QUESTIONS AND CORRECT VERIFIED ANSWERS
(complete solutions) ASSURED SUCCESS/GRADED
A+!!!
Nonmarketability of risks - answer-Inherent I medicine and medical practice
health insurance.
Moral hazard - answer-behaving differently when you know someone else is
taking the risk (induced demand)
Adverse selection - answer-The sicker people likely want more insurance (the
healthier, less)
Pooling of risk - answer-Sharing risk proportionately among many is a basic
insurance concept
Managed Care Organization (MCO) - answer-United health group is the largest
in 2017
About 66% - answer-of people under the age of 65 are covered through Private
Insurance
,About 11% - answer-of people under the age of 65 were uninsured in 2017.
(Self-pay or self-insured) (unassigned, no doctor)
About 8% - answer-of people under the age of 65 were uninsured in 2019
Out of pocket health care payments for insured patients are - answer-•
Copayments
• Coinsurance
• Deductibles
Copayments - answer-• Tend to decrease utilization- "First dollars" spent if
present
• Tiered copayment amounts tend to steer patients towards lower cost
products and services.
Coinsurance - answer-Intended to steer patients toward providers with lower
rates and / or less intense treatment (encouraging a patient to seek treatments
with lower cost rather than just fewer visits). This strategy relies on the
sophistication level of the patient.
*Example of Efficiency* - answer-As indicated by global cost for hospitalization
among seniors in the region.
Referents are either - answer-• Gold standard- a recognized "best
performance"
, •Benchmark- a starting point from which to begin the comparison (usually
implies "average", might even be mediocre)
Healthcare qualities is assessed in terms of - answer-• Structure
• Process
• Outcomes
Structure - answer-Materials, people , and characteristics of an organization
Financing health care in U.S. - answer-•Workarounds
•Redundancies
•Contradictions
(NHEA) - answer-National Health Expenditure Accounts
National health expenditures (NHE) - answer-All health care consumption and
investments in medical structures and equipment and non commercial health
services and biomedical research.