HSC 111 Final Exam Questions and Correct Answers, With Complete Solution 2024.

HSC 111 Final Exam Questions and Correct Answers, With Complete Solution 2024. What is the central role of health services financing in the United States? a. Fund health insurance b. Underwrite medical risk c. Support managed care d. Balance the supply of health care professionals a. Fund health insurance What is the primary mechanism that enables people to obtain health care services? a. Availability of services b. Health insurance c. Payment for services d. Control of expenditures b. Health insurance The phenomenon called 'moral hazard' results directly from a. the uninsured status of segment of the U.S. population b. inadequate payment to providers c. managed care enrollment d. health insurance coverage d. health insurance coverage Controlling total health care expenditures by restricting financing for health insurance. a. top-down control b. demand-side rationing c. underwriting d. underutilization b. demand-side rationing IN national health care systems, total expenditures are controlled mainly through a. cost shifting b. underwriting c. supply-side rationing d. demand-side rationing c. supply-side rationing In a general sense, what is the primary purpose of insurance? a. Predicting risk b. Risk assessment c. Protection against risk d. Underwriting c. Protection against risk Private health insurance is also referred to as a. mandatory health insurance b. public insurance c. employee health insurance d. voluntary health insurance d. voluntary health insurance Under community rating a. premiums are based on risk rating b. premiums are based on a group's utilization of health care services c. high-risk individuals pay a higher premium that low-risk individuals d. both high-risk and low-risk people are charged the same premium d. both high-risk and low-risk people are charged the same premium Which method of risk assessment is required by the ACA for individual and small-group health insurance? a. experience rating b. pure community rating c. adjusted community rating d. risk selection c. adjusted community rating Under experience rating, a. costs shift from people in poor health to people in good health b. favorable risk groups pay a lower premium than high-risk groups c. premiums rise for every one regardless of risk d. deductibles and copayments are eliminated b. favorable risk groups pay a lower premium than high-risk groups What is the main advantage of group insurance? a. More people can obtain insurance from a single insurer b. Risk is spread out among a large number of insured c. More comprehensive services can be covered than under an individual plan d. The employer has to deal with only one insurance company b. Risk is spread out among a large number of insured Cost is shifted from people in poor health to the healthy when a. premiums are based on experience rating b. people purchase individual private health insurance policies instead of group policies c. first-dollar coverage is predominant d. premiums are based on community rating d. premiums are based on community rating A health insurance plan pays for medical care only after the insured has first paid $1,000 out of pocket on an annual basis. The $1,000 annual cost is called a. first-dollar coverage b. coinsurance c. premium d. deductible d. deductible A copayment is generally paid a. once a year b. each time the insured receives health care services c. in form of a deduction from payroll checks d. by the employer to purchase health insurance on behalf of each covered employee b. each time the insured receives health care services Medigap policies are sold by a. private insurance companies b. the government c. HMO's d. Medicare a. private insurance companies The ACA specifies that ___________ can be covered under their parents' health insurance plans. a. Children attending college b. Children who are unemployed c. Children up to the age of 19 d. Children under the age of 26 d. Children under the age of 26 How are preexisting medical conditions covered under the Affordable Care Act? a. They will continue to be covered under a special federal program. b. States are mandated to have risk pools to cover preexisting conditions. c. Private insurance plans have to cover them starting 2014. d. There is no provision in the law to cover preexisting conditions. c. Private insurance plans have to cover them starting 2014. In general, how do bronze, silver, gold, and platinum health plans differ? a. They differ according the benefits offered. b. They differ according to cost sharing c. They differ according to both benefits and cost sharing d. They differ according to the length of service with an employer b. They differ according to cost sharing The majority of beneficiaries receiving health care through Medicare are a. elderly b. disabled c. financially poor d. those suffering from end-stage renal disease a. elderly To finance Medicare Part A, a. enrollees are required to pay a subsidized premium b. only employers are required to pay a payroll tax c. all income earned by a working person is subject to Medicare tax d. employee wages are taxed up to a certain ceiling that is raised each year c. all income earned by a working person is subject to Medicare tax Skilled nursing care is covered under ____________ of Medicare. a. Part A b. Part B c. Part C d. Part D a. Part A The HI portion of Medicare is financed through a. Premiums from enrollees b. General taxes c. Payroll taxes d. None of the above c. Payroll taxes For Medicare beneficiaries, the maximum stay in a SNF during a benefit period cannot exceed a. 30 days b. 60 days c. 100 days d. None of the above c. 100 days For hospitalizations, Medicare beneficiaries must pay a deductible a. each time they are admitted to a hospital b. once per benefit period c. on discharge from a hospital d. None of the above b. once per benefit period Medicare Part B premiums are a. standard for everyone b. market-based c. income-based d. None of the above c. income-based SMI provides a. hospital coverage b. skilled nursing facility coverage c. prescription drugs d. physician services d. physician services Part C of Medicare specifically covers a. rehabilitation services b. preventive care c. prescription drugs d. none of the above d. none of the above The primary criterion to become eligible for Medicaid is a. age b. medical necessity c. financial status d. family emergency c. financial status The insurance arm of military health care is called a. CHAMPUS b. VISN