Author Question: The nurse case manager is explaining to a group of health care providers how insurance expenditures ... (Read 32 times)

maychende · **on:** Jul 8, 2018

The nurse case manager is explaining to a group of health care providers how insurance expenditures for health spending led to the development of diagnosis-related groups (DRGs) in efforts to control spending.

The nurse case manager is explaining to a group of health care providers how insurance expenditures for health spending led to the development of diagnosis-related groups (DRGs) in efforts to control spending. What should the case manager emphasize as the driving force for directing health efforts with DRGs?
1. Organize services to be more cost-effective.
2. Decreasing length of stays for hospitalizations.
3. Placing the emphasis on the community to improve population health status.
4. Emphasizing health promotion to decrease hospitalizations and medical costs.

Question 2

While reviewing the history of health care services as part of an education program the nurse learns that the passage of the amended Social Security Act created Medicare and Medicaid, which increased demands for health care services.

While reviewing the history of health care services as part of an education program the nurse learns that the passage of the amended Social Security Act created Medicare and Medicaid, which increased demands for health care services. How did The National Health Planning and Resources Development Act of 1974 attempt to address the demand for health care services?
1. Increasing funds to improve the health status of the indigent poor.
2. Recognizing that increased hospitals improved the public health status.
3. Increasing funds for more health services to improve public health status.
4. Recognizing the contribution of health practitioners to the public health status.

nhea · **Reply #1 on:** Jul 8, 2018

Answer to Question 1

Answer: 4
Explanation: 4. The effect of DRGs has shifted emphasis to health promotion of populations rather than medical care for conditions preventable by health promotion efforts. DRGs have not been proven to make services more cost-effective, though that has been one of its objectives. DRGs pay a flat fee in advance for client diagnosis, which may not benefit the client health status during hospitalizations. DRGs have not emphasized the community as a whole to improve a population's health status. That is achieved through a variety of methods, not solely DRGs.

Answer to Question 2

Answer: 4
Explanation: 4. The 1974 Act recognized health practitioner efforts to improve public health status, which was an early legislative shift to recognize health promotion as an effective effort to improve public health status. Increasing funds to improve indigent health status was not addressed in the 1974 Act, though it was for the 1965 amended Social Security Act. Increased hospital building was not a public policy shift of recognizing an emphasis on health promotion. Increasing funding for health services was not the goal of the 1974 act.