CPM Pretest

The core functions of public health include disease prevention, health promotion, and health protection. Disease prevention involves implementing strategies to prevent the occurrence and spread of diseases. Health promotion focuses on improving the overall health and well-being of individuals and communities through education and awareness campaigns. Health protection involves implementing measures to protect individuals from environmental hazards and health threats. Therefore, the correct answer is "All of the above" as all three functions are essential components of public health.

Leadership is required in the health industry because problems of cost, quality, and access need to be solved. This implies that there are challenges related to the affordability, effectiveness, and availability of healthcare services that need to be addressed. Effective leadership is necessary to identify and implement solutions to these problems, ensuring that healthcare services are accessible, affordable, and of high quality for all individuals.

Performance appraisals are the most important tool for determining an individual's annual salary and/or salary bonus because they provide a comprehensive evaluation of an employee's job performance. Performance appraisals assess factors such as productivity, quality of work, teamwork, and adherence to company policies. These evaluations help employers make informed decisions about salary adjustments and bonuses based on an employee's performance and contribution to the organization. Longevity of the employee, personal relationships, and disciplinary actions may have some influence, but they are not as crucial as performance appraisals in determining salary and bonuses.

The $25 up front payment that the office administrator asks for is known as a co-payment. A co-payment is a fixed amount that a patient is required to pay for a specific medical service, such as a doctor's visit. It is typically a small portion of the total cost of the service and is paid at the time of the visit. The purpose of the co-payment is to share the cost of healthcare between the patient and the insurance company.

Lack of insurance can result in decreased utilization of lower cost preventive services because individuals without insurance may not have access to regular check-ups or screenings that can detect and prevent potential health issues. It can also lead to increased need for more expensive, emergency health care as uninsured individuals may delay seeking medical attention until their condition worsens, requiring emergency treatment. Additionally, the spread of infectious diseases can occur when uninsured individuals are unable to afford vaccinations or proper medical care, allowing diseases to spread more easily. Therefore, all of the above consequences can be a result of lacking insurance.

A protégé is a mentee that will eventually take on the responsibilities of the mentor in a professional position. A protégé is someone who is being guided and mentored by a more experienced person in order to develop their skills and knowledge. As they progress in their career, the protégé will acquire the necessary expertise and experience to eventually assume the role of a mentor themselves, passing on their knowledge and skills to the next generation.

Most privately insured Americans receive their health insurance through their employer. This means that their employer provides and pays for their health insurance coverage. This is a common arrangement in the United States, where employers often offer health insurance as part of their employee benefits package. It is different from being financed by the government or privately purchased by individuals. Therefore, the correct answer is employer-based.

The U.S. healthcare system can be described as expensive because healthcare costs in the country are significantly high compared to other developed nations. It is also fragmented, meaning that there is no unified healthcare system and instead, it is made up of multiple private and public entities. Lastly, the U.S. healthcare system is market-oriented, with a significant emphasis on private healthcare providers and insurance companies. Therefore, all of the given options accurately describe the U.S. healthcare system.

PPO stands for Preferred Provider Organization. This is a type of managed care health insurance plan where individuals have the freedom to choose their healthcare providers. PPO plans have a network of preferred healthcare providers, including doctors, hospitals, and specialists, who have agreed to provide services at discounted rates to plan members. However, individuals also have the option to seek care outside of the network, although it may result in higher out-of-pocket costs. PPO plans offer flexibility and choice to individuals while still providing some coverage for out-of-network care.

The Board of Directors should be responsible for hiring the CEO because it is their role to oversee the organization's leadership and ensure that the CEO is qualified and capable of fulfilling their duties. The CEO plays a crucial role in the organization's success, and it is important for the Board of Directors to be involved in the selection process to ensure the right fit for the organization's goals and values.

Medicare is primarily an entitlement for elderly persons. This government-funded health insurance program provides coverage for individuals who are 65 years or older. It helps to cover the costs of hospital care, medical services, and prescription drugs for this specific age group. Medicare is designed to ensure that elderly individuals have access to necessary healthcare services and can receive the medical care they need as they age.

Health policies are used in both the regulation of behaviors and the allocation of income, services, or goods. Health policies are put in place to guide and regulate individual and societal behaviors that may impact health outcomes, such as smoking bans or mandatory vaccinations. At the same time, health policies also aim to ensure fair and equitable access to healthcare services, income support for healthcare, and the distribution of essential goods like medications and medical equipment. Therefore, health policies serve the purpose of both regulating behaviors and allocating resources.

