HCD II Flashcards
(27 cards)
Types of problems that may benefit from QI process
recent outcomes have declined from previous outcomes
recent outcomes are lower than the benchmark
practice deviates from some known standard practice
NO: compliance is less than 100%
What does a run chart display?
key QI data over time
Process mapping helps the team develop
a shared mental model
Tools to DEFINE and UNDERSTAND quality problem
process map
voice of the customer
root cause analysis
NO: hierarchy of interventions (this falls Improving your problem)
general supervision
PTA
PTA stands for…
physical THERAPIST assistant
Who is EXCLUDED from individuals that a PT can supervise (at one time) under CO Physical Therapy Practice Act?
SPT, PTA student
Who is included? PTA, aide, other regulated professionals (massage therapists, OT, etc.)
Which is most likely to result in PT license revocation?
felony conviction for sexual assault
Who can sign off PT POC for medicare
PA, MD, DO, NP
what should be documented when a patient has medicare part B
total time spent with patient
total time spent on 1:1 services
T/F If states adopt a work requirement under medicaid, all individuals will be required to work
FALSE — work requirement does not just mean getting a job. It can also be the person is in school, volunteering, job training, etc.
T/F federal law requires that cost sharing for individuals on medicaid is identical, regardless of income
FALSE — states impose out of pocket costs, and the amounts that can be charged vary with income !!
Medicare therapy cap
- applies to all OP therapy settings
- PT and SLP combined capped benefit of $2150
- therapy cap: limited therapy services to set $ amount
-“soft” therapy cap: technically can exceed set $ if deemed necessary by PT via using modifiers
regressive tax
type of tax on spending habit
e.g. sales tax, car registration, tobacco, utilities, SSN
hurts poor more than wealthy
progressive tax
ex: federal income tax system
you get taxed more if you make more money
hurts wealthy more than poor
flat tax
taxes all income at same rate regardless of income level, spending habit, or asset level
An insurer offering a part C plan is most likely to experience which of the following outcomes when there are high numbers of enrollees?
Favorable selection
PDPM
SNF
PDGM
Home health
Part B medicare co-insurance for PT is what % of the medicare fee schedule?
20%
Most physical therapists generated charges in an acute care hospital are used to determine productivity, and may not even leave the building to be billed to medicare. Why?
The hospital is paid based on DRG
Definition of value?
Health outcomes achieved per dollar spent
Federal public option vs. state public option
Federal public option: federal government adds a public insurance (like medicare) but all can apply
State public option: public-private partnership— state contracts with private companies to create new insurance options, overseen by government (similar to Plan C)
When did private health insurance premiums/deductibles begin to rise?
BEFORE the ACA was passed
