance (NCQA)?

    <p>To develop and assess quality measures in healthcare</p> Signup and view all the answers

    Which grade indicates that a service is very recommended according to the US Preventative Services Task Force (USPSTF)?

    <p>Grade A</p> Signup and view all the answers

    What is a characteristic of the Program to Encourage Active, Rewarding Living for Seniors (PEARLS)?

    <p>Patient-centered and patient-directed depression care</p> Signup and view all the answers

    What is the approximate average cost of adult day care services per day?

    <p>$85</p> Signup and view all the answers

    What is a primary focus of the Evidence-Based Practice in health service research?

    <p>To examine both macro and micro levels of health systems</p> Signup and view all the answers

    Which type of healthcare model allows Medicare beneficiaries to enroll in HMO advantage plans?

    <p>Health Maintenance Organization (HMO)</p> Signup and view all the answers

    What is one of the objectives of the value-based care model?

    <p>Enhance the quality of care while controlling costs</p> Signup and view all the answers

    What does 'Meaningful Use' refer to in the context of the HITECH Act?

    <p>Incentives for healthcare providers to utilize EHR technology effectively</p> Signup and view all the answers

    What is the primary goal of the Medicare Shared Savings Program (MSSP)?

    <p>Create shared accountability for quality, cost, and experience of care</p> Signup and view all the answers

    Which of the following best describes the ACO REACH Model?

    <p>Focuses on promoting health equity and addressing disparities</p> Signup and view all the answers

    What are Accountable Care Organizations (ACOs) primarily responsible for?

    <p>Their assigned Medicare Beneficiaries population only</p> Signup and view all the answers

    Which payment model is utilized in value-based care compared to traditional fee-for-service models?

    <p>Capitated per member per month (PMPM) models</p> Signup and view all the answers

    Which of the following is a characteristic of Health Maintenance Organizations (HMOs)?

    <p>Fixed annual fees determined in advance for services</p> Signup and view all the answers

    What is a significant disadvantage of high deductible health plans (HDHPs)?

    <p>Higher out-of-pocket costs that may deter care utilization</p> Signup and view all the answers

    Which of the following tracks in MSSP allows organizations to enter higher shared risk arrangements?

    <p>Performance-based track for most significant savings</p> Signup and view all the answers

    Which component is NOT typically part of the healthcare triangle?

    <p>Profit</p> Signup and view all the answers

    Which statement about Preferred Provider Organizations (PPOs) is true?

    <p>They offer a network of providers while allowing members to choose from various doctors.</p> Signup and view all the answers

    The primary goal of healthcare reform efforts, including the Affordable Care Act, is to:

    <p>Support innovative medical care delivery methods to lower costs</p> Signup and view all the answers

    What is a benefit of the Accountable Care Organizations (ACOs) in terms of patient care?

    <p>They create shared accountability for quality and costs of care.</p> Signup and view all the answers

    Which of the following statements best describes the shift from fee-for-service (FFS) to value-based care?

    <p>Healthcare providers are incentivized to keep overall care costs low with a fixed reimbursement model.</p> Signup and view all the answers

    In the context of the Medicare Shared Savings Program (MSSP), what is a primary characteristic of different tracks available for organizations?

    <p>Organizations entering higher shared risk arrangements have potential for increased shared savings.</p> Signup and view all the answers

    What is a key feature of the ACO REACH Model?

    <p>It focuses on enhancing health equity for communities facing healthcare disparities.</p> Signup and view all the answers

    Which of the following best describes the role of health maintenance organizations (HMOs)?

    <p>They require enrollees to choose a primary care physician (PCP) for referrals to specialists.</p> Signup and view all the answers

    Which of the following goals is part of the Affordable Care Act's reforms?

    <p>To support innovative medical care delivery methods to lower health care costs.</p> Signup and view all the answers

    How do Point of Service (POS) plans differ from Health Maintenance Organizations (HMOs)?

    <p>POS plans have a hybrid structure allowing for both in-network and out-of-network coverage.</p> Signup and view all the answers

    What is a primary risk associated with capitated per member per month (PMPM) payment models?

    <p>Providers may under-serve patients to minimize costs and avoid financial losses.</p> Signup and view all the answers

    Which aspect is NOT considered within the healthcare triangle?

    <p>Provider income levels</p> Signup and view all the answers

    What is a significant limitation of high deductible health plans (HDHPs)?

    <p>They often discourage individuals from seeking necessary care due to higher initial costs.</p> Signup and view all the answers

    What is a key expected outcome of the Tai Chi program in falls prevention?

    <p>Enhanced flexibility and muscle strength</p> Signup and view all the answers

    Which of the following is NOT a component of the 'Matter of Balance' program?

    <p>Individual counseling sessions</p> Signup and view all the answers

    What is a primary focus of the National Family Caregiver Support Program?

    <p>Helping caregivers find resources for elder care</p> Signup and view all the answers

    What type of health insurance plan is characterized by coverage limitations and is connected to employers?

    <p>Self-funded/employer-based plan</p> Signup and view all the answers

    Which statement best describes the 'Comprehensive Primary Care Plus (CPC+)' model?

    <p>It supports primary care with financial resources for innovative solutions.</p> Signup and view all the answers

    Which of the following is a potential benefit of the Otago exercise program?

    <p>Professional therapy guidance over 6-12 months</p> Signup and view all the answers

    What does the term 'Meaningful Use' entail in the context of health information technology?

    <p>Financial incentives for meeting specific health criteria using technology</p> Signup and view all the answers

    Which grading indicates that a treatment cannot be recommended due to insufficient evidence?

    <p>Grade D</p> Signup and view all the answers

    What is one of the critical aims of the quintuple aim in healthcare?

    <p>Improving individual healthcare experiences</p> Signup and view all the answers

    Which organization is responsible for developing quality measures for healthcare performance?

    <p>National Committee for Quality Assurance (NCQA)</p> Signup and view all the answers

    Which method of evaluating healthcare involves understanding both individual patient outcomes and broader health system elements?

    <p>Health service research</p> Signup and view all the answers

    In what way does the PEARLS program approach the care for depression among older adults?

    <p>Patient-centered and patient-directed approach</p> Signup and view all the answers

    Which of the following statements accurately reflects the role of the Eldercare Locator?

    <p>Connects older adults to local resources and services</p> Signup and view all the answers

    Which of the following reflects a significant downside of adult day care services for caregivers?

    <p>They are not available during weekends</p> Signup and view all the answers

    What is a primary outcome of the Tai Chi program in falls prevention for older adults?

    <p>Improved balance and flexibility</p> Signup and view all the answers

    Which component is primarily focused on assessing home safety to prevent falls?

    <p>Matter of Balance group session</p> Signup and view all the answers

    What aspect of the National Family Caregiver Support Program is crucial for effective elder care?

    <p>Resource accessibility for caregiver needs</p> Signup and view all the answers

    Which of the following best describes the role of the US Preventive Services Task Force (USPSTF)?

    <p>Rating the effectiveness of services based on research</p> Signup and view all the answers

    In what aspect does the HITECH Act aim to enhance healthcare delivery?

    <p>Encouragement of electronic health record technology use</p> Signup and view all the answers

    What is the intended goal of Comprehensive Primary Care Plus (CPC+) regarding primary care?

    <p>To enhance payment for innovative primary care solutions</p> Signup and view all the answers

    What is the primary characteristic of the Otago exercise program?

    <p>Tailored exercise routines provided by physical therapists</p> Signup and view all the answers

    Which grade from the USPSTF indicates that a specific service cannot be recommended due to insufficient evidence?

    <p>Grade I</p> Signup and view all the answers

    What is a common benefit for caregivers using adult day care services?

    <p>Opportunity for respite during daytime hours</p> Signup and view all the answers

    Which of these programs specifically addresses mental health care for older adults?

