HSM 541 Week 4 Midterm (Version 1)
1. (TCO A) Briefly discuss how characteristics of individuals or populations may influence utilization of
health services. Discuss how these characteristics impact access, costs, and quality. Use an example to
support your point(s). (Points : 25)
Many countries striving to achieve universal health insurance coverage have done
so by means of multiple health insurance funds covering different population
groups. How ever, existence of multiple health insurance funds may also cause
variation in access to health care, due to the differential revenue raising capacities
and benefit packages offered by the various funds resulting in inequity and
inefficiency w ithin the health system. Recent studies have suggested that factors
related to the characteristics of communities could be important determinants of
access to health care in addition to characteristics of individuals living in urban
areas and the overall availability of health care services. Presently, there is
considerable interest in geographical variations in health and the effect of context
on health related problems. Studies on health behavior need to emphasize
structural constraints as w ell as personal choices. Individuals are affected by the
social, cultural, economic or physical factors acting at macro and micro levels. We
have defined access as the opportunity to identify healthcare needs, to seek
healthcare services, to reach, to obtain or use health care services and to actually
have the need for services fulfilled. In addition, there is a need for more research
examining the variability of access from both supply and demand-sides and
looking at the influence of local health systems and patients’ characteristics.
Question 2. 2. (TCO D) Describe two state or federal programs that provide health insurance benefits to
a specific population. Detail at least two strategies used by either agency to manage access, costs, or
quality. (Points : 20)
Medicaid and Medicare are tw o governmental programs that provide medical and
health-related services to specific groups of people in the United States. Although
the tw o programs are very different, they are both managed by the Centers for
Medicare and Medicaid Services, a division of the U.S. Department of Health and
Human Services. Medicaid is a means-tested health and medical services program
for certain individuals and families w ith low incomes and few resources. Although
the States are the final deciders of w hat their Medicaid plans provide, there are
some mandatory federal requirements that must be met by the States in order to
receive federal matching funds, and some of the requirements could be such as:
prenatal care, vaccines for children, or X-ray services. Medicare instead is a
Federal health insurance program that pays for hospital and medical care for
elderly and certain disabled Americans. It is divided in tw o parts that could give
more flexibility w ith prescriptions drugs and so forth, also because it is mainly
designed for elderly people. The strategies they use for both is simply by hitting
the target of people’s age w hich that ease the category and cost to allocate to the
individuals all over the US.
Question 3. 3. (TCO D) Describe the characteristics and demographics of uninsured populations.
This study source was downloaded by 100000829957125 from CourseHero.com on 03 -03-2022 18:26:59 GMT -06:00
https://www.coursehero.com/file/14560717/HSM-541-Week-4-Midterm/
1. (TCO A) Briefly discuss how characteristics of individuals or populations may influence utilization of
health services. Discuss how these characteristics impact access, costs, and quality. Use an example to
support your point(s). (Points : 25)
Many countries striving to achieve universal health insurance coverage have done
so by means of multiple health insurance funds covering different population
groups. How ever, existence of multiple health insurance funds may also cause
variation in access to health care, due to the differential revenue raising capacities
and benefit packages offered by the various funds resulting in inequity and
inefficiency w ithin the health system. Recent studies have suggested that factors
related to the characteristics of communities could be important determinants of
access to health care in addition to characteristics of individuals living in urban
areas and the overall availability of health care services. Presently, there is
considerable interest in geographical variations in health and the effect of context
on health related problems. Studies on health behavior need to emphasize
structural constraints as w ell as personal choices. Individuals are affected by the
social, cultural, economic or physical factors acting at macro and micro levels. We
have defined access as the opportunity to identify healthcare needs, to seek
healthcare services, to reach, to obtain or use health care services and to actually
have the need for services fulfilled. In addition, there is a need for more research
examining the variability of access from both supply and demand-sides and
looking at the influence of local health systems and patients’ characteristics.
Question 2. 2. (TCO D) Describe two state or federal programs that provide health insurance benefits to
a specific population. Detail at least two strategies used by either agency to manage access, costs, or
quality. (Points : 20)
Medicaid and Medicare are tw o governmental programs that provide medical and
health-related services to specific groups of people in the United States. Although
the tw o programs are very different, they are both managed by the Centers for
Medicare and Medicaid Services, a division of the U.S. Department of Health and
Human Services. Medicaid is a means-tested health and medical services program
for certain individuals and families w ith low incomes and few resources. Although
the States are the final deciders of w hat their Medicaid plans provide, there are
some mandatory federal requirements that must be met by the States in order to
receive federal matching funds, and some of the requirements could be such as:
prenatal care, vaccines for children, or X-ray services. Medicare instead is a
Federal health insurance program that pays for hospital and medical care for
elderly and certain disabled Americans. It is divided in tw o parts that could give
more flexibility w ith prescriptions drugs and so forth, also because it is mainly
designed for elderly people. The strategies they use for both is simply by hitting
the target of people’s age w hich that ease the category and cost to allocate to the
individuals all over the US.
Question 3. 3. (TCO D) Describe the characteristics and demographics of uninsured populations.
This study source was downloaded by 100000829957125 from CourseHero.com on 03 -03-2022 18:26:59 GMT -06:00
https://www.coursehero.com/file/14560717/HSM-541-Week-4-Midterm/
