Waste and abuse is a reason for rising healthcare costs. Which of the following is a contributory factor?
Chronic disease prevention and management
Fraud
Unequal access to health care
Competitive approaches
The Correct Answer is B
Rationale:
A. Chronic disease prevention and management: While chronic diseases can contribute to healthcare costs, they are not directly related to waste and abuse within the healthcare system.
B. Fraud: Fraudulent activities, such as billing for services not provided or submitting false
claims, contribute to waste and abuse in the healthcare system, leading to higher costs for payers and consumers.
C. Unequal access to health care: Unequal access to healthcare may lead to disparities in health outcomes and healthcare utilization but is not necessarily a direct cause of waste and abuse.
D. Competitive approaches: Competitive approaches may influence healthcare delivery models and pricing strategies but are not directly related to waste and abuse contributing to rising
healthcare costs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Daily weight scale: This option refers to a measurement tool for tracking daily weight changes and is not related to assessing functional ability.
B. The interval scale: This refers to a type of measurement scale used in statistics and is not related to assessing functional ability.
C. Activities of daily living (ADL) scale: ADL scales assess an individual's ability to perform basic self-care tasks independently, such as bathing, dressing, grooming, eating, and toileting.
These assessments are used to evaluate functional ability and determine levels of assistance or care needed.
D. CURB-65 Scale: The CURB-65 scale is a clinical prediction tool used to assess the severity of pneumonia and predict the risk of mortality but is not specifically related to assessing
functional ability.
Correct Answer is A
Explanation
A. Concurrent: Concurrent utilization review involves the ongoing monitoring of a patient's care and recovery while they are still receiving treatment. This type of review focuses on ensuring that the care provided is appropriate and that the patient is progressing as expected.
B. Preauthorization: Preauthorization involves obtaining approval from a health insurer before a service is provided to ensure it will be covered. It does not focus on monitoring a patient's recovery.
C. Retrospective: Retrospective review involves evaluating the care provided to a patient after the treatment has been completed. It looks at the appropriateness of care but does not monitor ongoing recovery.
D. Prospective: Prospective review involves evaluating the necessity of a treatment before it begins. It does not include ongoing monitoring of a patient's prognosis for recovery.
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