AHS 340 FINAL EXAM QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026
Examples of current changes in health information systems - Answers all computer systems,
networks, and data that these systems create and capture.
* AI
*Data exchange networks
*Telehealth and telemedicine that is remote status
Data from health information systems can be used for what? - Answers * Improve patient care
* Enhance clinical workflow
*Support public health initiatives
*Drive research
What must health care managers be able to achieve in terms of HIT and technology? - Answers
*Need to have competencies in IT use and be able to evaluate how staff are using it
*Ensure security of data and comply with HIPAA
*Optimal workflow/ efficiency in tech work
*Must understand and demonstrate flexibility to make sure they understand the barriers for staff and
can keep staff feeling productive is improving
What is PHI? - Answers Protected health information (PHI) is any health-related information that can
be related to a specific person. In the US, the Health Insurance Portability and Accountability Act
(HIPAA) mandates the protection of PHI.
What is NOPP? - Answers Notice of Privacy Practices. It details permitted uses and disclosures of PHI.
The patient should be given NOPP.
* mandated informed consent, which tells patients how their PHI is used.
What is HIPAA? What does it do? - Answers The Health Insurance Portability and Accountability Act.
This act protects patients personal health information
What is telemedicine and what is it used for? - Answers Using electronic information and tech
communication to provide health care services remotely.
* Allows patients to see doctors, therapists, or specialists from home
Interoperability - Answers ability of different info tech systems and software applications to
communicate exchange
Who has had difficulty adopting EHRs? - Answers physicians and small rural hospitals
E-Health - Answers Health care information and services are offered over the internet by
professionals and nonprofessionals alike.
High-deductible health plans (HDHP) - Answers *has a high deductible, but with a health savings
account option. Lower monthly premiums, but higher out-of-pocket deductibles.
*Covers preventative services before the deductible is met
*Usually, for healthier individuals who rarely see the doctor, it can save money.
*Once you meet the deductible, you get 100% coverage.
HSAs - Answers Health Savings Accounts
*For people with HDHP
*helps pay for medical costs with pre-tax dollars
private health insurance plans and which fall into that category - Answers - HMO: Health
Maintenance Organization. Pay the fixed prepayment amount. Get care from providers and people
within the HMO. Services at no charge, with co-payments. Gatekeeping!!!
Limited and controlled.
Limited care to geographic regions
Limited to in-network providers
Limitations could be imposed on services
- PPO: Preferred provider org. A combo of indemnity and manager care. Purchased on fee for service,
with deductibles and things to be met.
Most flexible plan for the provider
- High Deductible
- POS (point of service): can use services out of the plan, but with a higher deductible and payments.
What plans have unlimited provider choice? - Answers Indemnity plans, PPOs, and POS
What are the 3 main purposes of the ACA? - Answers 1. Contain the costs of health care services
2. expand the prevention and wellness program
3. eliminate costs of sharing for screening
, Medicare - Answers a federal program providing access to people over 65, permanently disabled
adults, and those suffering from end-stage renal disease.
Medicaid - Answers A federal and state assistance program that pays for health care services for
people who cannot afford them.
* Low-income/ medically indigent à pregnant women, kids, and infants.
* Some mandatory services, but beyond it is up to the state.
Forms of payment to providers - Answers * Fee-for-service: provider is paid by insurer or insured
person. Utilizing benefits from medical services, etc.
* Prepayment: insured individuals pay a fixed amount in exchange for the service
* Copayment: you pay at the time of service
* Deductibles: payments that the insured must meet before the insurance company pays for them.
Ex. Meeting a 4,000 deductible before it covers certain things.
* Co-insurance: insured pays a portion of the cost of care.
*Max Out-of-pocket: insured individual meets a cap and must pick up 100% of payment.
* Lifetime limit: The maximum amount the policy will pay over the lifetime. Ex. When care gets too
costly due to things like various transplants, etc, the limit could be $1 million or higher.
What is CMS? - Answers Centers for Medicare and Medicaid Services
all the types of costs - Answers * Fixed: remains the same despite a change in service volume
* Variable cost: changes or vary directly proportional to changes in volume
*Semivariable: partially fixed and partially variable
* Direct: can be traced to a particular patient, service
*Indirect: cannot be traced to a particular patient/service
* Full costs: both direct and indirect costs
* Controllable: under the manager's influence
*Uncontrollable costs: cannot be controlled by manger
*Opportunity cost: proceeds lost by rejecting alternatives
value-based care - Answers providers are paid more for better quality of care and improved
outcomes
Capitation - Answers An agreement where a health care provider is paid a fixed amount per member
per month by a health plan in exchange for a contract-specified set of medical services.
Characteristics of budgeting are important to health care managers - Answers - Operational: looks
only at the income statement, revenue, and expenses.
- Cash: enough cash is available to support the business and its goals.
- Revenue: data on forecasted utilization of specific services in org.
- Capital: plan for expenditure, new facilities, and equipment. So all the big things you're going to buy.
- Master: includes everything.
Difference between charges and prices - Answers - Charge: $ amount a health care provider sets for
services rendered before negotiating any discounts
- Price: opportunity costs what consumers or third-party payors pay to acquire medical goods or
services , such as:
* Money spent
* Perceived value of
* Goods and services
* Time sacrificed in acquiring these services
Impacts health care finances? - Answers - External: inflation, regulations, population health overall,
economy state, government policies.
- Internal: staffing, technology in department, efficiency of care, labor, strategic planning
What is supply chain management? - Answers - Managing the goods and services, clinical and
nonclinical goods and inventory purchased and used by personnel in health care to perform duties
needed
* Delivering care matters
* Need the right quantity and supplies
* Controlling costs
Master Budget - Answers a set of interrelated budgets that constitutes a plan of action for a specific
time period
Examples of current changes in health information systems - Answers all computer systems,
networks, and data that these systems create and capture.
