HSM 502 Final
What are the three types of managed care plans? - ANS-a. HMOs
b. PPOs
c. Point of Service Plans
What are two reimbursement methods of managed care? - ANS-a. Capitation
b. Discounted rates
How many cents on the dollar must insurers spend on health care services versus
administrative cost according to the ACA? - ANS-a. 80% health care services, 20%
administrative cost
Which part of Medicare covers prescription drugs?
a. Part A
b. Part B
c. Part C
d. Part D - ANS-d. Part D
How long do the states that have expanded Medicaid receive 100% of federal funding for the
expansion? - ANS-a. 3 years
1. As of the beginning of 2016, what percent of Americans were uninsured?
a. 10.1%
b. 22.3%
c. 55.7%
d. 8.6% - ANS-d. 8.6%
1. What is the maximum penalty for not having insurance in 2016 according to the ACA?
a. 500
b. 10,050
c. 2,085
d. 5,550 - ANS-c. 2,085
1. What does HMO stand for?
a. Health Managed Organization
b. Health Care Manipulated Offers
c. Health Maintenance Organization
d. Hospital Medicaid Operations - ANS-c. Health Maintenance Organization
1. What method does Medicare use for reimbursements?
,a. Fee for Service
b. Diagnostic Related Groups
c. Capitation
d. Prospective Payment - ANS-b. Diagnostic Related Groups
Accreditation by the National Committee for Quality Assurance is mandatory. True or False -
ANS-a. False
1) Which of the following is not an objective of the IHI Triple Aim Triangle?
a. Experience of Care
b. Per Capita Cost
c. Health of a Population
d. All of the above are objects of the triangle - ANS-d. All of the above are objects of the
triangle
2) List one of the major factors that have shaped US Health Care. - ANS-Cultural beliefs and
values; Social/Political factors; Science and technology; economic force
3) Which of the following is not a key characteristic of the U.S Health Care System?
a. Technology-driven and focus on acute care
b. Low cost, equal access, and perfect market conditions
c. No central governing agency
d. Little integration and coordination - ANS-b. Low cost, equal access, and perfect market
conditions
What is the difference between market justice and social justice? - ANS-Market Justice is
based on people's willingness and ability to pay (economic good)
Social Justice emphasizes universal health care (social resource)
5) When you behave in a way that is not desired because risk is removed demonstrates which
insurance concept?
a. Risk Averse
b. Moral Hazard
c. Adverse Selection
d. None of the above - ANS-b. Moral Hazard
6) Which of the following key functions is not a part of the quad-function model?
a. Financing
b. Insurance
c. Delivery
d. Education - ANS-d. Education
7) What are the main elements of the systems framework model?
a. Systems Foundations
,b. System Resources
c. System Processes
d. System Outcomes
e. All of the above - ANS-e. All of the above
List an indicator of health. - ANS-Self-reported health status; life expectancy; morbidity; mental
well-being; social functioning; functional limitations; disability; spiritual well-being
9) In what era was the first successful organ transplant?
a. Pre Industrial Era
b. Post Industrial Era
c. Corporate Era
d. Health Care Reform Era - ANS-b. Post Industrial Era
10) Which of the following is not a major development of the Corporate Era?
a. Information Revolution
b. Affordable Care Act
c. Corporatization
d. Globalization - ANS-b. Affordable Care Act
1. The "Triple Aim" approach to healthcare delivery includes the following:
A. Per capita cost, experience of care, quality of delivery
B. Per capita cost, quality of delivery, health of a population
C. Health of a population, per capita cost, experience of care
D. Quality of delivery, health of a population, experience of care - ANS-C. Health of a
population, per capita cost, experience of care
2. What is the central governing agency that oversees healthcare in the United States?
A. The Department of Health and Human Services (DHHS)
B. The Food and Drug Administration (FDA)
C. Centers for Medicare & Medicaid Services (CMS)
D. CMS oversees Medicare & Medicaid services, and DHHS oversees all other aspects of
healthcare
E. There is no central governing agency that oversees healthcare in the United States - ANS-E.
There is no central governing agency that oversees healthcare in the United States
3. The Hill-Burton Act provided federal grants to states for the construction of new community
hospital beds. The target number of beds for every 1,000 people in the population is _______.
A. 10.5
B. 4.5
C. 6.5
, D. 16 - ANS-B. 4.5
4. Medicare Part ___ helps to cover the cost of prescription drugs.
A. A
B. B
C. C
D. D
E. There is no option for prescription drug coverage under Medicare - ANS-D. D
5. The DRG method (Diagnosis Related Group) is used to pay for which of the following
services:
A. Inpatient services
B. Outpatient services
C. Minute-Clinic services
D. Surgical services - ANS-A. Inpatient services
6. What country spends the highest percentage of it's GDP on healthcare? - ANS-United States
7. Which of the following does NOT qualify a person for Medicaid under Title 19 of the Social
Security Act of 1965?
