Which of the following conclusions were made when Congress asked ...

[panfilo]

Which of the following conclusions were made when Congress asked for a report on the federal government's quality enhancement process on the care the federal government gave? (Select all that apply.)
 
  a. A clear responsibility at the federal level is to lead by example.
  b. Computerized clinical data have enabled practice guidelines to be written.
  c. Federally sponsored education and training programs have a strong impact.
  d. Quality assurance information has been consistent and useful in improvement.
  e. The quality of federal health care was very good.
  f.
  Writing regulations influences nonfederal health care providers and organizations.

Question 2

Which of the following describe current legislation acts that limit what managed care organizations (MCOs) are allowed to do? (Select all that apply.)
 
  a. Allowing patients to see a specialist without having to obtain approval from their primary care provider
  b. Allowing patients to go to the emergency department without first telephoning for approval
  c. Allowing patients the right to choose a physician
  d. Requiring the MCO to fulfill expectations of the national patients' rights bill
  e. Requiring the MCO to accept any provider who meets plan requirements
  f.
  Requiring the MCO to accept advanced practice nurses as primary care providers

[shailee]

Answer to Question 1

ANS: A, C, F
The report Leadership by Example concluded that there is a lack of consistent performance measurement, the information is not useful, computerized clinical data are missing, and the approach to gathering data is not systematic. The federal government is the largest purchaser of care because it gives direct care to specified groups and requires conforming to regulations for those accepting Medicare and Medicaid funds. Sponsored research, education, and training also have an impact. The report concluded that the federal government must accept leadership both by example and by coordinating improvement in health care quality.

Answer to Question 2

ANS: A, B, C
In 1999, the House and Senate passed bills that focused on client rights in the managed care environment, but more needs to be done to improve client rights. Client rights issues that are vitally important are information disclosure, physician and provider choice, direct access to specialists, reimbursement for emergency care, and reimbursement denial. As has been discussed, there is still no national patients' bill of rights.

[panfilo]

Excellent

[lcapri7]

Gracias!