A nursing informatics specialist hired by Blue Cross/Blue Shield
(a form of third-party payers benefit package for a prepaid fee that uses specific standards to approve a period of time for the use of inpatient and community health services) is participating in:
a. Critical pathways.
b. Healthcare networks.
c. Health maintenance organizations.
d. Managed care.
ANS: D
Managed care strives to contain costs (e.g., through limitation of time in care) while maintaining quality. Managed care combines care delivery with financing and provides comprehensive services for a fixed prepaid fee. Group practice plans take various forms. One form has a centralized administration that directs and pays salaries for physician practice (e.g., HMOs).
You might also like to view...
You are preparing to discharge a patient with a physical disability related to an automobile accident
You are reviewing the importance of preventative health care when the patient informs you that she will not have the money to pay for her annual gynecologic exams or mammograms due to the cost of this hospitalization. What information would be appropriate for you to share with the patient? A) "Limited finances are a common problem for patients with a disability. Since you were hospitalized this year, you can miss the gynecologic exam and mammogram." B) "These are very important health preventative measures, so you will need to borrow the money to pay for the exam and mammogram." C) "Federal assistance programs may be available to provide financial assistance for health-related expenses for people with disabling conditions." D) "These preventative measures should be a tax deduction, so you should consult with your accountant and then make your appointments."
A patient who has a terminal illness wants to be able to take a prescription medication to end life when suffering becomes unbearable. The patient asks the nurse for advice
Operating from a deontological point of reference, what action does the nurse take? a. Advises the patient about local providers willing to participate b. Assesses the patient for more information about the situation c. Determines what kind of insurance the patient has before acting d. Tells the patient that they cannot partici-pate in this action
Which is an appropriate recommendation for preventing tooth decay in young children?
a. Substitute raisins for candy. b. Substitute sugarless gum for regular gum. c. Use honey or molasses instead of refined sugar. d. When sweets are to be eaten, select a time not during meals.
Compare and contrast input, process, and output in systems organizational theory by selecting the options that represent process. Select all that apply
1. The physician admits a patient to the hospital. 2. The nurse provides excellent care to a patient postoperatively. 3. The dietary manager orders supplies based upon cost-effectiveness. 4. The patient delivers a healthy infant. 5. The nursing unit secretary identifies a potential medical error before it occurs.