Exam 7: Paying for Health Care in America: Rising Costs and Challenges

The precise classification of clients according to the highest diagnosis-related group (DRG)has created a new role for nurses,known as a _____ nurse.

A client is admitted with chest pain.A series of diagnostic tests are ordered,and the client undergoes coronary artery bypass grafting.The cost of care for this client is increased because of a four-pack-per-day smoking history that resulted in extension of the client's intensive care unit (ICU)stay by 3 days because of respiratory problems.The case manager realizes that under the terms of the diagnosis-related group (DRG)payment system for this diagnosis that the client's past history and present care needs will have what affect on reimbursement?

The type of insurance that shifts the largest percentage of costs for goods and services to employees and consumers is _____________ insurance.

A nurse who speaks at a health fair states that current attempts to increase efficiency of health care include what actions? (Select all that apply. )

A patient is upset because her health insurance plan refused to pay for a mammogram and services by a women's health specialist because the primary care physician did not order the referral or the mammogram.Which type of insurance plan adheres to this type of payment system?

A nurse is very interested in learning more about health care economics and how she can use that knowledge to become a better patient advocate.She comments,"Nurses should not only deliver care one day at a time in one facility but should coordinate patient care as they move from acute care to rehabilitation to home care." This nurse would be a candidate for which nursing role?