    <p>PEARLS</p> Signup and view all the answers

    What is the main focus of the Quintuple Aim in healthcare?

    <p>Promoting population health while ensuring equity</p> Signup and view all the answers

    In assessing healthcare performance, what does HEDIS measure primarily evaluate?

    <p>Quality performance across healthcare entities</p> Signup and view all the answers

    What service does the Eldercare Locator primarily provide?

    <p>Access to local elder care resources</p> Signup and view all the answers

    What is a crucial aspect of the Medicare Shared Savings Program (MSSP)?

    <p>It creates shared accountability for quality, cost, and experience of care rendered.</p> Signup and view all the answers

    Which of the following best describes the role of Accountable Care Organizations (ACOs) under MSSP?

    <p>ACOs are responsible for performance measurement across various quality metrics.</p> Signup and view all the answers

    What key benefit of the ACO REACH model focuses on health equity?

    <p>It promotes accommodations for communities facing specific health care disparities.</p> Signup and view all the answers

    How does a capitated per member per month (PMPM) payment model function?

    <p>It provides a fixed amount for each patient, regardless of care cost variations.</p> Signup and view all the answers

    What distinguishes Health Maintenance Organizations (HMOs) from Preferred Provider Organizations (PPOs)?

    <p>HMOs offer no out-of-network coverage, while PPOs do.</p> Signup and view all the answers

    What is one characteristic of the Point of Service (POS) plan?

    <p>It combines features of HMO and PPO, allowing for out-of-network services.</p> Signup and view all the answers

    Which of the following accurately reflects a risk associated with capitated payment models?

    <p>Providers might under-provide necessary services to cut down costs.</p> Signup and view all the answers

    Which of the following is a primary goal of the Affordable Care Act's reforms?

    <p>To expand access to affordable health insurance for a broader population.</p> Signup and view all the answers

    What is a common feature of High Deductible Health Plans (HDHPs)?

    <p>They encourage the use of health savings accounts to manage costs.</p> Signup and view all the answers

    What is a main characteristic of falls prevention programs for older adults?

    <p>They emphasize group discussions and environmental evaluations.</p> Signup and view all the answers

    Which factor has a considerable influence on the success of the Tai Chi program for fall prevention?

    <p>The duration of the program, requiring approximately 50 hours.</p> Signup and view all the answers

    What aspect does the PEARLS program focus on for older adults?

    <p>Patient-centered and patient-directed care for depression.</p> Signup and view all the answers

    What age-related factor is NOT considered a natural part of aging according to falls prevention initiatives?

    <p>Increased risk of falls.</p> Signup and view all the answers

    Which principle is fundamental to value-based care models?

    <p>Focus on patient outcomes and quality of care.</p> Signup and view all the answers

    What is a common support service provided by the National Family Caregiver Support Program?

    <p>Education about care options and resources.</p> Signup and view all the answers

    Which of the following describes an important component of the HITECH Act?

    <p>It incentivizes healthcare providers to embrace electronic health records.</p> Signup and view all the answers

    In the context of healthcare delivery, what is the primary aim of quality measure reporting programs?

    <p>To compare the quality performance of different healthcare entities.</p> Signup and view all the answers

    What is essential for the success of the Otago exercise program?

    <p>Ongoing supervision by a physical therapist for 6-12 months.</p> Signup and view all the answers

    How does the Comprehensive Primary Care Plus (CPC+) model financially support medical practices?

    <p>By offering Care Management Fees and performance-based incentives.</p> Signup and view all the answers

    Which of the following statements about Medicare Advantage Plans is accurate?

    <p>They are limited to in-network providers.</p> Signup and view all the answers

    What does the term 'high quality of care' refer to in relation to the US Preventative Services Task Force (USPSTF)?

    <p>A recommendation indicating very good treatment results.</p> Signup and view all the answers

    What is one of the key principles associated with the 'Quintuple Aim' in healthcare?

