HMGT 3311 Final Exam
Study online at https://quizlet.com/_4sli9x
1. Goals of the Access, cost, quality
Healthcare Sys-
tem
2. ACA Provisions of 1. Almost all individuals have insurance coverage
Impact 2. states create insurance exchanges
3.Expansion of Medicaid
4. Medical loss ratio & premium rate reviews
5. bundled payments & VBP
6. Accountable Care Organizations
3. Value Based Pur- payment method to provide incentives to providers for delivering quality health
chasing care at a lower cost
4. Factors affecting 1. VBP
the Decrease of 2. MGMT of physician preference in medical devices
cost 3. generic drugs into the market
4. Use of Health IT to manage pop/prevent errors
5. LSS
6. Informed consumers responsible for more of the cost of care
7. Workplace wellness & employer programs
5. Factors Increas- 1. New Medical technology
ing the Cost of 2. chronic diseases
care 3. aging population
4. influx of participants into the market due to extended coverage and insurance
mandate
5. professional liability and Malpractice costs
6. payor entity responsible for paying for the services of a health care provider
7. Major Functions
of ICDS
1/6
, HMGT 3311 Final Exam
Study online at https://quizlet.com/_4sli9x
1. provide justification of procedures and services provided by the physician
2. assist in establishing medical necessity for services and procedures performed
3. Serve as an indicator in measuring the quality of HC delivered.
8. copayment payment the patient is required to make to cover part of the cost of a health care
service. Fixed amount or percentage of the charge
9. Deductibles base amount the patient is responsible for paying before insurance coverage
begins
10. Medicare (A) inpatient services
11. Medicare (B) physician and outpatient services
12. Medicare (C) medicare advantage plans
13. Medicare (D) Prescription Drug Coverage
14. bundled pay- initiative in which physician and hospitals work together to provide inpatient and
ments post discharge care to MC Patients
15. Capitation form of payment that compensates the provider a certain amount per capita for a
defined set of services
16. account shows the effect of transactions on a given asset, liability, equity, revenue, or
expense account
17. Debits must Debits- expenses, losses, assets
equal credits credits- revenues, gains, liabilities
18. Assets = liabilities + (NA) or (SH Equity)
19. Balance Sheet Assets, liabilities and NA or SH Equity
20.
2/6
Study online at https://quizlet.com/_4sli9x
1. Goals of the Access, cost, quality
Healthcare Sys-
tem
2. ACA Provisions of 1. Almost all individuals have insurance coverage
Impact 2. states create insurance exchanges
3.Expansion of Medicaid
4. Medical loss ratio & premium rate reviews
5. bundled payments & VBP
6. Accountable Care Organizations
3. Value Based Pur- payment method to provide incentives to providers for delivering quality health
chasing care at a lower cost
4. Factors affecting 1. VBP
the Decrease of 2. MGMT of physician preference in medical devices
cost 3. generic drugs into the market
4. Use of Health IT to manage pop/prevent errors
5. LSS
6. Informed consumers responsible for more of the cost of care
7. Workplace wellness & employer programs
5. Factors Increas- 1. New Medical technology
ing the Cost of 2. chronic diseases
care 3. aging population
4. influx of participants into the market due to extended coverage and insurance
mandate
5. professional liability and Malpractice costs
6. payor entity responsible for paying for the services of a health care provider
7. Major Functions
of ICDS
1/6
, HMGT 3311 Final Exam
Study online at https://quizlet.com/_4sli9x
1. provide justification of procedures and services provided by the physician
2. assist in establishing medical necessity for services and procedures performed
3. Serve as an indicator in measuring the quality of HC delivered.
8. copayment payment the patient is required to make to cover part of the cost of a health care
service. Fixed amount or percentage of the charge
9. Deductibles base amount the patient is responsible for paying before insurance coverage
begins
10. Medicare (A) inpatient services
11. Medicare (B) physician and outpatient services
12. Medicare (C) medicare advantage plans
13. Medicare (D) Prescription Drug Coverage
14. bundled pay- initiative in which physician and hospitals work together to provide inpatient and
ments post discharge care to MC Patients
15. Capitation form of payment that compensates the provider a certain amount per capita for a
defined set of services
16. account shows the effect of transactions on a given asset, liability, equity, revenue, or
expense account
17. Debits must Debits- expenses, losses, assets
equal credits credits- revenues, gains, liabilities
18. Assets = liabilities + (NA) or (SH Equity)
19. Balance Sheet Assets, liabilities and NA or SH Equity
20.
2/6
