MHA 708 | MHA708 Exam 4: Healthcare Policy
Updated and Latest Questions and Correct
Answers with Rationale - Louisiana State
University in Shreveport
1. Which component of the Patient Protection and Affordable Care Act (ACA) was primarily
designed to address the ethical issue of ‘adverse selection’ in insurance markets?
A. The creation of Accountable Care Organizations
B. The Medicaid Expansion
C. The Hospital Readmissions Reduction Program
D. The Individual Mandate
Correct Answer: D
Explanation: The Individual Mandate required healthy individuals to purchase insurance
to balance the risk pool. Without this, only sick individuals would likely buy insurance,
leading to a ‘death spiral’ of rising premiums. This policy ensures a broader distribution of
risk across the population. It reflects a utilitarian approach to stabilizing the healthcare
marketplace. Ethical debates surrounding this policy often centered on individual liberty
versus the collective good.
2. Under the principle of Distributive Justice, how is healthcare resource allocation typically
prioritized in a policy context?
A. Resources are given to those who can pay the highest market price
B. Resources are allocated solely based on chronological age
C. Resources are strictly limited to emergency services only
D. Resources are distributed based on a fair and equitable system to meet population needs
Correct Answer: D
Explanation: Distributive justice focuses on the fair distribution of benefits and burdens
within a society. In healthcare policy, this involves determining how to allocate limited
resources like funding, specialists, or vaccines fairly. This principle underpins arguments
for health equity and universal access. It contrasts with market justice, which relies on the
ability to pay. Policymakers use this ethical framework to address disparities in health
outcomes.
3. What was the significant outcome of the Supreme Court case National Federation of
Independent Business v. Sebelius (2012) regarding healthcare policy?
A. It made Medicaid expansion optional for states rather than mandatory
,B. It ruled that the individual mandate was unconstitutional under all circumstances
C. It prohibited the federal government from regulating insurance premiums
D. It established healthcare as a fundamental constitutional right
Correct Answer: A
Explanation: The Supreme Court upheld the individual mandate as a valid exercise of
Congress’s power to tax. However, it struck down the provision that allowed the federal
government to withhold all Medicaid funding from states that did not expand their
programs. This decision created a ‘coverage gap’ in states that chose not to expand
Medicaid. It highlighted the tension between federal authority and state sovereignty in
health policy. This ruling fundamentally altered the ACA’s strategy for achieving universal
coverage.
4. A hospital administrator is evaluating the impact of Value-Based Purchasing (VBP). Which
of the following is the primary goal of this policy?
A. To increase the total volume of patient visits and procedures
B. To shift reimbursement from quantity of services to the quality and efficiency of care
C. To eliminate the need for electronic health records
D. To reduce the number of clinicians employed by the organization
Correct Answer: B
Explanation: Value-Based Purchasing (VBP) links provider payments to their performance
on specific quality measures. This policy is designed to reduce waste and improve patient
outcomes by incentivizing best practices. Unlike traditional Fee-For-Service models, VBP
holds providers accountable for both cost and clinical results. It reflects a shift toward the
‘Triple Aim’ of better care, better health, and lower costs. Organizations must now focus on
patient satisfaction and clinical process adherence to maintain revenue.
5. In the context of healthcare equity, what is the primary purpose of the ‘Social
Determinants of Health’ (SDOH) framework in policymaking?
A. To address the non-medical factors such as housing, education, and environment that
influence health
B. To focus exclusively on genetic factors that cause disease
C. To mandate that all patients receive the exact same medical treatment regardless of
diagnosis
D. To increase the profitability of pharmaceutical companies
Correct Answer: A
, Explanation: SDOH refers to the conditions in which people are born, grow, live, work, and
age. Healthcare policy increasingly recognizes that medical care alone cannot achieve
population health if social factors are ignored. Policies targeting SDOH aim to reduce health
disparities among vulnerable populations. For example, providing housing assistance can
reduce emergency room visits for homeless individuals. This holistic approach is essential
for achieving true health equity.
6. The Emergency Medical Treatment and Labor Act (EMTALA) is often described as an
‘unfunded mandate.’ What ethical dilemma does this create for hospitals?
A. The decision to hire more nurses or more administrative staff
B. The choice between using brand-name or generic medications
C. The conflict between the legal duty to treat regardless of ability to pay and the financial
sustainability of the hospital
D. The requirement to report patient data to the CDC
Correct Answer: C
Explanation: EMTALA requires hospitals with emergency departments to stabilize anyone
regardless of their insurance status or ability to pay. While this ensures emergency access
(a matter of justice), the federal government does not provide direct funding for this care.
This forces hospitals to shift costs to other payers or suffer financial losses. For safety-net
hospitals, this creates a significant ethical and financial strain. It represents a policy-driven
social contract that prioritizes immediate human life over market efficiency.
7. When evaluating a health policy using ‘Cost-Effectiveness Analysis’ (CEA), what is being
compared?
A. The total number of patients versus the total number of doctors
B. The political popularity of a policy versus its actual cost
C. The relative costs and outcomes (effects) of different courses of action
D. The speed of implementation versus the number of regulations
Correct Answer: C
Explanation: CEA helps policymakers determine which interventions provide the most
health benefit for a given level of resources. Outcomes are often measured in ‘Quality-
Adjusted Life Years’ (QALYs). This analysis is crucial for resource allocation when budgets
are limited. For instance, a policy might compare the cost per life saved for a screening
program versus a vaccination program. It provides a quantitative basis for ethical decisions
regarding which services to fund.
8. Which of the following describes a ‘Patient-Centered Medical Home’ (PCMH) model
encouraged by healthcare reform?
