Midterm

Exam 1: Chapters 1 & 2 1. A method of payment in which providers are reimbursed based on the quality of health care they delivered is called: Pay for value. 2. For most privately insured Americans, health insurance is ______: That is their employers financial healthcare as a fringe benefit. Employer based. 3. In 1984. Australia switched from: A privately financed system to a Medicare program. 4. And a free market Who would pay for the delivery of health care services? Pa�ents. 5. In which country are employers required by law to contribute toward health insurance for their employees? Germany. 6. R eimbursement is associated with which of the quad func�ons. Payment. 7. T he Affordable Care Act mandates that children and adults are allowed to remain on their parents health insurance un�l what age ? 26. 8. T rue or false? In a free market, mul�ple pa�ents and providers act independently. False. 9. T rue or false? In a single payer system, the primary pair usually is an insurance company. False 10. T rue or false? Moral hazard has to do with insured pa�ents demand for health care services. True. 11. T rue or false? The US healthcare system is a fragmented, loosely coordinated network that involves A diverse array of organiza�ons and individuals. True. 12. T rue or false? The United States provides universal health care coverage. False. 13. T rue or false? The central agency that delivers health care in the United States is Medicare . False. 14. U nder free market condi�ons, the rela�onship between the quan�ty of Medicare services demanded and the price of medical services is: Inverse 15. W hen providing, deliver unnecessary services with the objec�ve of protec�ng themselves against lawsuits. This prac�ce is called. : Defensive medicine. 16. When the COVID- 19 pandemic occurred in 2020, what healthcare sector received a huge boost in u�liza�on and growth? bTelemedicine. 17. W hich country spends the most in administra�ve health care cost? United States. 18. W hich of the following en��es in the United St ates employes lobbyist? a. Physicians. b. Insurance companies. c. Large employers. d. All of these are correct. 19. W hich of the following is not a func�on of managed care? Increases pa�ent engagement by promo�ng and facilita�ng pa�ent provider communica�on. 20. An example of an issue addressed by the One health approach to public health is: Zoono�c disease The total number of cases at a specific period in �me divided by the popula�on at risk. 21. Crude birth weight is calculated by : Dividing the number of live births in a period of �me by the total popula�on. 22. Crude rates refers to: The total popula�on 23. True or False? C ultural beliefs have very litle to do with health. False 24. H ealthy People 2020 is the first na�onal ini�a�ve to advocate : Focusing on a broad array of health determinants. 25. In the epidemiology Triangle the organism that becomes sick is known as the : Host 26. Incidence is: The number of new cases occurring during a specified. Divided by the popula�on at risk.

Exam 1: Chapters 1 & 2 27. N ew diagnos�c methods, medical procedures, and pharmaceu�cals that have significantly improved the treatment of acute illnesses, survival rates and longevity have also contributed to an increased prevalence of: Chronic condi�ons. 28. Prevalence is: The total number of cases at a specific point in �me divided by the specified popula�on. 29. The ACA is an example of: Social jus�ce. 30. True or false? Funding for public health in the United States has been consistent and priori�zed over the years. False. 31. T rue or false? Generally, people with beter educa�on have higher incomes and beter health status. True. 32. T rue or false? If a country is slow in issuing public health measures, guidelines and informa�on on an emerging epidemic. This would demonstrate the country's poor capability and the deten�on and repor�ng category of the Global Health Security (GHS) Index. False. 33. T rue or false? New HIV infec�ons among newborns has declined by 50% since 2010 because fewer women with HIV are becoming pregnant. False. 34. T rue or false? Secondary preven�on refers to Rehabilita�ve therapies and the monitoring of healthcare processes to prevent complica�ons or to prevent further illnesses, injury or disability. False. 35. T rue or false? The safety of neighborhoods can be considered an environmental factor contribu�ng to health status. True. 36. W hich of the following factors is the leading cause of preventable disease and death in the United States? Smoking . 37. W hich of the following is an example of ter�ary preven�on? Foot care for pa�ent newly diagnosed with diabetes. 38. W hich of the following is the best interven�on to prevent chronic disease? Lifestyle modifica�on.

Exam 2: Chapters 3 & 4 19. True or False. Middle-class Americans have historically opposed proposals for a national health insurance program. a. True 20. True or False. The CHIP program was created in the form of an expansion to Medicaid a. True 21. True or False. The Patient Protection and Affordable Care Act was passed through compromises between the Democrats and the Republicans a. False 22. True or False. When bills for compulsory health insurance were introduced in several states, they were opposed by labor unions a. True 23. What main purpose was served by an almshouse in the preindustrial era? a. It performed general welfare and custodial functions 24. What was the function of a pesthouse in the preindustrial period? a. To house people who had a contagious disease 25. What was the main reason for initiating national health care in countries such as Geramny and England? a. Ward off political instability 26. When a profession’s services are generally accepted and are legitimized, they impart _____ to the profession a. Cultural authority 27. Which of the following is not true about the Patient Protection and Affordable Care Act of 2010? a. Most American supported the legislation once they found out what was in it 28. Which of the following was the main force that prevented a government-run national health care program from becoming a reality in the US? a. Beliefs and values 29. Why did physicians remain independent of corporate settings even after the medical profession became well recognized? a. Physicians who took up practice in a corporate setting were castigated by the medical profession 30. Why did the first Blue Cross plans cover only hospital care? a. The AMA objected to the inclusion of physician services 31. An excessive workload, administrative burden, and inability to find meaning and purpose in work or have all been singled out as factors contributing to what among health care providers? a. Burnout 32. Health care team models are thought to be beneficial to providers in what way? a. Higher job engagement b. Better relationships with colleagues c. Mitigate heavy work demands d. All of these are correct 33. MCO stands for: a. Managed care organization

