HCMG

HCMG EXAM QUESTIONS AND ANSWERS LATEST EDITION ALREADY GRADED A+ "Explain the concept of a deductible in health insurance" "A deductible is the amount a patient must pay out-of-pocket before the insurance plan begins covering expenses It reduces unnecessary healthcare usage by involving patient costs initially" "What is coinsurance and how does it differ from a copay" "Coinsurance is a percentage of the total cost that a patient pays for a service whereas a copay is a fi...

HCMG EXAM QUESTIONS AND ANSWERS LATEST EDITION ALREADY GRADED A+ What is a primary reason the U.S. spends more on healthcare than other countries? Higher prices for healthcare services and goods, not necessarily higher service usage How is healthcare spending calculated? Spending = Price * Quantity What major issue does high U.S. healthcare spending present? Opportunity costs of funds, which limit resources for other sectors Why might healthcare markets fail to self-regulate effectively? ...

HCMG EXAM QUESTIONS AND ANSWERS LATEST EDITION ALREADY GRADED A+ DONABEDIAN FRAMEWORK Outcome- Patient, organizational, Community of environmental -infection rates -rates of rehospitalization -patient satisfaction Vulnerable porpulations -racial and ethnic minorities -children -women -unisured -people living in rural areas -homeless -medically ill -chronically ill and disabled -HIV/AIDS Predisposing characteristics -race/ethnicity -gender/age -geographic location Enabling cha...

HCMG EXAM QUESTIONS AND ANSWERS LATEST EDITION ALREADY GRADED A+ what's an example of a service that was underutilized during covid mammograms, cancer screenings (much fewer diagnoses) many high value care services skipped T/F: Covid hit low income groups significantly harder on both economic and health fronts? true more likely to be uninsured, employed in essential work settings (grocery stores, public transport, etc), crowded housing conditions/mulit-gen households, higher comorb...

HCMG EXAM QUESTIONS AND ANSWERS LATEST EDITION ALREADY GRADED A+ what are some payment reforms that followed the readmission reduction program? requiring hospitals to disclose their negotiated prices with insurers (Jan 2021) - the gross charges, discounted prices, payer-specific negotiated prices, min and max negotiated prices, machine readable file Goal: force hospitals to post prices so patients know what to expect/can shop around - and can use these values for bargaining power of insurer ...

HCMG EXAM QUESTIONS AND ANSWERS LATEST EDITION ALREADY GRADED A+ What is another extreme model for paying physicians? What is this? a salary insurer pays FFS to hospital/group who collects it all and then pays the doctor a salary The main source of HC revenue was from which payment model (2016)? fee for service why is collecting data on the revenue of physicians difficult? because doctors don't really understand which payment model they are using two crucial lessons learned in physi...

HCMG EXAM QUESTIONS AND ANSWERS LATEST EDITION ALREADY GRADED A+ Define opportunity social structures, labor market factors, institutions, and resources that enable people to both build hope and positive expectations for their future and realize their potential a characteristic of places, not people **Distinct from income, wealth, or income inequality Name two ways to measure opportunity: 1. Retrospective: average adult incomes of children of poor parents 2. Prospective: survey-based perc...

HCMG EXAM QUESTIONS AND ANSWERS LATEST EDITION ALREADY GRADED A+ See slide 3/44 on "Health and the Environment" lecture. Why are there geographic differences in life expectancy?? Many southern states (southern belt) did not undergo Medicaid expansion - their populations are facing the consequences What can a geographic life expectancy map tell you? socioeconomics, food access, healthcare access, weather patterns (# of cold/hot days) in a given state/city What can't a geographic lif...

HCMG EXAM QUESTIONS AND ANSWERS LATEST EDITION ALREADY GRADED A+ mental health and telemedicine visits for mental health and substance abuse increased for telehealth what happens now? uninsured rate reaches historic low of 7.7% in Q1 (more people enrolled) -increase in medicaid and marketplace enrollment this may be reversed after PHE provisions expire premium fairly stable uneven coverage landscapes -11 states have not expanded Medicaid -abortion access limited proposals singl...

HCMG EXAM QUESTIONS AND ANSWERS LATEST EDITION ALREADY GRADED A+ voluntary physician payment reform NJ hospitals allow doctors to keep Medicare FFS payments and get bonus if reduce patient costs -bonus did not decrease costs or quantity of services -doctors pick cheaper patients (decrease in costs) FFS not much savings when switched to APM (still so many doctors on FFS) -so many other factors like complexity and selection in voluntary programs which don't reduce cost physicians in U...