* AI
*Data exchange networks
*Telehealth and telemedicine that is remote status
Data from health information systems can be used for what? - Answers * Improve patient care
* Enhance clinical workflow
*Support public health initiatives
*Drive research
What must health care managers be able to achieve in terms of HIT and technology? - Answers
*Need to have competencies in IT use and be able to evaluate how staff are using it
*Ensure security of data and comply with HIPAA
*Optimal workflow/ efficiency in tech work
*Must understand and demonstrate flexibility to make sure they understand the barriers for staff and
can keep staff feeling productive is improving
What is PHI? - Answers Protected health information (PHI) is any health-related information that can
be related to a specific person. In the US, the Health Insurance Portability and Accountability Act
(HIPAA) mandates the protection of PHI.
What is NOPP? - Answers Notice of Privacy Practices. It details permitted uses and disclosures of PHI.
The patient should be given NOPP.
* mandated informed consent, which tells patients how their PHI is used.
What is HIPAA? What does it do? - Answers The Health Insurance Portability and Accountability Act.
This act protects patients personal health information
What is telemedicine and what is it used for? - Answers Using electronic information and tech
communication to provide health care services remotely.
* Allows patients to see doctors, therapists, or specialists from home
Interoperability - Answers ability of different info tech systems and software applications to
communicate exchange
Who has had difficulty adopting EHRs? - Answers physicians and small rural hospitals
E-Health - Answers Health care information and services are offered over the internet by
professionals and nonprofessionals alike.
High-deductible health plans (HDHP) - Answers *has a high deductible, but with a health savings
account option. Lower monthly premiums, but higher out-of-pocket deductibles.
*Covers preventative services before the deductible is met
*Usually, for healthier individuals who rarely see the doctor, it can save money.
*Once you meet the deductible, you get 100% coverage.
HSAs - Answers Health Savings Accounts
*For people with HDHP
*helps pay for medical costs with pre-tax dollars
private health insurance plans and which fall into that category - Answers - HMO: Health
Maintenance Organization. Pay the fixed prepayment amount. Get care from providers and people
within the HMO. Services at no charge, with co-payments. Gatekeeping!!!
Limited and controlled.
Limited care to geographic regions
Limited to in-network providers
Limitations could be imposed on services
- PPO: Preferred provider org. A combo of indemnity and manager care. Purchased on fee for service,
with deductibles and things to be met.
Most flexible plan for the provider
- High Deductible
- POS (point of service): can use services out of the plan, but with a higher deductible and payments.
What plans have unlimited provider choice? - Answers Indemnity plans, PPOs, and POS
What are the 3 main purposes of the ACA? - Answers 1. Contain the costs of health care services
2. expand the prevention and wellness program
3. eliminate costs of sharing for screening
, Medicare - Answers a federal program providing access to people over 65, permanently disabled
adults, and those suffering from end-stage renal disease.
Medicaid - Answers A federal and state assistance program that pays for health care services for
people who cannot afford them.
* Low-income/ medically indigent à pregnant women, kids, and infants.
* Some mandatory services, but beyond it is up to the state.
Forms of payment to providers - Answers * Fee-for-service: provider is paid by insurer or insured
person. Utilizing benefits from medical services, etc.
* Prepayment: insured individuals pay a fixed amount in exchange for the service
* Copayment: you pay at the time of service
* Deductibles: payments that the insured must meet before the insurance company pays for them.
Ex. Meeting a 4,000 deductible before it covers certain things.
* Co-insurance: insured pays a portion of the cost of care.
*Max Out-of-pocket: insured individual meets a cap and must pick up 100% of payment.
* Lifetime limit: The maximum amount the policy will pay over the lifetime. Ex. When care gets too
costly due to things like various transplants, etc, the limit could be $1 million or higher.
What is CMS? - Answers Centers for Medicare and Medicaid Services
all the types of costs - Answers * Fixed: remains the same despite a change in service volume
* Variable cost: changes or vary directly proportional to changes in volume
*Semivariable: partially fixed and partially variable
* Direct: can be traced to a particular patient, service
*Indirect: cannot be traced to a particular patient/service
* Full costs: both direct and indirect costs
* Controllable: under the manager's influence
*Uncontrollable costs: cannot be controlled by manger
*Opportunity cost: proceeds lost by rejecting alternatives
value-based care - Answers providers are paid more for better quality of care and improved
outcomes
Capitation - Answers An agreement where a health care provider is paid a fixed amount per member
per month by a health plan in exchange for a contract-specified set of medical services.
Characteristics of budgeting are important to health care managers - Answers - Operational: looks
only at the income statement, revenue, and expenses.
- Cash: enough cash is available to support the business and its goals.
- Revenue: data on forecasted utilization of specific services in org.
- Capital: plan for expenditure, new facilities, and equipment. So all the big things you're going to buy.
- Master: includes everything.
Difference between charges and prices - Answers - Charge: $ amount a health care provider sets for
services rendered before negotiating any discounts
- Price: opportunity costs what consumers or third-party payors pay to acquire medical goods or
services , such as:
* Money spent
* Perceived value of
* Goods and services
* Time sacrificed in acquiring these services
Impacts health care finances? - Answers - External: inflation, regulations, population health overall,
economy state, government policies.
- Internal: staffing, technology in department, efficiency of care, labor, strategic planning
What is supply chain management? - Answers - Managing the goods and services, clinical and
nonclinical goods and inventory purchased and used by personnel in health care to perform duties
needed
* Delivering care matters
* Need the right quantity and supplies
* Controlling costs
Master Budget - Answers a set of interrelated budgets that constitutes a plan of action for a specific
time period