A. A facility where patients live permanently while receiving care
Updated and Latest Questions and Correct
Answers with Rationale - Louisiana State
University in Shreveport
1. Which component of the Patient Protection and Affordable Care Act (ACA) was primarily
designed to address the ethical issue of ‘adverse selection’ in insurance markets?
A. The creation of Accountable Care Organizations
B. The Medicaid Expansion
C. The Hospital Readmissions Reduction Program
D. The Individual Mandate
Correct Answer: D
Explanation: The Individual Mandate required healthy individuals to purchase insurance
to balance the risk pool. Without this, only sick individuals would likely buy insurance,
leading to a ‘death spiral’ of rising premiums. This policy ensures a broader distribution of
risk across the population. It reflects a utilitarian approach to stabilizing the healthcare
marketplace. Ethical debates surrounding this policy often centered on individual liberty
versus the collective good.
2. Under the principle of Distributive Justice, how is healthcare resource allocation typically
prioritized in a policy context?
A. Resources are given to those who can pay the highest market price
B. Resources are allocated solely based on chronological age
C. Resources are strictly limited to emergency services only
D. Resources are distributed based on a fair and equitable system to meet population needs
Correct Answer: D
Explanation: Distributive justice focuses on the fair distribution of benefits and burdens
within a society. In healthcare policy, this involves determining how to allocate limited
resources like funding, specialists, or vaccines fairly. This principle underpins arguments
for health equity and universal access. It contrasts with market justice, which relies on the
ability to pay. Policymakers use this ethical framework to address disparities in health
outcomes.
3. What was the significant outcome of the Supreme Court case National Federation of
Independent Business v. Sebelius (2012) regarding healthcare policy?
A. It made Medicaid expansion optional for states rather than mandatory
,B. It ruled that the individual mandate was unconstitutional under all circumstances
C. It prohibited the federal government from regulating insurance premiums
D. It established healthcare as a fundamental constitutional right
Correct Answer: A
Explanation: The Supreme Court upheld the individual mandate as a valid exercise of
Congress’s power to tax. However, it struck down the provision that allowed the federal
government to withhold all Medicaid funding from states that did not expand their
programs. This decision created a ‘coverage gap’ in states that chose not to expand
Medicaid. It highlighted the tension between federal authority and state sovereignty in
health policy. This ruling fundamentally altered the ACA’s strategy for achieving universal
coverage.
4. A hospital administrator is evaluating the impact of Value-Based Purchasing (VBP). Which
of the following is the primary goal of this policy?
A. To increase the total volume of patient visits and procedures
B. To shift reimbursement from quantity of services to the quality and efficiency of care
C. To eliminate the need for electronic health records
D. To reduce the number of clinicians employed by the organization
Correct Answer: B
Explanation: Value-Based Purchasing (VBP) links provider payments to their performance
on specific quality measures. This policy is designed to reduce waste and improve patient
outcomes by incentivizing best practices. Unlike traditional Fee-For-Service models, VBP
holds providers accountable for both cost and clinical results. It reflects a shift toward the
‘Triple Aim’ of better care, better health, and lower costs. Organizations must now focus on
patient satisfaction and clinical process adherence to maintain revenue.
5. In the context of healthcare equity, what is the primary purpose of the ‘Social
Determinants of Health’ (SDOH) framework in policymaking?
A. To address the non-medical factors such as housing, education, and environment that
influence health
B. To focus exclusively on genetic factors that cause disease
C. To mandate that all patients receive the exact same medical treatment regardless of
diagnosis
D. To increase the profitability of pharmaceutical companies
Correct Answer: A
, Explanation: SDOH refers to the conditions in which people are born, grow, live, work, and
age. Healthcare policy increasingly recognizes that medical care alone cannot achieve
population health if social factors are ignored. Policies targeting SDOH aim to reduce health
disparities among vulnerable populations. For example, providing housing assistance can
reduce emergency room visits for homeless individuals. This holistic approach is essential
for achieving true health equity.
6. The Emergency Medical Treatment and Labor Act (EMTALA) is often described as an
‘unfunded mandate.’ What ethical dilemma does this create for hospitals?
A. The decision to hire more nurses or more administrative staff
B. The choice between using brand-name or generic medications
C. The conflict between the legal duty to treat regardless of ability to pay and the financial
sustainability of the hospital
D. The requirement to report patient data to the CDC
Correct Answer: C
Explanation: EMTALA requires hospitals with emergency departments to stabilize anyone
regardless of their insurance status or ability to pay. While this ensures emergency access
(a matter of justice), the federal government does not provide direct funding for this care.
This forces hospitals to shift costs to other payers or suffer financial losses. For safety-net
hospitals, this creates a significant ethical and financial strain. It represents a policy-driven
social contract that prioritizes immediate human life over market efficiency.
7. When evaluating a health policy using ‘Cost-Effectiveness Analysis’ (CEA), what is being
compared?
A. The total number of patients versus the total number of doctors
B. The political popularity of a policy versus its actual cost
C. The relative costs and outcomes (effects) of different courses of action
D. The speed of implementation versus the number of regulations
Correct Answer: C
Explanation: CEA helps policymakers determine which interventions provide the most
health benefit for a given level of resources. Outcomes are often measured in ‘Quality-
Adjusted Life Years’ (QALYs). This analysis is crucial for resource allocation when budgets
are limited. For instance, a policy might compare the cost per life saved for a screening
program versus a vaccination program. It provides a quantitative basis for ethical decisions
regarding which services to fund.
8. Which of the following describes a ‘Patient-Centered Medical Home’ (PCMH) model
encouraged by healthcare reform?
A. A facility where patients live permanently while receiving care
