Domain III: Management of Food and Nutrition Programs and Services: Quality Management and Regulatory Compliance Flashcards
(56 cards)
____ organizations certify, manage, and promote quality improvement
Accreditation
____ ___ Healthcare accreditation program validates Medicare compliance
DNV GL
The ____ ____ accredits and certifies healthcare organizations
Joint Commission
____ is a health insurance program for people over 65 or of any age with end-stage renal disease (employers and employees pay)
Medicare
A ____ ____ is provided by the Affordable Care Act to Medicare beneficiaries; RDNs are listed as eligible medical professionals who may screen and counsel Medicare beneficiaries
Wellness Visit
Medicare Part A covers ____ ____ ___ under the Prospective Payment System using predetermined rates for hospital discharges
Inpatient hospital stays
Medicare Part B is ____ insurance for supplementary benefits
Optional
____ ____ ____ is a benefit for obese patients under Medicare B; coverage is granted only in the primary care setting for those with BMI > 30
Intensive Behavioral Therapy
With Intensive Behavioral Therapy, there is continued treatment contingent on ____ ____ assessed at the seventh month of treatment; can only be provided by a physician
Weight loss
_____ is a federal law administered by states for the payment of medical care for all eligible needy (all ages, blind, disabled, dependent children)
Medicaid
The ACA Patient Protection and Affordable Care Act allows for opportunities to provide ____ under the benefit category of “Preventative and Wellness Services”
MNT
The Children’s Health Insurance Plan (CHIP) is under the ____ ___ ____
Social Security Act
The Children’s Health Insurance Plan is a partnership between the federal and state governments expanding health coverage to ____ children whose families earn too much income to qualify for Medicaid but too little to afford private coverage
Uninsured
A ____-____ Medical Home focuses on the relationship between the patient and their personal physician; the physician takes responsibility for all aspects of the health care for the patient and coordinates and communicates with other providers as needed; if specialty care is needed, the physician is responsible for ensuring that the transition is seamless (the RDN should be considered part of the medical home treatment plan
Patient-Centered
An ____ ____ ____ is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care; in the U.S, they are formed from a group of coordinated healthcare practitioners
Accountable Care Organization (ACO)
An ____ ____ ____ is a payment approach that gives added incentive payments to provide high-quality and cost-efficient care; they can apply to a specific critical condition, a care episode, or a population (ex: fee-for-service)
Alternative Payment Model
The ICD-10-CM describes an individual’s ____ or ___ ___
Disease or medical condition
The ICD-10-CM codes for malnutrition are…
E43-E46
The Codes for Current Procedural Terminology are five-digit codes that describe the ____ rendered
Services
MNT Codes for Current Procedural Terminology are 97802-97806, and are used to report ____-provided services
RDN
A ____ ____ form is used to submit non-institutional claims to Medicare/Medicaid to healthcare services
CMS 1500
____-____ studies determine whether the goal of the intervention is worthwhile in terms of cost; the value of the benefits derived from the intervention must outweigh the costs of providing the intervention
Cost-benefit
A ____-____ analysis assumes that the goal of the project is worthwhile; the question to resolve is which methods of intervention is the most effective (in terms of value) in achieving the goal; it compares the costs of alternative strategies using the results of outcomes research
Cost-effectiveness
An ____ is a formal study that retrospectively monitors performance (did performance meet the standards?)
Audit