    <p>Improving health equity.</p> Signup and view all the answers

    What purpose does the Eldercare Locator serve for older adults and caregivers?

    <p>It lists services available in a specific geographic area.</p> Signup and view all the answers

    Which component is crucial for assessing the performance of Accountable Care Organizations (ACOs)?

    <p>Quality measures and cost benchmarking</p> Signup and view all the answers

    What distinguishes the ACO REACH Model from earlier ACO models?

    <p>Emphasis on health equity and addressing healthcare disparities</p> Signup and view all the answers

    What is a key characteristic of the Medicare Shared Savings Program (MSSP)?

    <p>It encourages shared accountability for quality and cost of care.</p> Signup and view all the answers

    In value-based care models, what is an essential risk for organizations under capitated per member per month (PMPM) models?

    <p>Financial losses if care costs exceed the fixed amount</p> Signup and view all the answers

    In which way do health maintenance organizations (HMOs) typically control costs?

    <p>Through a smaller network of providers with predetermined fees</p> Signup and view all the answers

    Which of the following accurately reflects the purpose of the Affordable Care Act's reforms?

    <p>To support innovative medical care delivery methods</p> Signup and view all the answers

    What differentiates a Point of Service (POS) plan from a Health Maintenance Organization (HMO)?

    <p>POS plans offer both in-network and out-of-network provider choices.</p> Signup and view all the answers

    Which type of healthcare method can lead to significant financial risks for organizations managing patient care?

    <p>Capitated payment models</p> Signup and view all the answers

    What aspect is NOT part of the healthcare triangle?

    <p>Patient enrollment</p> Signup and view all the answers

    Which statement describes a significant feature of high deductible health plans (HDHPs)?

    <p>They are designed to offset out-of-pocket expenses with health savings accounts.</p> Signup and view all the answers

    Study Notes

    Healthy Aging and Community-Based Programs

    • Evidence-based programs offer the highest effectiveness for older adults.
    • Falls prevention programs are crucial, as 1 in 4 older adults died due to falls in 2021, showing falls are not a natural part of aging.
    • "Matter of Balance" group sessions emphasize control over falls and evaluate environmental risk factors.
    • "Stepping On" program examines visual issues, safe footwear, and discusses coping strategies after falls while involving community experts.
    • Tai Chi promotes strength and flexibility and requires approximately 50 hours for optimal fall reduction benefits.
    • The Otago exercise program, led by physical therapists, spans 6-12 months and focuses on balance and strength.
    • PEARLS (Program to Encourage Active, Rewarding Living for Seniors) takes a patient-centered approach to depression care.

    Home and Community-Based Resources

    • The Eldercare Locator provides access to local services for elderly care.
    • The National Family Caregiver Support Program aids caregivers in finding necessary resources.
    • Family dynamics influence care decisions, with parents prioritizing independence and children focusing on health and safety.
    • Adult day care costs average $85 per day, with funding from various sources including insurance and Medicaid.
    • Respite care provides temporary relief for caregivers, typically lasting 14-21 days.

    Healthcare Delivery

    • Managed care allows organizations to offer integrated insurance and healthcare services, exemplified by HMO and PPO models.
    • HITECH Act established "Meaningful Use" incentives for healthcare providers using electronic health records.
    • Evidence-based practice encompasses clinical and health service research to assess treatment impact and health system efficiency.
    • The US Preventive Services Task Force (USPSTF) evaluates evidence levels and associated recommendations for treatments, using a grading system from A (recommended) to D (not recommended).
    • The Quintuple Aim includes health equity, workforce well-being, reducing costs, enhancing care, and improving population health.
    • Quality measure programs utilized by organizations like the NCQA and National Quality Forum assess healthcare quality across multiple domains.

