Research shows that issues with access to both primary care and specialty care prevail in:
Preferred Provider Organization (PPO) plan
Medicare advantage plans.
Medicaid managed care.
Health Maintenance Organization (HMO) plans
The Correct Answer is D
Rationale:
A. Preferred Provider Organization (PPO) plan: PPO plans typically offer members greater flexibility in choosing healthcare providers and may not have as strict requirements for referrals to specialists, reducing barriers to access.
B. Medicare advantage plans: Medicare Advantage plans, also known as Medicare Part C, offer additional benefits beyond traditional Medicare, but they may not exhibit the same issues with access to primary and specialty care as other managed care plans.
C. Medicaid managed care: Medicaid managed care plans vary by state and may have different structures for accessing care, but they often emphasize primary care coordination and may not exhibit the same issues with access as HMO plans.
D. Health Maintenance Organization (HMO) plans: HMO plans typically require members to select a primary care physician (PCP) and obtain referrals from the PCP to see specialists. This structure can create barriers to accessing specialty care, particularly if there are limitations in provider networks or delays in obtaining referrals.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Cost cutting: While cost containment measures are important in healthcare, they are not necessarily a foreseeable trend in the future of health services delivery. Trends may involve cost containment strategies, but they are not the overarching trend.
B. Demographics: Changes in demographics, such as an aging population or shifts in population distribution, are significant factors that will influence the future of health services delivery. These changes can impact healthcare needs, resource allocation, and service delivery models.
C. Quicker discharge of patients: While there may be efforts to improve efficiency in healthcare delivery, such as reducing hospital lengths of stay, this is not necessarily a widespread trend or a defining characteristic of the future of health services delivery.
D. Level of education of healthcare personnel: The level of education of healthcare personnel may evolve over time, but it is not necessarily a trend that defines the future of health services delivery.
Correct Answer is A
Explanation
A. A nonfederal short-stay hospital whose services are available to the general public: Community hospitals are defined as nonfederal short-stay hospitals that provide a range of services to the general public and are accessible to all members of the community.
B. Nongovernment and privately owned: While many community hospitals may be privately owned, this option does not encompass the full definition as it excludes government-owned hospitals that serve the community.
C. Government ownership (federal, state, or local): Community hospitals can be government- owned, but this answer does not capture the full scope of what defines a community hospital.
D. Often located in large urban areas: Community hospitals can be found in both urban and rural areas, so this answer is not sufficiently inclusive.
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