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Board Review Course - Study Materials (Study Quest ...
Health Services Management (Systems-Based Practice ...
Health Services Management (Systems-Based Practice) Study Materials
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Pdf Summary
The Health Services Management course focuses on Systems-Based Practice and aims to equip students with comprehensive knowledge about the U.S. healthcare system. Key objectives include understanding the various roles of government in healthcare and identifying primary agencies involved. Students will learn eligibility criteria for Medicare, Medicaid, and the State Children's Insurance Plan benefits, and differentiate between Medicare's various parts and Medicaid. They will also grasp concepts like usual, customary, and reasonable fees, alongside funding sources for healthcare.<br /><br />Another key area is understanding hospital and healthcare provider reimbursement processes. The course covers principles of total quality management, continuous quality improvement, and the relationship between structure, process, and outcomes in healthcare. Additionally, students will explore the Institute of Medicine's definition of quality, the correlation between quality and costs, and will discuss specific concepts such as capitation, co-payment, deductible, fee-for-service, managed care, and various payment models.<br /><br />Students will learn about the role of regulatory agencies and the distinction between laws and ethics in healthcare.<br /><br />The course includes a list of multiple-choice questions (MOC) as a form of assessment, querying knowledge on managed care organizations, Medicare and Medicaid administration, government financing of healthcare, primary payers for government-sponsored healthcare, distinctions between process and outcome measures, the Institute of Medicine's definition of quality, and the National Practitioner Data Bank.<br /><br />The answers to these MOC questions are: 1. b, 2. d, 3. a, 4. a, 5. b, 6. b, 7. e.<br /><br />A reading and reference list is provided to supplement learning, including resources from the Association of State and Territorial Health Officials, the Centers for Disease Control, the Joint Commission, the Kaiser Commission on Medicaid and the Uninsured, the National Association of County and City Health Officials, and the U.S. Department of Health and Human Services. This comprehensive list of references is intended to enhance students' understanding of public health achievements and trends.
Keywords
Healthcare System
Medicare
Medicaid
Quality Management
Reimbursement
Regulatory Agencies
Managed Care
Institute of Medicine
Health Services Management
Public Health
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