HCMG EXAM QUESTIONS AND ANSWERS LATEST
EDITION ALREADY GRADED A+
What is another extreme model for paying physicians? What is this?
a salary
insurer pays FFS to hospital/group who collects it all and then pays the doctor a salary
The main source of HC revenue was from which payment model (2016)?
fee for service
why is collecting data on the revenue of physicians difficult?
because doctors don't really understand which payment model they are using
two crucial lessons learned in physician payment from CMMI
1. voluntary participation in almost all models
2. benchmarking is crucial for determining if costs go up or down
in the NJ hospital Medicare pilot program study, what was the role of the bonus, and what was the
finding?
the bonuses were supposed to counteract volume incentives in FFS, but found they did not actually
decrease costs or quantity of services.
instead, doctors responded by sorting patients and changing admissions decisions
why have there not been large savings from switching from FFS to APM
complexities involve, dealing with various targets from the different insurers, selection into voluntary
programs, not enough of revenue at risk
T/F: Hosptials have 24/7 Nursing care
true
How did covid contribute to the current perception of nurses?
frontline workers were risking their lives everyday, burnout photos and articles passed around, really
saw how hard they worked
Describe the history of nursing (1873, 1920, 1930, 1983, 1990s)
1873 and onward: Nursing students would provide labor to hospitals in exchange for education
1920: at this point, 800 hospitals ran on that model (beneficial to hospitals bc didn't have to pay staff)
- huge bulk of care was FREE labor
- about 80% of graduate nurses worked in the private sectors because hospitals would not hire them
, that model started to change as sicknesses increased because there was a need for more specialized
care.
- nursing education began moving to academic settings (schools)
- hospitals tried to push back on this change since they then had to pay graduate nurses
1930: Nursing shortage! Horrible working conditions so hospitals had troubling hiring/retaining
1983: major change in hospital financing! Move from FFS to PPS (perspective payment system - like
bundled payments)
1990s: nursing shortage again
- so J&J put forth a $50 million campaign (ads) to inspire young ppl to go into nursing
what is/was the complex issue for payment inequalities between nurses and physicians?
physicians got paid FFS, but nurses did not
Rank the nursing degrees in increasing qualification
CNA < LPN < ADN < BSN < MSN < DNP
How did finances change in 1983 for nurses?
FFS --> PPS
- hospitals incentivized to do perspective payment systems because they could choose less expensive
services to retain more of the bundled payment.
- hospitals hired lower wage nurses (LPNs and CNAs and got rid of RNs because they were more $$)
Out of Canada, the UK, USA, and Sweden, which country has the most nurses?
USA, then Sweden, then Canada, then UK as of 2020 (but only UK and Canada are positive slopes)
Are nurses quitting?
yes, but not JUST nurses The trend follows same as other professions in health care as well -- its all
about framing/selective reporting
When was there max turnover rate during covid for health care professionals?
Postperiod 1 - during April-Dec 2020
What are some causes for high turnover rates for nurses?
Poor working conditions (so not a shortage of nurses, but rather a shortage of nursing care since bad
working environment - high patient volume)
Burnout
Issues patients face from poor working conditions for nurses
EDITION ALREADY GRADED A+
What is another extreme model for paying physicians? What is this?
a salary
insurer pays FFS to hospital/group who collects it all and then pays the doctor a salary
The main source of HC revenue was from which payment model (2016)?
fee for service
why is collecting data on the revenue of physicians difficult?
because doctors don't really understand which payment model they are using
two crucial lessons learned in physician payment from CMMI
1. voluntary participation in almost all models
2. benchmarking is crucial for determining if costs go up or down
in the NJ hospital Medicare pilot program study, what was the role of the bonus, and what was the
finding?
the bonuses were supposed to counteract volume incentives in FFS, but found they did not actually
decrease costs or quantity of services.
instead, doctors responded by sorting patients and changing admissions decisions
why have there not been large savings from switching from FFS to APM
complexities involve, dealing with various targets from the different insurers, selection into voluntary
programs, not enough of revenue at risk
T/F: Hosptials have 24/7 Nursing care
true
How did covid contribute to the current perception of nurses?
frontline workers were risking their lives everyday, burnout photos and articles passed around, really
saw how hard they worked
Describe the history of nursing (1873, 1920, 1930, 1983, 1990s)
1873 and onward: Nursing students would provide labor to hospitals in exchange for education
1920: at this point, 800 hospitals ran on that model (beneficial to hospitals bc didn't have to pay staff)
- huge bulk of care was FREE labor
- about 80% of graduate nurses worked in the private sectors because hospitals would not hire them
, that model started to change as sicknesses increased because there was a need for more specialized
care.
- nursing education began moving to academic settings (schools)
- hospitals tried to push back on this change since they then had to pay graduate nurses
1930: Nursing shortage! Horrible working conditions so hospitals had troubling hiring/retaining
1983: major change in hospital financing! Move from FFS to PPS (perspective payment system - like
bundled payments)
1990s: nursing shortage again
- so J&J put forth a $50 million campaign (ads) to inspire young ppl to go into nursing
what is/was the complex issue for payment inequalities between nurses and physicians?
physicians got paid FFS, but nurses did not
Rank the nursing degrees in increasing qualification
CNA < LPN < ADN < BSN < MSN < DNP
How did finances change in 1983 for nurses?
FFS --> PPS
- hospitals incentivized to do perspective payment systems because they could choose less expensive
services to retain more of the bundled payment.
- hospitals hired lower wage nurses (LPNs and CNAs and got rid of RNs because they were more $$)
Out of Canada, the UK, USA, and Sweden, which country has the most nurses?
USA, then Sweden, then Canada, then UK as of 2020 (but only UK and Canada are positive slopes)
Are nurses quitting?
yes, but not JUST nurses The trend follows same as other professions in health care as well -- its all
about framing/selective reporting
When was there max turnover rate during covid for health care professionals?
Postperiod 1 - during April-Dec 2020
What are some causes for high turnover rates for nurses?
Poor working conditions (so not a shortage of nurses, but rather a shortage of nursing care since bad
working environment - high patient volume)
Burnout
Issues patients face from poor working conditions for nurses
