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FACHE Exam QUESTIONS AND CORRECT ANSWERS|
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Sarbanes Oxley answers US federal law that set new or expanded requirements for all US public company boards, management and public accounting firms. Cover responsibilities of a public corporation's board of directors, adds criminal penalties and required SEC to create regulations Licensed Independent Practitioners (LIPs) answers Caregivers granted legal status to provide specific kinds of healthcare, categorized as primary care or specialist providers who are usually physicians or advanced practice nurses (NPs, nurse midwives) Primary Care Practitioners (PCPs) answers physicians and advanced practice nurses specializing in family medicine, general internal medicine, pediatrics, obstetrics, and psychiatry and are the most common initial contacts for patients and specialize in family medicine, general internal medicine, peds, OB/GYN, and psychiatry Specialist Practitioners answers LIPs who care for patients referred by PCPs on a more limited and transiet basis. More likely to manage episodes of inpatient care Hospitalists answers Accept relatively broad categories of patients and manage inpatient care only Community Benefit answers Requires hospitals to satisfy the community benefit standard in order to qualify as tax-exempt charities under 501c3 of the IRS code. The standard
addresses charitable care, educational services, and other benefits HCOs provide to their communities Healthcare Systems answers A corporate or governmental structure including one or more hospitals and often other HCO services Privileges answers Define quality and service obligations but allow a wide variety of financial agreements Federally Qualified Health Center (FQHC) answers Services for underserved areas or populations that offer a sliding fee scale, provide comprehensive services, have ongoing quality program, and seat a board of directors, funded with grants under section 330 of the Public Health Service Act, also referred to as community health centers. not-for-profit clinics addressing the needs of the poor and uninsured. Independent local governing boards, but affiliate with local hospitals Accountable care organizations (ACOs) answers created by ACA. Set of healthcare providers, PCP, specialists, and hospitals - work collaboratively and accept collective accountability for the cost and quality of care delivered to a population of patients. The patient- centered medical home is an accepted model for achieving ACO goals Patient-Centered medical home answers A mechanism for organizing primary care to provide high-quality care across the full range of individuals' healthcare needs Vertical Integration answers Affiliation of organizations that provide different kinds of service, such as hospital care, ambulatory care, long-term care, and social services. They integrate and support a large group of care teams, most commonly in acute care and rehabilitation but also primary care and long-term care Horizontal Integration answers Integration of organizations that provide the same kind of service, such as two hospitals or two clinicals
Boundary Spanning answers Establishing and maintaining effective relationships with all stakeholders, and adapting the HCO to the needs of its community Data warehouse answers Library of work processes, protocols, and performance measures available to all associates. Keeps all associates current on measured performance and goal achievement; communication system to relay information relevant to immediate applications. Performance Improvement Council (PIC) answers Formal coordinating structure composed of representatives from all major activities or activity groups; the PICs first job is to prioritize the OFIs Strategic Positioning answers Integrative activity that seeks maximum return from the resources available. Boundary spanning (externally oriented) and organization OFIs (internally oriented) generate proposals for responding to the most important questions. Ratio analysis answers Evaluation of an organization's performance by computing the relationships of important line items in the financial statements. Capital analysis answers A process to determine how much a capital expenditure will cost and what return it will generate 3rd party payer answers Agent of the patient (the 1st party) who contracts with providers (the 2nd party) to pay all or a portion of the bill to the patient Prospective Payment answers A payment system in which a healthcare organization accepts a fixed, predetermined amount to treat a patient, regardless of the true ultimate cost of that treatment. DRGs (diagnosis-related groups) are one type of payment; Medicare pays hospitals a fixed amount for an episode of treatment based on that treatment's DRG. HCOs lose money if they provide care that costs more than the prospective payment.
