What is the single most dominant force in U.S. health care delivery?

Rationale:

A. Look at the performance of an individual or organization: Micro perspectives on quality focus on evaluating the performance of specific individuals, healthcare providers, or organizations, such as hospitals or clinics.

B. Look at quality from the population's standpoint: This is an example of a macro perspective on quality, which considers healthcare outcomes and quality indicators at a broader population level.

C. Joint Commission quality check website: The Joint Commission is a healthcare accrediting organization that evaluates and accredits healthcare organizations and programs based on

established standards and quality measures. While it contributes to quality assessment, it does not represent a specific perspective (micro or macro).

D. Reflect the performance of the entire health care delivery system: This is another example of a macro perspective on quality, which assesses the overall performance and effectiveness of the healthcare delivery system as a whole.

A. By integration of several organizations under the same ownership or contractual

arrangements: MCOs garner enormous buying power by integrating various healthcare providers and services under one ownership or through contractual agreements, which allows them to negotiate better rates with suppliers and providers.

B. By shared savings program under the ACA: While the shared savings program under the ACA aims to reduce healthcare costs, it is not the primary method through which MCOs gained their buying power.

C. By providing an array of health care services to a large community: Providing a wide range of services enhances the value offered by MCOs but does not directly lead to significant buying power.

D. By enrolling a large segment of the insured population: Enrolling a large number of insured

individuals helps MCOs spread risk but is not the main factor that provides them with enormous buying power.