WGU C425 Healthcare Delivery, Regulation, and Compliance Questions and Answers

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WGU C425 Healthcare Delivery, Regulation, and Compliance Questions and Answers Capitation A covers all services an enrollee may need during an entire year Market Justice most equitably distribut... ed through the market forces of supply and demand, rather than government interventions. Distributed on the basis of willingness and ability to pay Social Justice An ideal that embraces all aspects of civilized life and that is linked to fundamental notions of fairness and to cultural beliefs about right and wrong. defensive medicine Ordering more tests and procedures than are necessary in order to protect physicians from a lawsuit. medical model emphasizes clinical diagnosis and medical intervention in the treatment of diseases or symptoms. Health is defined as lack of illness National Health Insurance course of care delivered by providers (Canada) National Health System Great Britain taxes support the system, but government also manages the infrastructure for healthcare delivery Socialized Health Insurance government mandated contributions by employers and employees finance health care (Germany) Acute Care relatively severe, short duration, often treatable. Ex. stroke Chronic Care continuing for a long time Planned Rationing The government making deliberate attempts to limit the supply of health care services Medicare Benefit period = 60 days after admitted Pt B: cover physicians bill, small premiums for elderly Premiums are income based Part D: Prescription Drug coverage Voluntary, w monthly premium 1973- expanded to non elderly disabled, end stage renal disease patients. Financed by pay roll taxes American Medical Association protect the interests of physicians, organized medicine. S [Show More]

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