Quantitative research methodologies cannot usually be substituted for qualitative research methodologies. Quantitative research focuses on gathering and analyzing numerical data, while qualitative research focuses on gathering and analyzing non-numerical data such as interviews, observations, and textual analysis. Each methodology has its own strengths and limitations, and they are used for different purposes. Therefore, they cannot be easily substituted for one another.

Mean, median, mode, and standard deviation are all measures of central tendency. The mean is the average value of a set of data, calculated by summing all the values and dividing by the number of values. The median is the middle value in a set of data when arranged in ascending order. The mode is the value that appears most frequently in a set of data. The standard deviation measures the spread or dispersion of the data, indicating how much the values deviate from the mean. These measures provide information about the typical or central value of a dataset.

The bias that may be taking place in this scenario is selective (outcome) reporting bias. This bias occurs when researchers selectively report or emphasize certain results while ignoring or downplaying others. In this case, the researchers only describe their later experiments and statistically significant results, leaving out their initial findings that did not support their hypothesis. This selective reporting can lead to a distorted view of the true findings and may be misleading for readers and other researchers.

Defensive medicine refers to the practice of ordering unnecessary tests by physicians to protect themselves from potential lawsuits. This is done to avoid any potential legal claims or allegations of negligence. By ordering additional tests, physicians aim to demonstrate that they have taken every possible precaution, even if the tests may not be medically necessary. This defensive approach is driven by the fear of litigation, rather than the best interests of the patient.

Upcoding is the term used when a clinician knowingly submits a CPT code that provides higher reimbursement than the procedure that was actually performed. This is considered fraudulent behavior as it results in the clinician receiving more money than they are entitled to for the services rendered.

Confidentiality is the term used to describe the fact that any personal health information that a patient reveals will not be revealed to anyone else without the permission of the patient. This means that healthcare professionals are legally and ethically obligated to keep patient information private and secure, ensuring that it is not shared with unauthorized individuals or entities. Confidentiality is a fundamental principle in healthcare that helps build trust between patients and healthcare providers, allowing patients to feel comfortable sharing sensitive information without fear of it being disclosed without their consent.

The correct answer is "Scientific" because theories are subject to scientific scrutiny to determine their value, truth, and validity. This involves testing the theory through experiments, observations, and data analysis to ensure its accuracy and reliability. Scientific scrutiny helps to establish the credibility and usefulness of a theory in the scientific community.

Lifestyle and behaviors contribute most to premature death in the U.S. population because unhealthy habits such as smoking, poor diet, lack of physical activity, and substance abuse increase the risk of developing chronic diseases such as heart disease, cancer, and diabetes. These lifestyle choices can also lead to obesity, which is a major risk factor for various health conditions. Additionally, behaviors like not wearing seatbelts or engaging in risky activities can result in fatal accidents. Therefore, adopting a healthy lifestyle and making positive behavior changes can significantly reduce the risk of premature death.

In Mintzberg's framework, the operating core refers to the employees who directly provide the core services or produce the products of the organization. In a hospital, physicians are the ones who diagnose and treat patients, which is the main reason why hospitals exist. Therefore, physicians can be considered as part of the operating core in a hospital.

HMO (Health Maintenance Organization) typically has no benefits for services that are out-of-network. HMO plans usually require members to choose a primary care physician (PCP) and get referrals for specialist visits. If a member seeks services from a provider that is not in the HMO network, they may have to pay for the services out-of-pocket. HMO plans are designed to provide cost-effective healthcare within a specific network of providers, so going out-of-network may not be covered or may have limited coverage.

Central tendency refers to the tendency of data to cluster around a single value. It is a measure that represents the "center" or "typical" value of a dataset. The arithmetic mean, median, and mode are all measures of central tendency, but in this case, the correct answer is central tendency itself, as it is the general term that encompasses all these measures.

When leadership views individuals of a certain race as being homogenous and fitting in with other members of the racial group by default, it can decrease an organization's effectiveness. This perspective overlooks the unique qualities, skills, and perspectives that individuals from different races can bring to the table. It promotes a narrow and limited understanding of diversity and hinders the organization's ability to benefit from a diverse workforce. By failing to recognize and value individual differences, the organization misses out on the potential for innovation, creativity, and varied perspectives that can contribute to its overall success.

