Public Health 200 Final Exam Actual Questions And 100% Verified Correct Detailed Answers.

10 essential public health services - correct answer 1) MONITOR population health status to identify an solve community health problems 2) DIAGNOSE and investigate health problems and hazards in community 3) INFORM AND EDUCATE people about health issues 4) MOBILIZE COMM. PARTNERSHIPS and action to identify health problems 5) DEVELOP POLICIES and plans that support individual and community health efforts 6) ENFORCE laws that protect health and safety 7) LINK people to needed personal health services and assure provision of healthcare 8) ASSURE competent public and personal health workforce 9) EVALUATE effectiveness, accessibility, quality 10) CONDUCT RESEARCH for new insights and solutions to problems Types of Healthcare Services - correct answer Primary care Specialty care Subspecialty services (e.g., neurosurgery; gynecological cancer) Diagnostic services Treatment: medical and surgical (procedures) Mental health/behavioral health care Pharmaceutical care Dental Vision Occupational health assessments/services Physical therapy Rehabilitation Long-term care End of life care: Palliative care/hospice Clinical Workforce - correct answer Physicians, surgeons, physician assistants Nurses: Nurse practitioners, RNs, LPNs, aides Dentists, podiatrists, optometrists, chiropractors, naturopaths, etc. Pharmacists, physical therapists, nutritionists, etc. Psychologists, social workers, case managers, patient educators, etc. Amount of specialty physicians vs. primary care physicians - correct answer Specialty: ~ 65 per 100,000 population Primary: ~ 45 per 100,000 Primary care physician shortage: trends, reasons, and consequences - correct answer -Dropped sharply from -Slight increase from 2009 Reasons/consequences: -Not as high-paying, prestigious, exciting -Not enough physicians for aging baby boomer population -Not enough physicians for newly insured people under federal health care law Nursing shortage trends - correct answer -Average age of nursing workforce is getting older (44 years) -During the last decade, 20,000 nurses retired per year -After 2020, that number will be 80,000 per year -The supply of nurses is projected to increase after 2020 -Even so, shortage is forecasted through the Baby Boom years Assurance/Oversight in the health system - correct answer -Accreditation of training programs -Licensure/professional standards -Laboratory safety/quality standards -Quality of care protocols and systems -Radiation safety standards -FDA: Drug regulations -Facility safety regulations -Certificate of need laws Governance in the healthcare system - correct answer -Executive and administrative leadership -Boards of directors/trustees Trends in Percent Uninsured - correct answer -Was 14% in 2008 -Rose to 18% in 2013 -Fell to 11% in 2016 Healthcare Access Safety Net - correct answer Publicly funded healthcare which can be accessed by uninsured people. Includes: -local clinics : provide vaccines and preventative services -Family planning clinics -school-based health centers -Community health centers Medicare Eligibility - correct answer -People 65 and older -People of any age who have kidney failure -People who are disabled/cannot work Medicaid Eligibility - correct answer Low income.... -Children under 19 -Pregnant women -65+ -Blind/disables -People who need nursing home care Dual Eligibility (Medicare and Medicaid) - correct answer -Low income people who are disabled and cant work -Low income 65+ Medicare - correct answer -1965 amendment to the social security act of 1935 -Social insurance for elderly and disabled -Defined benefit plan with no limit on annual spending -Covers 55 million people -Age 65+ Medicaid's roles in our health system - correct answer -Coverage for 33 million children and 19 million adults in low-income families; 16 million elderly and people w/ disabilities -Long-term care assistance (1.5M institutional residents and 2.9M community based residents) -Support for healthcare system and safety net (16% of national health spending; half of long term care spending) -State capacity for health coverage Shares of federal budget (Medicare, Medicaid, soc. security) - correct answer Medicare: 15% Medicaid: 10% Social security: 24% Structural flaws of the US healthcare system - correct answer -"Fee for service" system -Organization of services; "paradox of excess and deprivation" -Insurance coverage of the population; health insurance is connected w/ employment and not available to everyone *Healthcare system exacerbates and creates social inequalities in health ACA Health Insurance Industry Reform - correct answer -"Guaranteed issue"— cannot -exclude people with pre-existing conditions -No rescission - cannot kick sick people off of their plans -No annual or lifetime caps -Can cover dependents up to 26 years old -Effective clinical preventive services must be offered at no charge to patients ACA Essential health benefits package - correct answer -Essential Health Benefits Package -Minimum required set of services to be covered -Includes: Outpatient care, hospitalization, emergency services, maternity and newborn care, pediatric care; mental health and addiction treatment, prescription drugs; rehab services and devices; laboratory services; clinical preventive services ACA Limit on Annual Out-of-Pocket Spending - correct answer Individual: $6,600 Family: $13,200 ACA Insurance Industry Rates - correct answer -Federal government can regulate insurance company rate increases and unfair practices. -Health insurance companies must spend 80-85% of premiums on health care (medical loss ratio) -Insurance companies are already sending rebates to consumers when they fail to meet these standards. Massachusetts Individual Mandate of 2006 - correct answer -Governor Mitt Romney (R) championed the reform Provisions: -health insurance mandate -employer coverage mandate -free health insurance for those 150% of the federal poverty level -subsidized insurance for others -Health Insurance Connector -Romney: Should be left to the states, not mandated by federal government Penalties for not purchasing plan under ACA individual mandate Who gets exempt/subsidies? - correct answer -Penalty was $95 or 1% of income in 2014; -Penalty was $325 or 2% of income in 2015; -Increased to $695 or 2.5% of income in 2016 -Exemptions: financial hardship, those who don't pay Social Security for religious reasons, Indian tribes, unauthorized immigrants, uninsured for period of less than 3 months, etc. -In June 2012, Supreme Court ruled this is a TAX and constitutional -Subsidies and tax credits to households below 250% of FPL and premium tax credits for households between 251% and 400% FPL ACA Insurance Marketplaces (exchanges) - correct answer -Individuals and small employee groups can purchase private insurance plans through insurance marketplaces (at state level through federal exchange). -Cost varies by actuarial value: % of expected expenses that plan covers -All health insurance plans offered through marketplaces must be "qualified health plans" and meet actuarial value levels -Funding for "Navigators" to help people choose plans -Supreme Court ruling (June, 2015): Tax credits OK for federal exchange ACA Cost-sharing reductions - correct answer -Under ACA, Federal government provides extra subsidies for low-income people buying Silver plans to increase actuarial value -Actuarial value: Percent of anticipated costs consumer will cover -Referred to as "extra savings" to consumers -Subsidies are available to families at or below 250% FPL to protect them from high out-of-pocket costs ACA Medicaid Expansion (How many states adopted?) - correct answer Before ACA, very few states offered Medicaid coverage to people without extremely low incomes AND categorical qualification (cognitive or physical disability, certain diseases, pregnancy) Mandated Expansion: Medicaid will cover everyone under 133% of FPL, including childless adults (12-20 million people) Feds cover 100% of costs for newly eligible (2014-17), then 95% (2018-19), then 90% of costs after 2020 Reauthorized Children's Health Insurance Plan (CHIP) until 2019 -Court ruled that federal govt. cannot mandate state Medicaid expansion **Adopted by 32 states Healthy Michigan Plan - correct answer -3rd Republican state to expand Medicaid -Market-oriented reforms -Cost-sharing -Financial incentives -Health-savings accounts