CHLH-455 Exam 1 Questions with verified answers
Acute Hospital Ans✓✓✓ Most patients stay less than 30 days
Adverse Selection Ans✓✓✓ Those most likely to need health insurance
are most likely to buy health insurance
Provisions: smokers pay more, pre-existing conditions
Capital (4 Cs) Ans✓✓✓ Funds used to acquire:
-Land
-Buildings
-Equipment
Capitation Ans✓✓✓ Based on people covered
Paid a fix amount per life covered for all care per period (by contract)
-per member per month (PMPM)
Case weight DRG Ans✓✓✓ 1.00 is average
values over 1.00 denote greater difficulty
values less than 1.00, less complicated
Cash (4 Cs) Ans✓✓✓ Must have sufficient cash on hand or be able to
raise it quickly to meet obligations
, Control (4 Cs) Ans✓✓✓ Assures fincances and physical resources are
being used widely to:
-Achieve mission
-Assure future operations
Cost (4 Cs) Ans✓✓✓ Measurement and minimization of cost
cost>revenue=doom
Disproportionate Share (DSH) Ans✓✓✓ Adjustment in serving high
numbers of medicaid and non-paying patients
Fee-for-service Ans✓✓✓ Based on service provided per encounter
Cost based- pay for cost (retrospective)
Charge based - per charge master
Prospective payment - per diagnosis (comorbidities)
For-profit Corporation Ans✓✓✓ Unlimited life, transfer of ownership is
easy, limited liability, double taxation, costly and hard to establish,
owners defined, residuals belong to owner, pay taxes
Healthcare Finance Ans✓✓✓ System society uses to pay for healthcare
services
Acute Hospital Ans✓✓✓ Most patients stay less than 30 days
Adverse Selection Ans✓✓✓ Those most likely to need health insurance
are most likely to buy health insurance
Provisions: smokers pay more, pre-existing conditions
Capital (4 Cs) Ans✓✓✓ Funds used to acquire:
-Land
-Buildings
-Equipment
Capitation Ans✓✓✓ Based on people covered
Paid a fix amount per life covered for all care per period (by contract)
-per member per month (PMPM)
Case weight DRG Ans✓✓✓ 1.00 is average
values over 1.00 denote greater difficulty
values less than 1.00, less complicated
Cash (4 Cs) Ans✓✓✓ Must have sufficient cash on hand or be able to
raise it quickly to meet obligations
, Control (4 Cs) Ans✓✓✓ Assures fincances and physical resources are
being used widely to:
-Achieve mission
-Assure future operations
Cost (4 Cs) Ans✓✓✓ Measurement and minimization of cost
cost>revenue=doom
Disproportionate Share (DSH) Ans✓✓✓ Adjustment in serving high
numbers of medicaid and non-paying patients
Fee-for-service Ans✓✓✓ Based on service provided per encounter
Cost based- pay for cost (retrospective)
Charge based - per charge master
Prospective payment - per diagnosis (comorbidities)
For-profit Corporation Ans✓✓✓ Unlimited life, transfer of ownership is
easy, limited liability, double taxation, costly and hard to establish,
owners defined, residuals belong to owner, pay taxes
Healthcare Finance Ans✓✓✓ System society uses to pay for healthcare
services