A. Low-income families
B. Anyone 65 years or older
C. Indigent Individuals
D. Low-income elderly - ANS-B. Anyone 65 years or older
8. The total percentage of healthcare expenses incurred by the U.S. government is
approximately:
A. 43%
B. 76%
C. 24%
D. 13% - ANS-A. 43%
9. What are the 3 ways one can qualify for Medicare? - ANS-65 years or older, disabled, End
Stage Renal Disease (ESRD)
10. Compared to other developed countries, the U.S. healthcare system is:
A. Equal in access, low in cost
B. Unequal in access, high in cost
C. Unequal in access, low in cost
D. Equal in access, high in cost - ANS-B. Unequal in access, high in cost
What are the three types of managed care plans? - ANS-a. HMOs
b. PPOs
c. Point of Service Plans
What are two reimbursement methods of managed care? - ANS-a. Capitation
b. Discounted rates
How many cents on the dollar must insurers spend on health care services versus
administrative cost according to the ACA? - ANS-a. 80% health care services, 20%
administrative cost
Which part of Medicare covers prescription drugs?
a. Part A
b. Part B
c. Part C
d. Part D - ANS-d. Part D
How long do the states that have expanded Medicaid receive 100% of federal funding for the
expansion? - ANS-a. 3 years
1. As of the beginning of 2016, what percent of Americans were uninsured?
a. 10.1%
b. 22.3%
c. 55.7%
d. 8.6% - ANS-d. 8.6%
1. What is the maximum penalty for not having insurance in 2016 according to the ACA?
a. 500
b. 10,050
c. 2,085
d. 5,550 - ANS-c. 2,085
1. What does HMO stand for?
a. Health Managed Organization
b. Health Care Manipulated Offers
c. Health Maintenance Organization
d. Hospital Medicaid Operations - ANS-c. Health Maintenance Organization
1. What method does Medicare use for reimbursements?
,a. Fee for Service
b. Diagnostic Related Groups
c. Capitation
d. Prospective Payment - ANS-b. Diagnostic Related Groups
Accreditation by the National Committee for Quality Assurance is mandatory. True or False -
ANS-a. False
1) Which of the following is not an objective of the IHI Triple Aim Triangle?
a. Experience of Care
b. Per Capita Cost
c. Health of a Population
d. All of the above are objects of the triangle - ANS-d. All of the above are objects of the
triangle
2) List one of the major factors that have shaped US Health Care. - ANS-Cultural beliefs and
values; Social/Political factors; Science and technology; economic force
3) Which of the following is not a key characteristic of the U.S Health Care System?
a. Technology-driven and focus on acute care
b. Low cost, equal access, and perfect market conditions
c. No central governing agency
d. Little integration and coordination - ANS-b. Low cost, equal access, and perfect market
conditions
What is the difference between market justice and social justice? - ANS-Market Justice is
based on people's willingness and ability to pay (economic good)
Social Justice emphasizes universal health care (social resource)
5) When you behave in a way that is not desired because risk is removed demonstrates which
insurance concept?
a. Risk Averse
b. Moral Hazard
c. Adverse Selection
d. None of the above - ANS-b. Moral Hazard
6) Which of the following key functions is not a part of the quad-function model?
a. Financing
b. Insurance
c. Delivery
d. Education - ANS-d. Education
7) What are the main elements of the systems framework model?
a. Systems Foundations
,b. System Resources
c. System Processes
d. System Outcomes
e. All of the above - ANS-e. All of the above
List an indicator of health. - ANS-Self-reported health status; life expectancy; morbidity; mental
well-being; social functioning; functional limitations; disability; spiritual well-being
9) In what era was the first successful organ transplant?
a. Pre Industrial Era
b. Post Industrial Era
c. Corporate Era
d. Health Care Reform Era - ANS-b. Post Industrial Era
10) Which of the following is not a major development of the Corporate Era?
a. Information Revolution
b. Affordable Care Act
c. Corporatization
d. Globalization - ANS-b. Affordable Care Act
1. The "Triple Aim" approach to healthcare delivery includes the following:
A. Per capita cost, experience of care, quality of delivery
B. Per capita cost, quality of delivery, health of a population
C. Health of a population, per capita cost, experience of care
D. Quality of delivery, health of a population, experience of care - ANS-C. Health of a
population, per capita cost, experience of care
2. What is the central governing agency that oversees healthcare in the United States?
A. The Department of Health and Human Services (DHHS)
B. The Food and Drug Administration (FDA)
C. Centers for Medicare & Medicaid Services (CMS)
D. CMS oversees Medicare & Medicaid services, and DHHS oversees all other aspects of
healthcare
E. There is no central governing agency that oversees healthcare in the United States - ANS-E.
There is no central governing agency that oversees healthcare in the United States
3. The Hill-Burton Act provided federal grants to states for the construction of new community
hospital beds. The target number of beds for every 1,000 people in the population is _______.
A. 10.5
B. 4.5
C. 6.5
, D. 16 - ANS-B. 4.5
4. Medicare Part ___ helps to cover the cost of prescription drugs.
A. A
B. B
C. C
D. D
E. There is no option for prescription drug coverage under Medicare - ANS-D. D
5. The DRG method (Diagnosis Related Group) is used to pay for which of the following
services:
A. Inpatient services
B. Outpatient services
C. Minute-Clinic services
D. Surgical services - ANS-A. Inpatient services
6. What country spends the highest percentage of it's GDP on healthcare? - ANS-United States
7. Which of the following does NOT qualify a person for Medicaid under Title 19 of the Social
Security Act of 1965?
A. Low-income families
B. Anyone 65 years or older
C. Indigent Individuals
D. Low-income elderly - ANS-B. Anyone 65 years or older
8. The total percentage of healthcare expenses incurred by the U.S. government is
approximately:
A. 43%
B. 76%
C. 24%
D. 13% - ANS-A. 43%
9. What are the 3 ways one can qualify for Medicare? - ANS-65 years or older, disabled, End
Stage Renal Disease (ESRD)
10. Compared to other developed countries, the U.S. healthcare system is:
A. Equal in access, low in cost
B. Unequal in access, high in cost
C. Unequal in access, low in cost
D. Equal in access, high in cost - ANS-B. Unequal in access, high in cost