    Healthcare Financing and Insurance

    • Blue Cross and Blue Shield provide primary health insurance services in the U.S.
    • HMO Act facilitates integrated insurance and health service delivery, typically for a fixed annual fee.
    • The healthcare triangle embodies access, quality, and cost considerations.
    • The Affordable Care Act aims to expand health insurance availability, enhance Medicaid, and support innovative cost-reducing care methods.
    • Managed care models include HMO (fixed network), POS (hybrid model), PPO (flexible provider selection), and HDHP (high deductible with health savings accounts).

    Healthy Aging and Community-Based Programs

    • Evidence-based programs offer the highest effectiveness for older adults.
    • Falls prevention programs are crucial, as 1 in 4 older adults died due to falls in 2021, showing falls are not a natural part of aging.
    • "Matter of Balance" group sessions emphasize control over falls and evaluate environmental risk factors.
    • "Stepping On" program examines visual issues, safe footwear, and discusses coping strategies after falls while involving community experts.
    • Tai Chi promotes strength and flexibility and requires approximately 50 hours for optimal fall reduction benefits.
    • The Otago exercise program, led by physical therapists, spans 6-12 months and focuses on balance and strength.
    • PEARLS (Program to Encourage Active, Rewarding Living for Seniors) takes a patient-centered approach to depression care.

    Home and Community-Based Resources

    • The Eldercare Locator provides access to local services for elderly care.
    • The National Family Caregiver Support Program aids caregivers in finding necessary resources.
    • Family dynamics influence care decisions, with parents prioritizing independence and children focusing on health and safety.
    • Adult day care costs average $85 per day, with funding from various sources including insurance and Medicaid.
    • Respite care provides temporary relief for caregivers, typically lasting 14-21 days.

    Healthcare Delivery

    • Managed care allows organizations to offer integrated insurance and healthcare services, exemplified by HMO and PPO models.
    • HITECH Act established "Meaningful Use" incentives for healthcare providers using electronic health records.
    • Evidence-based practice encompasses clinical and health service research to assess treatment impact and health system efficiency.
    • The US Preventive Services Task Force (USPSTF) evaluates evidence levels and associated recommendations for treatments, using a grading system from A (recommended) to D (not recommended).
    • The Quintuple Aim includes health equity, workforce well-being, reducing costs, enhancing care, and improving population health.
    • Quality measure programs utilized by organizations like the NCQA and National Quality Forum assess healthcare quality across multiple domains.

    Healthcare Financing and Insurance

    • Blue Cross and Blue Shield provide primary health insurance services in the U.S.
    • HMO Act facilitates integrated insurance and health service delivery, typically for a fixed annual fee.
    • The healthcare triangle embodies access, quality, and cost considerations.
    • The Affordable Care Act aims to expand health insurance availability, enhance Medicaid, and support innovative cost-reducing care methods.
    • Managed care models include HMO (fixed network), POS (hybrid model), PPO (flexible provider selection), and HDHP (high deductible with health savings accounts).

    Healthy Aging and Community-Based Programs

    • Evidence-based programs offer the highest effectiveness for older adults.
    • Falls prevention programs are crucial, as 1 in 4 older adults died due to falls in 2021, showing falls are not a natural part of aging.
    • "Matter of Balance" group sessions emphasize control over falls and evaluate environmental risk factors.
    • "Stepping On" program examines visual issues, safe footwear, and discusses coping strategies after falls while involving community experts.
    • Tai Chi promotes strength and flexibility and requires approximately 50 hours for optimal fall reduction benefits.
    • The Otago exercise program, led by physical therapists, spans 6-12 months and focuses on balance and strength.
    • PEARLS (Program to Encourage Active, Rewarding Living for Seniors) takes a patient-centered approach to depression care.

    Home and Community-Based Resources

    • The Eldercare Locator provides access to local services for elderly care.
    • The National Family Caregiver Support Program aids caregivers in finding necessary resources.
    • Family dynamics influence care decisions, with parents prioritizing independence and children focusing on health and safety.
    • Adult day care costs average $85 per day, with funding from various sources including insurance and Medicaid.
    • Respite care provides temporary relief for caregivers, typically lasting 14-21 days.

