ACTUAL EXAM 2024 QUESTIONS WITH DETAILED
VERIFIED ANSWERS /A+ GRADE ASSURED
Moral Hazard - ANSWER: When the act of insuring an event increases the likelihood
that the event will happen
behaving different when you know someone is taking the risk (induced demand)
Adverse Selection - ANSWER: the situation in which one party to a transaction takes
advantage of knowing more than the other party to the transaction
the sicker people likely want more insurance, compared to those who are healthy
Pooling of Risk - ANSWER: Allows individuals to share risk, i.e., insurance companies
National Health Expenditure Accounts (NHEA) - ANSWER: Provides official estimates
of health care spending in the US. It measures health care consumption and health
care investment.
NHEA Benefits - ANSWER: Comprehensive: includes all major components of health
care system in unified, mutually exclusive, and exhaustive structure
Multidimensional: encompasses expenditures as well as payers
Consistent: applies a common set of definitions that permits longitudinal
comparisons
Published by DHHS
Accounts in the NHEA - ANSWER: National Health Expenditures: NHE
Health Consumption Expenditures: HCE
Personal Health Care: PHC
National Health Expenditures: NHE - ANSWER: all health care consumption and
investments in medical structures and equipment and noncommercial health
services and biomedical research
NHE - HCE = Amount of investment in the medical sector of economy (buildings,
research, equipment)
Health Consumption Expenditures: HCE - ANSWER: a subset of NHE, includes
personal health care spending, government administration and net cost of private
health insurance and public health activities
, Personal Health Care: PHC - ANSWER: subset of HCE, including all medical goods and
service that's used to diagnose, treat, and prevent health problems of a specific
person
How much NHE spent on Health Care? - ANSWER: $3.49 Trillion
Per capita amount: over $10k
% of GDP: 18%
Buying Power: $1,200 when adjusted by CPI
Largest contributors to the Personal Health Care (PHC) - ANSWER: hospitalization,
physician services, Rx, other health care goods and services
What accounted for the largest share of NHE? - ANSWER: Hospital Care: 33% of
spending
Professional Services: 20% doctors NHE
Retail Rx: 10.5%
Three Categories of PHC increased as a share of NHE - ANSWER: Health Residential
and Personal Care: 5.2% of NHE
Net Cost of Private Health Ins: 6.6% of NHE
Home Health Care: 2.8% of NHE
Chronic Disease and Mental Health Diseases in NHE (percentage) - ANSWER: 90%
Among the top 5% of users account for about half of the spending
Medical Conditions and Parentages on Americans - ANSWER: 90% of Americans have
1 risk factor, 52% have 2 or more highest proportion in impoverished and
racial/ethnic minorities
Americans Stat on Health Ins Coverage - ANSWER: 92% of the US population have
some sort of ins (8% or 26.4 M uninsured)
Cost/Cost Plus - ANSWER: how hospitals/providers describe payments received for
services they have already provided. The organization tracks all the costs associated
with each customer and then asks to be paid that amount. Contracts specific that the
organization will be reimbursed for actual cost plus an additional percentage of cost
(includes built in profit)
How Money is Paid to Health Care Providers - ANSWER: Cost/Cost Plus
Time and Materials
Fee for Service
Fixed Price
Capitation
Value
Time and Materials - ANSWER: A contract type where the seller charges the
buyer for the time and the materials for the