The decrease in uninsured individuals does not directly influence medical cost inflation. When more people are insured, they have access to healthcare services, which can lead to an increase in demand for medical services and subsequently drive up costs. However, the decrease in uninsured individuals may indirectly impact medical cost inflation by reducing the burden of uncompensated care on healthcare providers, which could potentially lead to lower overall costs.

The CEO may engage in direct contract relationships if he or she is vested with the authority of the board. This means that the CEO has been granted the power and decision-making capabilities by the board of directors to enter into contracts on behalf of the company. This authority allows the CEO to negotiate and finalize contracts without needing additional approval or involvement from the board. It demonstrates a high level of trust and confidence in the CEO's abilities to make contractual decisions for the organization.

The American Medical Association (AMA) created the CPT codes. CPT stands for Current Procedural Terminology, and these codes are used to describe medical procedures and services provided by healthcare professionals. The AMA developed the CPT coding system to standardize the reporting of medical procedures and services, making it easier for healthcare providers, insurers, and researchers to communicate and analyze healthcare data. The AMA continues to maintain and update the CPT codes to ensure their accuracy and relevance in the ever-evolving field of healthcare.

The correct answer is "Prohibit physicians from referring a patient to a health facility in which the physician may have financial interest." The purpose of Stark Laws is to prevent conflicts of interest and ensure that physicians make referrals based on the best interests of the patient rather than financial gain. These laws aim to maintain the integrity of healthcare decision-making and protect patients from unnecessary or potentially harmful treatments.

The weight loss center claims that they are not a covered entity as defined by the 1997 Balanced Budget Act, which is why they believe asking for a list of prescriptions does not violate HIPAA regulations. HIPAA regulations apply to covered entities, which include healthcare providers, health plans, and healthcare clearinghouses. If the weight loss center does not fall under any of these categories, they may not be subject to HIPAA regulations and can request a list of prescriptions.

Capitation is a payment model in healthcare where providers receive a fixed amount per patient, regardless of the services provided. This removes the incentive to control costs because providers are not financially rewarded for reducing expenses. However, it does create a potential incentive to provide unnecessary services in order to maximize revenue. Providers may be tempted to offer additional tests, procedures, or treatments that may not be medically necessary, leading to increased healthcare spending without improving patient outcomes.

The State determines a person's eligibility for Medicaid. Medicaid is a joint federal and state program that provides health coverage for low-income individuals and families. Each state has its own specific eligibility criteria and guidelines for determining who qualifies for Medicaid benefits. The state government is responsible for evaluating an individual's income, assets, and other factors to determine if they meet the requirements to receive Medicaid coverage.

In any strategic management scenario planning, gathering information from as many sources as possible is the first step. This is important because it allows the organization to have a comprehensive understanding of the current situation, potential risks, and opportunities. By gathering information from various sources such as market research, industry reports, customer feedback, and competitor analysis, the organization can make informed decisions and develop effective strategies. Conducting a literature review, developing courses of action, and conducting a make vs buy analysis are all important steps in the strategic management process, but they come after gathering information from multiple sources.

Resources are considered inputs in health service organizations because they are the essential elements needed to carry out the organization's activities and achieve its objectives. Resources can include financial resources, such as funding and budgets, as well as human resources, such as healthcare professionals and staff. Other types of resources may also be involved, such as medical equipment, supplies, and technology. These resources are necessary for the organization to provide quality healthcare services and meet the needs of patients and the community.

The statement is false because while evidence-based medicine is an important factor in determining the effectiveness of a treatment, it should not be the sole reason for using it. Other factors such as cost, potential side effects, patient preferences, and clinical judgment should also be taken into consideration. Evidence-based medicine provides a framework for making informed decisions, but it should be used in conjunction with other relevant factors to determine the best course of action.

Managed care organizations have gatekeeper access, which means that individuals must first see a primary care physician or a designated healthcare provider before being referred to a specialist or receiving certain medical services. This is different from traditional fee-for-service organizations where individuals have more freedom to directly access specialty care without needing a referral. Gatekeeper access helps managed care organizations control costs and ensure appropriate utilization of healthcare services.

In statistics, it is commonly known that approximately 95% of a population or sample falls within two standard deviations above and below the mean. Therefore, the correct answer is 1.96 standard deviations, as it is the closest option to this commonly accepted value.

The alpha level represents the significance level or the probability of making a Type I error in hypothesis testing. A 99% confidence interval means that there is a 1% chance of making a Type I error. Therefore, the correct alpha level for a 99% confidence interval is .01, as it represents a 1% chance of rejecting the null hypothesis when it is actually true.

