HCSA MODULE 1 EXAM | 108 QUESTIONS |
WITH COMPLETE SOLUTIONS!!
What are the 2 primary objectives that an acceptable healthcare delivery
system should have? Answer - 1. Enable all citizens to obtain needed health
care services - access
2. Deliver services that are cost-effective and meet certain pre-established
standards of quality.
What are the 4 functional components in the Quad-Function Model? What are
they each used for? Answer - 1. Financing - used to purchase insurance or pay
for healthcare services consumed
2. Insurance - to protect against catastrophic risk
3. Delivery - to provide health care services
4. Payment - to reimburse providers for services delivered
What are the 2 groups that insurance can be divided into? Answer - 1. Private -
Employer-based health insurance & privately purchased health insurance
2. Public - Government programs
True/False
A true system of delivery does not exist Answer - True
True/False
Americans are not automatically covered by health insurance Answer - True
,The health care system is ____________. Answer - fragmented
What are 5 characteristics of the US healthcare system? Answer - 1. Multiple
financial arrangements for health services
2. Numerous insurance agencies or MCO's
3. Multiple payers that determine way they pay for services
4. Diverse array of settings
5. Numerous consulting firms
True/False
The US consumes less health care services as a proportion of its total economic
output than any other country in the world. Answer - False - more
What was the main objective of the Patient Protection and Affordable Care Act
of 2010 (ACA)? Answer - The reduce the number of uninsured
What are the 3 goals of Managed Care Organization (MCO)? Answer - 1. Seeks
to achieve efficiencies by integrating the basic functions of healthcare delivery
2. Employs mechanisms to control (manage) utilization of medical services
3. Determines the price of services, and how much providers are paid
What does MCO offer? Answer - Employer contracts with MCO that offer an
insurance plan or health plan to employees. The health plan uses select
providers for enrollees to choose from.
What did MCO accomplish? Answer - Cost-control and greater integration of
health care delivery.
, The US has no ______________ to govern the system. Answer - central agency
The ability of an individual to obtain health care services when needed. Answer
- Access
What kind of market is the US considered to have? What are the
consequences? Answer - Imperfect (quasi) market; Consequences include
moral hazard (increased utilization when covered by insurance) and supplier-
induced demand.
The US is only partially a what? Answer - Free market
Quantity of service demanded will increase as the price is lowered for a
product or service. Answer - Free market
What does a free market require? Answer - Adequate information; patients
and providers can act independently
What was created by providers to create an artificial demand? Answer -
Supplier-induced demand
With third party insurers and multiple payers, insurance becomes a(n)
________________ _________________. This results in what? Answer -
Intermediary function; higher administrative costs
What type of payer system does the US have? What does this cause? Answer -
Multiple; Makes the system more cumbersome and causes the US to spend the
most in administrative costs (
WITH COMPLETE SOLUTIONS!!
What are the 2 primary objectives that an acceptable healthcare delivery
system should have? Answer - 1. Enable all citizens to obtain needed health
care services - access
2. Deliver services that are cost-effective and meet certain pre-established
standards of quality.
What are the 4 functional components in the Quad-Function Model? What are
they each used for? Answer - 1. Financing - used to purchase insurance or pay
for healthcare services consumed
2. Insurance - to protect against catastrophic risk
3. Delivery - to provide health care services
4. Payment - to reimburse providers for services delivered
What are the 2 groups that insurance can be divided into? Answer - 1. Private -
Employer-based health insurance & privately purchased health insurance
2. Public - Government programs
True/False
A true system of delivery does not exist Answer - True
True/False
Americans are not automatically covered by health insurance Answer - True
,The health care system is ____________. Answer - fragmented
What are 5 characteristics of the US healthcare system? Answer - 1. Multiple
financial arrangements for health services
2. Numerous insurance agencies or MCO's
3. Multiple payers that determine way they pay for services
4. Diverse array of settings
5. Numerous consulting firms
True/False
The US consumes less health care services as a proportion of its total economic
output than any other country in the world. Answer - False - more
What was the main objective of the Patient Protection and Affordable Care Act
of 2010 (ACA)? Answer - The reduce the number of uninsured
What are the 3 goals of Managed Care Organization (MCO)? Answer - 1. Seeks
to achieve efficiencies by integrating the basic functions of healthcare delivery
2. Employs mechanisms to control (manage) utilization of medical services
3. Determines the price of services, and how much providers are paid
What does MCO offer? Answer - Employer contracts with MCO that offer an
insurance plan or health plan to employees. The health plan uses select
providers for enrollees to choose from.
What did MCO accomplish? Answer - Cost-control and greater integration of
health care delivery.
, The US has no ______________ to govern the system. Answer - central agency
The ability of an individual to obtain health care services when needed. Answer
- Access
What kind of market is the US considered to have? What are the
consequences? Answer - Imperfect (quasi) market; Consequences include
moral hazard (increased utilization when covered by insurance) and supplier-
induced demand.
The US is only partially a what? Answer - Free market
Quantity of service demanded will increase as the price is lowered for a
product or service. Answer - Free market
What does a free market require? Answer - Adequate information; patients
and providers can act independently
What was created by providers to create an artificial demand? Answer -
Supplier-induced demand
With third party insurers and multiple payers, insurance becomes a(n)
________________ _________________. This results in what? Answer -
Intermediary function; higher administrative costs
What type of payer system does the US have? What does this cause? Answer -
Multiple; Makes the system more cumbersome and causes the US to spend the
most in administrative costs (
