Healthcare Finance: Test 2 Question
and answers verified to pass
2025/2026
The most common third-party payers in the US healthcare system are - correct answer ✔the
government and insurance companies
Third party payers are - correct answer ✔Agents of patients that contract with providers to medical
bills
Under a direct service plan, the employer prepays ______ to take care of its employees - correct answer
✔specific hospitals and physicians
Organizations setting premiums by ____ assume all organizations pay the same rate - correct answer
✔community rating
Organizations using ____ to set premiums assume groups pay different premiums based on risk - correct
answer ✔an experience rating
Which three aspects of healthcare do managed care organizations address? - correct answer ✔Quality,
access, and cost
Consumer-driven health plans give their members greater ______ in their healthcare and decrease the
employer's ______ - correct answer ✔choice; cost
Which type of HMS employs physicians to provide care exclusively to its members? - correct answer
✔Closed-panel HMO
, The Affordable Care Act of 2010 set out to - correct answer ✔A. Reduce the rate of increase for
Medicare and Medicaid Spending
B. Provider insurance to the 32 million Americans still uninsured
C. Require individuals to have health insurance
D. {All} of these answers are correct
Most providers agree that _________ is the best way to be reimbursed. - correct answer ✔Charges
Medicare Part ___covers hospital services, whereas Medicare Part ___ covers physicians services -
correct answer ✔A; B
In 2010, Medicare was financed through which three primary sources? - correct answer ✔General tax
revenue, beneficiary premiums, payroll contributions
Which piece of federal legislation called for the development of a prospective payment system for
hospitals? - correct answer ✔Social Security Amendments of 1983
To ensure quality, Medicare prefers accreditation through which agency? - correct answer ✔The Joint
Commission
Resource-based relative value systems reimburse ____ for services provided to Medicare beneficiaries -
correct answer ✔hospitals
Why are healthcare expenditures disproportionately higher for people aged 65 or older? - correct
answer ✔This group uses healthcare at a much higher rate than the under 65 pop
The Balanced Budget act of 1997 established _____, the managed care option for Medicare. - correct
answer ✔Medicare Advantage (Part C)
and answers verified to pass
2025/2026
The most common third-party payers in the US healthcare system are - correct answer ✔the
government and insurance companies
Third party payers are - correct answer ✔Agents of patients that contract with providers to medical
bills
Under a direct service plan, the employer prepays ______ to take care of its employees - correct answer
✔specific hospitals and physicians
Organizations setting premiums by ____ assume all organizations pay the same rate - correct answer
✔community rating
Organizations using ____ to set premiums assume groups pay different premiums based on risk - correct
answer ✔an experience rating
Which three aspects of healthcare do managed care organizations address? - correct answer ✔Quality,
access, and cost
Consumer-driven health plans give their members greater ______ in their healthcare and decrease the
employer's ______ - correct answer ✔choice; cost
Which type of HMS employs physicians to provide care exclusively to its members? - correct answer
✔Closed-panel HMO
, The Affordable Care Act of 2010 set out to - correct answer ✔A. Reduce the rate of increase for
Medicare and Medicaid Spending
B. Provider insurance to the 32 million Americans still uninsured
C. Require individuals to have health insurance
D. {All} of these answers are correct
Most providers agree that _________ is the best way to be reimbursed. - correct answer ✔Charges
Medicare Part ___covers hospital services, whereas Medicare Part ___ covers physicians services -
correct answer ✔A; B
In 2010, Medicare was financed through which three primary sources? - correct answer ✔General tax
revenue, beneficiary premiums, payroll contributions
Which piece of federal legislation called for the development of a prospective payment system for
hospitals? - correct answer ✔Social Security Amendments of 1983
To ensure quality, Medicare prefers accreditation through which agency? - correct answer ✔The Joint
Commission
Resource-based relative value systems reimburse ____ for services provided to Medicare beneficiaries -
correct answer ✔hospitals
Why are healthcare expenditures disproportionately higher for people aged 65 or older? - correct
answer ✔This group uses healthcare at a much higher rate than the under 65 pop
The Balanced Budget act of 1997 established _____, the managed care option for Medicare. - correct
answer ✔Medicare Advantage (Part C)