    Healthcare Delivery

    • Managed care allows organizations to offer integrated insurance and healthcare services, exemplified by HMO and PPO models.
    • HITECH Act established "Meaningful Use" incentives for healthcare providers using electronic health records.
    • Evidence-based practice encompasses clinical and health service research to assess treatment impact and health system efficiency.
    • The US Preventive Services Task Force (USPSTF) evaluates evidence levels and associated recommendations for treatments, using a grading system from A (recommended) to D (not recommended).
    • The Quintuple Aim includes health equity, workforce well-being, reducing costs, enhancing care, and improving population health.
    • Quality measure programs utilized by organizations like the NCQA and National Quality Forum assess healthcare quality across multiple domains.

    Healthcare Financing and Insurance

    • Blue Cross and Blue Shield provide primary health insurance services in the U.S.
    • HMO Act facilitates integrated insurance and health service delivery, typically for a fixed annual fee.
    • The healthcare triangle embodies access, quality, and cost considerations.
    • The Affordable Care Act aims to expand health insurance availability, enhance Medicaid, and support innovative cost-reducing care methods.
    • Managed care models include HMO (fixed network), POS (hybrid model), PPO (flexible provider selection), and HDHP (high deductible with health savings accounts).

    Healthy Aging and Community-Based Programs

    • Evidence-based programs offer the highest effectiveness for older adults.
    • Falls prevention programs are crucial, as 1 in 4 older adults died due to falls in 2021, showing falls are not a natural part of aging.
    • "Matter of Balance" group sessions emphasize control over falls and evaluate environmental risk factors.
    • "Stepping On" program examines visual issues, safe footwear, and discusses coping strategies after falls while involving community experts.
    • Tai Chi promotes strength and flexibility and requires approximately 50 hours for optimal fall reduction benefits.
    • The Otago exercise program, led by physical therapists, spans 6-12 months and focuses on balance and strength.
    • PEARLS (Program to Encourage Active, Rewarding Living for Seniors) takes a patient-centered approach to depression care.

    Home and Community-Based Resources

    • The Eldercare Locator provides access to local services for elderly care.
    • The National Family Caregiver Support Program aids caregivers in finding necessary resources.
    • Family dynamics influence care decisions, with parents prioritizing independence and children focusing on health and safety.
    • Adult day care costs average $85 per day, with funding from various sources including insurance and Medicaid.
    • Respite care provides temporary relief for caregivers, typically lasting 14-21 days.

    Healthcare Delivery

    • Managed care allows organizations to offer integrated insurance and healthcare services, exemplified by HMO and PPO models.
    • HITECH Act established "Meaningful Use" incentives for healthcare providers using electronic health records.
    • Evidence-based practice encompasses clinical and health service research to assess treatment impact and health system efficiency.
    • The US Preventive Services Task Force (USPSTF) evaluates evidence levels and associated recommendations for treatments, using a grading system from A (recommended) to D (not recommended).
    • The Quintuple Aim includes health equity, workforce well-being, reducing costs, enhancing care, and improving population health.
    • Quality measure programs utilized by organizations like the NCQA and National Quality Forum assess healthcare quality across multiple domains.

    Healthcare Financing and Insurance

    • Blue Cross and Blue Shield provide primary health insurance services in the U.S.
    • HMO Act facilitates integrated insurance and health service delivery, typically for a fixed annual fee.
    • The healthcare triangle embodies access, quality, and cost considerations.
    • The Affordable Care Act aims to expand health insurance availability, enhance Medicaid, and support innovative cost-reducing care methods.
    • Managed care models include HMO (fixed network), POS (hybrid model), PPO (flexible provider selection), and HDHP (high deductible with health savings accounts).

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    Description

    This quiz covers strategies for healthy aging, focusing on community-based programs designed for older adults. It highlights evidence-based practices and tested models for falls prevention, addressing myths around falls and promoting group discussions to evaluate risks in the environment.

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