C425 Study guide with Key Concepts

Study Guide to Prepare for the Objective Assessment ** The OA requires critical thinking and is scenario based. You will need to APPLY the knowledge that you have learned on the assessment. Topic 1: Overview of the US Healthcare System (20% weighted) Topic 1 Publisher PowerPoints: Chapter 1: https://lrps.wgu.edu/provision/207540327 Chapter 2: https://lrps.wgu.edu/provision/207540427 Chapter 3: https://lrps.wgu.edu/provision/207540643 Chapter 6: https://lrps.wgu.edu/provision/207540933 Chapter 8: https://lrps.wgu.edu/provision/207541092 Chapter 13: https://lrps.wgu.edu/provision/207541579  Key concepts to focus on: o What is the definition of health? o Describe the types of Insurances  Medicare  Parts A, B, C and Medicare Advantage  Medicaid  CHIP  Private o Discuss Medicare and Medicaid (federal and state) legislation o Discuss Managed Care Organizations o Discuss Accountable Care Organizations o Discuss Workers Compensation o Discuss VA Medical Care o Discuss Reimbursement methods o Discuss Risk Pooling o Discuss the Affordable Care Act o Discuss the Health Insurance Portability and Accountability Act (HIPAA) o Discuss HITECH Act o Discuss the Stark regulation (law) o Discuss ERISA o Discuss Anti-trust regulations  Demand-side incentives  Supply-side regulation o Describe Resource-Based Relative Value Scale o Describe the Flexner Report o Discuss the h istory of health insurance Topic 2: Healthcare Delivery Processes (18% weighted)

Topic 2 Publisher PowerPoints: Chapter 7 : https://lrps.wgu.edu/provision/207541017 Chapter 8: https://lrps.wgu.edu/provision/207541092 Chapter 9: https://lrps.wgu.edu/provision/207541150 Chapter 10: https://lrps.wgu.edu/provision/207541311  Key concepts to focus on: o Discuss the various Healthcare delivery processes to include the following:  Telemedicine and Remote monitoring  Outpatient / primary care  Facility types and the care provided at each  Managed care / integrated care  HMO  PPO – in network / out of network  POS  Long-term care  Intermediate care  Home health care – what services are offered? o Discuss Hospital delivery processes  Inpatient vs Outpatient  Hill-Burton Act  Types of hospitals o Describe the impact on structure and processes of healthcare delivery  Reasons for high health care costs  Globalization o Describe:  Adult Day Care  Senior Centers  Assisting Living Facilities  Different types of nursing facilities  Subacute Care Facilities  Respite Care  Restorative Care  Hospice Care o Describe the difference between an Acute, Subacute and Chronic Condition Topic 3: Major Stakeholders (17% weighted) **Be sure to read Chapter 4, this is a traditionally difficult topic for student to pass. Topic 3: Publisher PowerPoints: Chapter 2: https://lrps.wgu.edu/provision/207540427 Chapter 3: https://lrps.wgu.edu/provision/207540643 Chapter 4: https://lrps.wgu.edu/provision/207540728 Chapter 5: https://lrps.wgu.edu/provision/207540856 Chapter 6: https://lrps.wgu.edu/provision/207540933  Key concepts to focus on: