BHS Healthcare Administration and Management 1 — Questions and Answers
Question 1: Which federal agency is primarily responsible for overseeing the quality of healthcare facilities through accreditation standards in the US?
- The Joint Commission (Correct answer)
- Centers for Medicare & Medicaid Services
- FDA
- OSHA
Correct answer: The Joint Commission
The Joint Commission accredits and certifies healthcare organizations to ensure they meet performance standards for quality and safety.
Question 2: What does the acronym HIPAA stand for in US healthcare?
- Health Insurance Portability and Accountability Act (Correct answer)
- Hospital Insurance Privacy and Access Act
- Health Information Protection and Assurance Act
- Healthcare Integrity Policy and Administration Act
Correct answer: Health Insurance Portability and Accountability Act
HIPAA stands for the Health Insurance Portability and Accountability Act, which protects patient health information privacy.
Question 3: A hospital's 'payer mix' refers to which of the following?
- The proportion of patients covered by different insurance types (Correct answer)
- The ratio of doctors to nurses on staff
- The types of medical services offered
- The hospital's investment portfolio
Correct answer: The proportion of patients covered by different insurance types
Payer mix describes the distribution of patients by insurance type (Medicare, Medicaid, private insurance, self-pay), which significantly affects revenue.
Question 4: Which management approach focuses on continuous improvement of processes to reduce waste and improve patient outcomes?
- Lean methodology (Correct answer)
- Matrix management
- Laissez-faire leadership
- Scalar chain management
Correct answer: Lean methodology
Lean methodology, derived from Toyota's production system, emphasizes eliminating waste and improving efficiency in healthcare workflows.
Question 5: Under the US Affordable Care Act (ACA), what is the primary purpose of Accountable Care Organizations (ACOs)?
- To coordinate patient care and share savings from reducing unnecessary costs (Correct answer)
- To replace private insurance with government coverage
- To standardize drug pricing across hospitals
- To mandate electronic health record adoption
Correct answer: To coordinate patient care and share savings from reducing unnecessary costs
ACOs are groups of healthcare providers who coordinate care for Medicare patients and share in any savings achieved by reducing unnecessary spending.
Question 6: Which term describes the process of reviewing a patient's care against established criteria to ensure appropriateness and quality?
- Utilization review (Correct answer)
- Credential review
- Risk stratification
- Fiscal auditing
Correct answer: Utilization review
Utilization review evaluates the necessity, appropriateness, and efficiency of healthcare services delivered to patients.
BHS Healthcare Administration and Management 1
Which federal agency is primarily responsible for overseeing the quality of healthcare facilities through accreditation standards in the US?