Capitated price answers A price per head or subscriber. And, a healthcare payment system that an organization accepts a monthly payment from a 3rd party payer for each individual covered by that payer's plan, whether a given individual is treated in a given month. Provides a financial incentive to an HCO to keep its population from using more healthcare services than necessary because the organization only profits if the total cost of treating the specified population falls below the total capitation provided by the 3rd party payer Sentinel indicator answers Measures a process so important that every time the indicators occur, the manager initiates an individual case review Would be a lost bill, initiating a case review on why the bill was lost Rate-based indicator answers Measures a process of lesser importance and allows for an error rate; the manager initiates case reviews only if the error rate is exceeded percentage of total bills going to a collection agency. Reviews would be necessary only if the rate exceeded a predetermined rate. Conflicts of interest answers An individual owes duties to two or more persons or organizations and when meeting a duty to one somehow harms the other Financial Management Functions answers Planning: responsible for completing the operating and capital budgets Organizing: Provides a chart of accounts based on the organizational chart that identifies revenue and cost centers Staffing: staffs a variety of departments and processes important to the HCO Directing: Financial management provides rewards and penalties to motivate others to accomplish the organization's purposes Controlling: control of the budget, financial reports, financial policies and procedures and financial audits
Success of a recruitment function answers Quantity of applicants: proper use of recruitment methods and sources will yield a number of candidates Quality of applicants: bring employees who have the appropriate education, qualifications, skills and attitudes Overall recruitment cost and cost per applicant: provides the opportunity to determine the cost effectiveness of alternative recruitment methods Diversity of applicants: assuming that one goal of the recruitment program is to identify and hire qualified candidates who represent the diversity of the service population Recruitment time or time-to-fill: the more time spent on proper recruitment, the greater the chance that the ideal candidate will emerge Person-Organization Fit answers The extent to which an applicant will fit with the values and culture of the organization and value congruence is the overriding principle Content Validity answers Extent to which a selection tool representatively samples the content of the job for which the measure will be used. Construct validity answers Degree to which a selection tool actually measures the construct it intends to measure; this concept ultimately determines the conclusions that can be legitimately drawn from the tool's use. Criterion-related validity answers Extent to which a selection tool is associated with or predicts actual job performance Turnover Rate answers Ratio that provides a summary of the gross movement in and out of the organization during a specific time frame (usually one year), or the number of time on average that employees must be replaced during a year. Retention Rate answers Percentage of employees who are employed at the beginning of a period and who remain with the organization at the end of the period. Retention
views and individual or group as an entity; therefore, retention allows for a more thorough examination of how the loss of one individual or cohort individuals retention strategies and productivity FMLA answers 1993: law requiring covered employers to provide employees with job-protected and unpaid leave for qualified medical family reasons Purpose of any HCO answers to provide care to individual patients and is usually stated in organization's "mission" Population Health answers defining the population (by geography, sociodemographic factors, disease state, risk, insurance coverage or in some other way), measuring the current state of health in the population, setting goals for improvement and directing resources to making improvements. US HSS specifies national goals and objectives for population health in the Healthy People 2020 program Caregiving/Clinical/Logistic/Strategic Teams answers Caregiving Teams: Provide care to patients with similar needs (PCP, ACUTE, rehab) Clinical Support Teams: provide specific clinical services to Caregiving Teams (clinical laboratory, pharmacy, imaging, cardiopulmonary) Logistic Support Teams - provide trained personnel, information, facilities, accounting, cash, management and supplies Strategic Support Teams: provide marketing, governance, internal consulting, finance, stakeholder relations management and strategic positioning Service Lines answers Patient care teams coordinated around a set of similar diseases or patient needs
Certificate-of-need laws answers Certificate or approval of new services and construction and renovation of hospitals or related facilities; issued in many states. Require that HCOs seek permission for construction or expansion. EMTALA - Emergency Medical Treatment and Active Labor Act answers Requires all HCOs providing emergency care to accept all patients, regardless of ability to pay, until they are stabilized and can be safely moved The Joint Commission answers A voluntary consortium of professional provider organizations that evaluates and accredits a wide range of different HCOs. HCOs MUST have an accreditation by a CMS deemed-status organization in order to receive funds from Medicare. Some insurance plans are accredited by the National Committee for Quality Assurance (NCQA) Associates answers People who give their time and energy to the organization. They can be employees, trustees and other volunteers and medical staff members.