Environmental analysis is the process of assessing and understanding the external factors that can impact an organization's performance. This includes analyzing the political, economic, social, technological, and ecological factors that make up the organization's environment. By conducting environmental analysis, organizations can identify opportunities and threats, and position themselves accordingly. Therefore, the correct answer is "Environment" as it accurately reflects the goal of environmental analysis, which is to understand and adapt to the external environment in which the organization operates.

The correct answer is false because not-for-profit organizations may have to consider the values of their stakeholders along with the cost of the intangible asset when making decisions. This is because not-for-profit organizations often have a wider range of stakeholders, including donors, volunteers, and the community, whose values and interests need to be taken into account when making decisions about intangible assets. For-profit organizations, on the other hand, primarily focus on maximizing profits and shareholder value.

Conflict management styles can be learned. This means that individuals can acquire the necessary knowledge, skills, and techniques to effectively manage conflicts. Through training, education, and experience, individuals can develop a better understanding of different conflict management styles and learn how to apply them in various situations. By learning conflict management styles, individuals can improve their ability to resolve conflicts, enhance communication, and maintain positive relationships.

The Stark law deals with physician referral to facilities in which they have a financial interest. This law prohibits physicians from referring Medicare patients to entities with which they have a financial relationship, unless an exception applies. The purpose of the Stark law is to prevent conflicts of interest and ensure that referrals are based on the best interests of the patient rather than financial gain.

When billing for a particular procedure for a primary care encounter, a physician's office will use DRG (Diagnosis-Related Group) to justify costs to the insurance company. DRG is a system that categorizes patients into groups based on their diagnosis, treatment, and other relevant factors. It helps in determining the appropriate reimbursement amount for healthcare services provided. By using DRG, the physician's office can provide evidence to the insurance company regarding the complexity and resources required for the procedure, thus justifying the costs.

The correct answer is 16%. This suggests that approximately 16% of a country's GDP is allocated towards healthcare expenditures. This indicates a significant portion of the economic resources is dedicated to maintaining and improving the health of the population.

If the standard deviation is greater than the mean, it suggests that the data points are spread out widely from the mean. This indicates that the distribution is likely to have both skewness and kurtosis. Skewness refers to the asymmetry of the distribution, while kurtosis measures the thickness of the tail ends of the distribution. Therefore, a data set with both skewness and kurtosis is the most plausible explanation for a standard deviation greater than the mean.

The P-value is used to determine the significance of a statistical result. It measures the probability of obtaining a result as extreme as the observed data, assuming that the null hypothesis is true. A small P-value (typically less than 0.05) indicates strong evidence against the null hypothesis, suggesting that the observed result is statistically significant. Therefore, the correct answer is "Significance".

False. Patients have the right to review, add, change, or delete information in their medical records. This is in accordance with the Health Insurance Portability and Accountability Act (HIPAA), which grants patients the right to access and amend their own health information. Patients can request copies of their medical records and have the ability to make corrections or additions to ensure the accuracy and completeness of their records.

Environmental analysis is the process of assessing and understanding the external factors that can impact an organization's operations and strategies. By conducting environmental analysis, organizations can identify opportunities and threats in their external environment. The goal of this analysis is to position the organization within its environment, meaning that it aims to understand how the organization fits into its surrounding context and how it can adapt and respond to the external factors effectively. Therefore, the correct answer is "Environment."

The comparison of beneficence to malevolence is a higher order set of constructs in the Omnibus Leadership Model. This means that beneficence, which refers to the act of doing good and showing kindness, is being contrasted with malevolence, which refers to the act of doing harm or showing ill will. In the context of leadership, this suggests that leaders should strive to be benevolent and avoid any malevolent actions or intentions.

Concluding that a relationship exists between variables when, in fact, it does not, is referred to as a Type I error. This error occurs when a researcher rejects the null hypothesis (which assumes no relationship between variables) when it is actually true. In other words, it is a false positive result, leading to the incorrect conclusion that there is a relationship between the variables when there is not.

A business strategy refers to a set of deliberate choices and actions that an organization takes to effectively compete in a specific industry or market. It involves determining the company's goals and objectives, analyzing the competitive environment, and formulating plans to achieve a sustainable competitive advantage. This includes decisions on target market segments, product differentiation, pricing, distribution, and marketing strategies. A business strategy helps the organization allocate resources, make informed decisions, and adapt to changes in the market to achieve long-term success.