Exam 2: Chapters 3 & 4 34. Primary care: a. Provides initial diagnosis 35. True or False. The ACA is going to reduce the need for primary care providers. a. False 36. The basic source of the physician distribution problem in the US is: a. Shortage of MDs 37. The health care sector constituted what percentage of the US gross domestic product in 2016? a. 17.1% 38. The number of specialists is increasing because: a. Of the development of medical technology 39. The percentage of active primary care physicians: a. Has decreased since 1949 40. The rise of virtual care improves what aspect of health care delivery in the US? a. Access 41. True or False. Hospitalists maintain a relationship with the patient prior to and after hospitalization. a. False 42. True or False. Less than 2% of all active physicians are osteopaths (DOs) a. False 43. True or False. More than half of MDs are specialists. a. True 44. True or False. More than half of osteopaths (Dos) are generalists. a. True 45. True or False. Specialty maldistribution refers to a surplus or a shortage of physicians by geographical area a. False 46. True or False. The number of active nurses has steadily increased over time. a. False 47. Which federal agency is primarily responsible for funding graduate medical education? a. Centers for Medicare and Medicaid 48. Which of the following is not an example of a non-physician provider? a. Licensed practical nurse 49. Development of the hospital and _____ happened almost hand and hand in a symbiotic relationship between the two. a. Professionalization of medical practice

18. True or false the term applies only to electronic delivery of healthcare by qualified, healthcare professionals o False 19. True or false the utilization of technology has a greater impact on total healthcare expenditures than the cost of acquiring technology o True 20. What is the effect of chronic conditions on healthcare cost? o Cost continues to aggregate overtime 21. What is the main advantage of inability within an ER system? o Information can be shared between physicians, pharmacist and hospitals 22. What is the main and the determination of efficacy? o How to define and measure outcomes 23. Which law requires certain allergy medication, containing pseudoephedrine to be kept behind the pharmacy counter, and sold only and limited quantities upon verification of a person’s identity o Patriot at 2006 24. Which of the following gave the FTA the authority to review the effectiveness and safety of a new drug before it could be marketed o Kefauver 25. Which of the following is generally not role of IT managers o And insurance compliance with various laws and regulations 26. And MS-DRG is a refined DRG that includes o Clinical severity of the patient 27. For hospitalizations Medicare beneficiaries must pay a deductible o Once per benefit. 28. National health expenditures amount to 18% of the GDP. What does this mean? o Healthcare consumes 18% of the total economic production 29. In general prospective payment systems, establish reimbursement for o Bundled services 30. Liberal reimbursement for technology will _____ innovation, diffusion, and utilization of that technology o Increase 31. Preferred providers are paid o Negotiated discounted fees 32. RVUs reflect o Resource inputs 33. The donut hole and Medicare prescription drug coverage o Provides no benefit until the beneficiary qualifies for the catastrophic level 34. The HI portion of Medicare is financed through o Payroll taxes 35. The majority of beneficiaries receiving healthcare through Medicare are o Elderly 36. To receive payment for services delivered providers must file a _____ with third-party payers o Claim

37. True or false health insurance plans are allowed to have annual dollar limits on a person medical expenditures o True 38. True or false Medicaid recipients are classified as medically uninsured o False 39. True or false research shows that perspective set bundled payment methods are effective and reducing healthcare spending without significantly affecting quality of care o True 40. True or false the government plays is significant role in financing healthcare services in the United States o True 41. True or false under the ACA private health insurance is no longer the main source of coverage o False 42. Under the ACA the majority of gains in health insurance coverage are attributed to o Medicaid expansion 43. Under the ACA what purpose do the exchanges have? o They allow individuals to purchase health plans 44. Under the DRG method of reimbursement, A PSYCHIATRIC HOSPITAL IS PAID o A PER DIEM RATE BASED ON PSYCHIATRIC DRG’S 45. UNDER THE DRG method of reimbursement and acute care hospital is paid o A fixed rate amount for the particular DRG classification 46. What is the minimum data set? o It is a patient assessment instrument for skilled nursing facilities 47. What is the primary mechanism that enables people to obtain healthcare services? o Health insurance 48. Which method of risk assessment is required by the ACA for individual and small group, health insurance o Adjusted community rating 49. Which of the following is not a type of perspective reimbursement methodology o Cost plus 50. Why was Medicare part C created? o To channel beneficiaries into managed care programs