Answer to Question 1
ANS: A
As a result of managed care and prospective payment systems, the managed care organization assumes financial risk, in addition to providing patient care. The organization's focus of care shifts from individual illness care to concern for the health of its covered population. If people stay healthy, the cost of medical care declines. Soon after prospective payment began, hospitals started to increase discharge planning activities, and lengths of stay began to shorten.
Answer to Question 2
ANS: D
Managed care describes health care systems in which the provider or the health care system receives a predetermined capitated payment for each patient enrolled in the program. Capitation means that providers receive a fixed amount per patient or enrollee of a health care plan. The actual cost of care is the responsibility of the provider. In this case, the managed care organization (provider) assumes financial risk, in addition to providing patient care. The focus of care of the organization shifts from individual illness care to prevention, early intervention, and outpatient care.