Question: Which of the following reimburses an individual for fees paid for medical services after they are performed. Payments may be made to the patient or directly to the provider, on a retrospective, fee-for-service basis.
Answer Options:
a. Indemnity insurance, b. Capitation, c. Coinsurance, d. Per diem
Answer: a. Indemnity insurance
Question: Which of the following is interfering with the Affordable Care Act’s (ACA’s) goal of attaining health care coverage for all?
Answer Options:
a. Privatization of hospitals, b. States’ rejection of Medicaid expansion, c. Continuing medical education expectations, d. Implementation of electronic medical records
Answer: b. States’ rejection of Medicaid expansion
Question: An underlying assumption of the ACA was that cost, quality, and equity are linked.
Answer Options:
True, False
Answer: True
Question: One reason that the Clinton Plan failed was that many people were concerned that the limitations imposed on care would lead to “rationing” – care not approved by the HSA would be illegal to obtain.
Answer Options:
True, False
Answer: True
Question: The US health care system underwent several important, incremental changes including:
Answer Options:
a. an increase in the proportion of single, free-standing hospitals, b. a marked increase in non-profit health care organizations (HCOs), c. the growth of vertical and horizontal integration of health care organizations, d. a decrease of managed care
Answer: c. the growth of vertical and horizontal integration of health care organizations
Question: Establishing insurance premiums via Experience Rating means:
Answer Options:
a. insurance rates are set by the government, b. setting rates based on the costs of insuring an individual similar to the insured, c. establishing rates based on the experience of the community in which the insured lives, d. establishing rates based on zip code
Answer: b. setting rates based on the costs of insuring an individual similar to the insured
Question: What organization was a major opponent of national health insurance in the 20th Century?
Answer Options:
a. American Medical Association, b. Committee for Economic Development, c. Committee on the Quality of Health Care, d. American Nurses Association
Answer: a. American Medical Association
Question: Under the ACA, the Center for Medicare and Medicaid Innovation was to be established to develop cost savings through evaluating the effectiveness and efficiency of health care treatments (Like NICE in United Kingdom).
Answer Options:
True, False
Answer: True
Question: Which of the following is the practice of paying a flat fee to a health care provider in exchange for a defined set of services for an individual during a given time period, usually a year?
Answer Options:
a. Per diem, b. Indemnity insurance, c. Capitation, d. Coinsurance
Answer: c. Capitation
Question: What has been strongly challenged under the Affordable Care Act (ACA)?
Answer Options:
a. Limits on pharmaceutical costs, b. Mandatory purchase of health insurance, c. Children’s ability to remain on a parent’s health insurance until age 26, d. Increase in private-sector involvement
Answer: b. Mandatory purchase of health insurance
Question: Consider the Modified Value Equation. If the nursing staff receives a 5% pay raise, all else being equal, the Value of the health care received will:
Answer Options:
a. Increase, b. Decrease, c. Stay the same
Answer: b. Decrease
Question: The ACA was unsuccessful in lowering the number of uninsured in America.
Answer Options:
True, False
Answer: False
Question: Which of the following describes a health maintenance organization (HMO)?
Answer Options:
a. It is an organization that assumes or shares both the financial risks and the delivery risks associated with providing comprehensive medical care, b. It usually provides medical services in return for a fixed, prepaid fee, c. It usually charges a substantial deductible, copayment, or coinsurance for use of nonpanel providers, d. All of the above
Answer: d. All of the above
Question: A good share of health care expenditures are due to which of the following potentially avoidable factors?
Answer Options:
a. denial of discretionary spending by consumers, b. Individual lifestyle choices, c. lower prices likely caused by using a market approach to setting prices, tech diffusion, and access in “non-markets”
Answer: b. Individual lifestyle choices
Question: Which statement is true regarding the Affordable Care Act (ACA)?
Answer Options:
a. Eliminates the private system, b. Eliminates the public system, c. Maintains the mixed public and private system, d. Emphasizes privatization
Answer: c. Maintains the mixed public and private system
Question: HIPAA:
Answer Options:
a. provides that data within the medical record is the property of the patient, b. allowed for portability of health insurance, c. mental health was given the same status as physical health, d. extended privacy protections to a patient’s medical record and also certain financial transactions, e. All of the above are true of the HIPAA legislation
Answer: e. All of the above are true of the HIPAA legislation
Question: When the ACA repealed the Pre-existing Conditions exclusions used by most private insurers:
Answer Options:
a. it made changing employers (and insurance carriers) more feasible, b. it removed some incentives to practice more healthy lifestyles, c. it disallowed insurers from excluding people with early life events, d. Only choices A and C are correct, e. A, B and C are all correct.
Answer: e. A, B and C are all correct.
Question: Market power is a more potent driver of price in health care than cutting costs (efficiency).
Answer Options:
True, False
Answer: False
Question: A major emphasis of health policy in the 20th Century has been improving access to health care. Which of the following was not a major effort to improve access to care?
Answer Options:
a. Providing health insurance, b. Developing managed care, c. Funding military clinics, d. Building community hospitals
Answer: c. Funding military clinics
Question: Which of the following is a primary feature of the Clinton health plan?
Answer Options:
a. Single payer plan, b. Universal health coverage, c. Cost control measures, d. All of the above
Answer: d. All of the above
Question: A likely outcome of Single Payer insurance will be the expansion and acceleration of technology diffusion in health care.
Answer Options:
True, False
Answer: False
Question: EMTALA is:
Answer Options:
a. a program that allows for-profit hospitals to transfer patients to charity hospitals, b. prohibits hospitals and doctors from “dumping”, c. does not apply to patients in active labor, d. is an acronym for “Every Medical Transferor Allowed to Act”
Answer: b. prohibits hospitals and doctors from “dumping”
Question: What was the basis of the Supreme Court’s decision to uphold the Affordable Care Act (ACA) in 2012?
Answer Options:
a. Government’s taxing authority, b. Government’s authority to regulate interstate commerce, c. Government’s authority to grant physician licenses, d. Government’s authority to approve health insurance plans
Answer: a. Government’s taxing authority
Question: Which of the following most accurately depicts the evolution of health care delivery in the U.S. over the course of the 20th Century?
Answer Options:
a. Solo physician practices, prepaid group practices, indemnity health insurance, HMOs, b. Indemnity health insurance, solo physician practices, prepaid group practices, HMOs, c. HMOs, solo physician practices, prepaid group practices, indemnity health insurance, d. Prepaid group practices, solo physician practices, HMOs, indemnity health insurance
Answer: a. Solo physician practices, prepaid group practices, indemnity health insurance, HMOs
Question: Which of the following looks at a patient’s past use of services, past behavioral choices, and existing health needs to forecast his or her future use of health care services?
Answer Options:
a. Patient Resource Advocacy, b. Predictive analytics, c. Preventive analysis, d. Data provenance
Answer: b. Predictive analytics
Question: What health care policy patched the health insurance gap for people who were changing jobs?
Answer Options:
a. Medicaid, b. Health Insurance Portability and Accountability Act (HIPAA), c. Medicare
Answer: b. Health Insurance Portability and Accountability Act (HIPAA)