Management for Nurses and Nurse Leaders, Third
Edition Penner
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, Test Bank for
ECONOMICS AND FINANCIAL
MANAGEMENT FOR NURSES AND
NURSE LEADERS
Third Edition
Susan J. Penner, DrPH, MN,
MPA, RN, CNL
ISBN: 978-0-8261-6007-2
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ISBN: 978-0-8261-6007-2
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, Contents
1. Economics of Health Care
2. Health Insurance and Reimbursement
3. Managed Care and ACOs
4. Measuring Nursing Care
5. Reporting and Managing Budgets
6. Budget Planning
7. Special Purpose, Capital, and Other Budgets
8. Cost Finding, Break Even, and Charges
9. Comparing Costs and Benefits
10. Writing a Business Plan
11. Health Program Grant Writing
12. Assessing Financial Health
13. Entrepreneurship and Practice Management
14. Ethical Issues and International Health Care Systems
15. Health Policy and Future Trends
Copyright © Springer Publishing Company, LLC. All Rights Reserved. 1
, CHAPTER 1
Economics of Health Care
1. Health care is an important segment of the U.S. economy because
a. The greater the quantity of hip replacements, the fewer the automobiles supplied.
b. Nurses keep fighting for higher and higher wages.
c. Health care costs have been completely controlled by managed care.
d. National health care expenditures are an increasing portion of the GDP.
2. Two influences that increase the quantity of health care demanded include
a. Income and insurance.
b. Ancient history and monopsony.
c. Hospital revenue and transparency.
d. Market power and market failure.
3. Which of the following is NOT a characteristic of a market surplus?
a. The product’s market price is higher than the equilibrium price.
b. Producers reduce the product’s price to bring the market to competitive equilibrium.
c. The quantity demanded for the product exceeds the quantity supplied.
d. The quantity supplied exceeds the quantity demanded by consumers.
4. One purpose of a union is
a. To guarantee that all nurses have jobs.
b. To influence the market power of nurse employers.
c. To ensure that nurses are assigned only three patients per shift.
d. To allow hospitals to pay nurses based only on seniority.
5. One effective way to resolve a nursing shortage is
a. Replace all RNs with nurse assistants.
b. Ask physicians to write fewer orders.
c. Increase nurses’ wages.
d. Close hospitals.
6. Concerns about health care costs arose
a. Soon after the passage of Medicare and Medicaid.
b. At the dawn of human history.
c. As a result of World War II shortages.
d. When U.S. health care costs surpassed 15% of GDP.
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,7. The price for a good or service falls. What likely happens to the quantity supplied?
a. Increases.
b. Levels off.
c. Is not affected by price.
d. Decreases.
8. A good example of an input is
a. A nurse giving care to a patient who is hospitalized.
b. A patient arriving at the emergency room needing care.
c. A patient leaving a clinic after seeing a nurse practitioner.
d. A hospital building a new surgical center.
9. One reason health care markets are not competitive is that
a. There are often no suitable substitutes.
b. Health care markets are based on communist theory.
c. No one can enter or leave a health care market.
d. The prices for medical care are too high.
10. An example of public goods is
a. A federal holiday.
b. Social Security taxes.
c. Market equilibrium.
d. Safe drinking water.
Answer key Chapter. 1 1d, 2a, 3c, 4b, 5c, 6a, 7d, 8b, 9a, 10d
Copyright © Springer Publishing Company, LLC. All Rights Reserved. 3
, CHAPTER 2
Health Insurance and Reimbursement
1. What is an important characteristic of asymmetric information in health care markets?
a. Physicians always know more about a patient’s condition than the patient.
b. Patients always know more about their condition than the physician.
c. One party has knowledge that the other party does not.
d. One party has to pay the other party for information.
2. Americans who do not have health insurance not only face increased health risks, but
a. They face financial risks such as credit problems and bankruptcy.
b. They are always poor and unemployed.
c. They should stop trying to obtain preventive care.
d. They are automatically enrolled in Medicaid.
3. Nearly a third of U.S. health expenditures
a. Are allocated to the care of children.
b. Go to support hospital services.
c. Fund public health programs.
d. Are spent on pharmaceuticals.
4. An example of cost shifting is
a. Requiring health plan members to pay an annual premium.
b. Finding ways to reduce waste and improve the collection of payments.
c. Dropping out of one health plan because another plan seems better.
d. Charging private payers more to cover other unreimbursed costs.
5. Coinsurance represents the percent of health costs the insurer requires the consumer to pay, while
a. Deductibles have been outlawed by the ACA.
b. A lifetime cap is required to control excessive costs.
c. A co-payment is another form of cost sharing.
d. Cost sharing is not a concern if the consumer is insured.
6. People need health insurance
a. Whether they are healthy or unhealthy.
b. Only if they suddenly feel ill.
c. Once they turn 65 years.
d. If it seems affordable and comprehensive.
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,7. If a provider charges $1,000 for a procedure
a. The provider contacts a collection agency if reimbursement is less than $1,000.
b. The reimbursement is often somewhat less than $1,000.
c. The reimbursement is denied because the charges are too high.
d. The health plan will shift this cost to the plan member.
8. The source of most health care reimbursement is
a. The government.
b. Out-of-pocket payments.
c. Fee-for-service (FFS) systems.
d. Private insurance.
9. FFS is a volume-based payment system because
a. Reimbursement is tied to a patient’s income level.
b. Reimbursement is spread over the entire risk pool.
c. Reimbursement depends on utilization.
d. Reimbursement depends on deductibles.
10. Adverse selection
a. Results in lower premiums for high-risk populations.
b. Motivates patients to adopt healthier lifestyles.
c. Is only a problem for physicians and hospitals.
d. Causes healthier plan members to drop insurance coverage.
Answer key Chapter 2 1c, 2a, 3b, 4d, 5c, 6a, 7b, 8a, 9c, 10d
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, CHAPTER 3
Managed Care and ACOs
1. In managed care settings, capitation
a. Aligns incentives so that adverse selection disappears.
b. Is unnecessary except for government contracts.
c. Encourages providers to reduce health care costs.
d. Induces demand for services.
2. Allowing providers to keep the surplus capitation payment as earnings leads to the under-care of patients who do
not receive the services they need.
a. This could be true or false, depending on the amount of surplus.
b. False, as these patients asked for care that was not necessary.
c. False, as regulating care quality addresses this problem.
d. True, because profitability should not be part of health care.
3. Calculating the PCP visits per member per year is important because:
a. It results in a P&L statement.
b. It is an indicator for evaluating PCP performance.
c. It tells the manager how much specialty service is required.
d. It determines the capitation rate for the following year.
4. What of the following is the best reason to calculate costs and utilization per member per year (PMPY)?
a. The group practice can estimate the capitation revenue to cover costs.
b. If specialist referrals are not monitored, costs may exceed revenues.
c. Inpatient utilization is quite low for most populations.
d. The cost for children exceeds the cost for elderly patient care.
5. The ACA led to hospitals
a. Refusing to treat Medicaid patients.
b. Focusing more on volume than on the quality of care.
c. Increasing preventable readmissions whenever possible.
d. Participating in the Value-Based Purchasing program.
6. The prudent layperson’s standard
a. Is a mistake and should be abolished.
b. Reflects how much an ordinary American would likely pay for health care.
c. Applies to automobile insurance, not health insurance.
d. Is applied to determine the necessity of emergency care services.
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