HCD Midterm Questions With Complete Solutions
A claims data is what type of analysis? Correct Answers
retrospective - find ways where drug therapy is improved
A value of a good is measured by what? Correct Answers
Marginal Utility (marginal = extra)
Actuarial analysis Correct Answers estimates the amount of risk
assumed.
Estimates the income (premiums) that must be earned to cover
the estimated expenses, usually expressed as cost per member
per month (PMPM)
Administrative costs Correct Answers associated with the
management of the financing, insurance, delivery, and payment
functions. Include management of the enrollment process,
setting up contract with providers, claims processing, etc.
administrative functions of MCO Correct Answers premiums
based on contract negotiations between employers and mCO
Administrative services Correct Answers contracts with
providers including discounts on services
Advantages of RCT Correct Answers -random assignment of
subjects
-groups tend to be similar
-confounding variables minimized
,Advertising DTC drug products influences what? Correct
Answers Attitudes, tastes and preferences of the consumer
AHRQ- agency for health care research quality Correct Answers
mission- research that enhances the quality appropriateness and
effectiveness of health services
* basic research, evaluation studies, demonstration projects
American Recovery and Reinvestment Act Correct Answers
provided funding for health information advancement
Analytical Epidemiology Correct Answers Study of
determinants of health related outcomes
Are Cohort studies primarily prospective or retrospective?
Correct Answers retrospective
Are costs incurred from research and development included in
the total health care expenditure? Correct Answers Yes
Are mail services used for all prescriptions? Correct Answers
No- PBM's use it only for certain prescriptions and may give
discounts for using it
Are MCO's required to become accredited? Correct Answers
NO! NO! NO! VOLUNTARY
Asymptomatic screening Correct Answers implies people
already have the disease but are not aware
,at first medical professionals Correct Answers objected to MCO
type organizations
Average Wholesale price (AWP) Correct Answers a list price
that is significantly higher than the actual acquisition cost
(AAC) that most pharmacies pay wholesalers and manufacturers
for drug products
Between 2000 and 2030 the proportion of US population that is
65+ is expected to rise from ____ to _____. Correct Answers
12.4% to 20%
Bias Correct Answers systematic error in conducting the study
(study design, execution of the study, analysis/interpretation of
the data)
Bioinformatics Correct Answers Use of advanced
computational tools to expand the use of health data
capitation Correct Answers is when the provider is paid a fixed
monthly sum per enrollee, often call per member per month
payment PMPM
Case management for monitoring and controlling cost of MCO
Correct Answers an experienced health care professional with
knowledge of available resources monitors the patients care
along with the case manager to create a cost effective and
efficient care plan for the patient
, Case-control Study Correct Answers - comparison groups are
formed based upon health outcome status and NOT exposure
status
- potential for SELECTION and RECALL bias
- Inferior to other methods
- appropriate control group is a must
CDC - centers for disease control and prevention Correct
Answers are stationed in 25 countries
*work to prevent and control infectious disease
* provide a system of health surveillance to monitor and prevent
disease outbreaks
CDSS Correct Answers -allow for administrative ease
-assist in making patient-specific decisions
-decrease costs by monitoring therapy and intervention use
eg. Pathways or protocols, drug interaction or dosage checks
CDSS stands for Correct Answers Clinical Decision Support
System
Centers for Medicare and Medicaid (CMS) Correct Answers
1/4 of Americans are covered by CMS
There are 3 divisions
Initiate outreach and education programs
Challenges of Smart Pump Technology Include: Correct
Answers - Cost
- Maintaining drug databases
A claims data is what type of analysis? Correct Answers
retrospective - find ways where drug therapy is improved
A value of a good is measured by what? Correct Answers
Marginal Utility (marginal = extra)
Actuarial analysis Correct Answers estimates the amount of risk
assumed.
Estimates the income (premiums) that must be earned to cover
the estimated expenses, usually expressed as cost per member
per month (PMPM)
Administrative costs Correct Answers associated with the
management of the financing, insurance, delivery, and payment
functions. Include management of the enrollment process,
setting up contract with providers, claims processing, etc.
administrative functions of MCO Correct Answers premiums
based on contract negotiations between employers and mCO
Administrative services Correct Answers contracts with
providers including discounts on services
Advantages of RCT Correct Answers -random assignment of
subjects
-groups tend to be similar
-confounding variables minimized
,Advertising DTC drug products influences what? Correct
Answers Attitudes, tastes and preferences of the consumer
AHRQ- agency for health care research quality Correct Answers
mission- research that enhances the quality appropriateness and
effectiveness of health services
* basic research, evaluation studies, demonstration projects
American Recovery and Reinvestment Act Correct Answers
provided funding for health information advancement
Analytical Epidemiology Correct Answers Study of
determinants of health related outcomes
Are Cohort studies primarily prospective or retrospective?
Correct Answers retrospective
Are costs incurred from research and development included in
the total health care expenditure? Correct Answers Yes
Are mail services used for all prescriptions? Correct Answers
No- PBM's use it only for certain prescriptions and may give
discounts for using it
Are MCO's required to become accredited? Correct Answers
NO! NO! NO! VOLUNTARY
Asymptomatic screening Correct Answers implies people
already have the disease but are not aware
,at first medical professionals Correct Answers objected to MCO
type organizations
Average Wholesale price (AWP) Correct Answers a list price
that is significantly higher than the actual acquisition cost
(AAC) that most pharmacies pay wholesalers and manufacturers
for drug products
Between 2000 and 2030 the proportion of US population that is
65+ is expected to rise from ____ to _____. Correct Answers
12.4% to 20%
Bias Correct Answers systematic error in conducting the study
(study design, execution of the study, analysis/interpretation of
the data)
Bioinformatics Correct Answers Use of advanced
computational tools to expand the use of health data
capitation Correct Answers is when the provider is paid a fixed
monthly sum per enrollee, often call per member per month
payment PMPM
Case management for monitoring and controlling cost of MCO
Correct Answers an experienced health care professional with
knowledge of available resources monitors the patients care
along with the case manager to create a cost effective and
efficient care plan for the patient
, Case-control Study Correct Answers - comparison groups are
formed based upon health outcome status and NOT exposure
status
- potential for SELECTION and RECALL bias
- Inferior to other methods
- appropriate control group is a must
CDC - centers for disease control and prevention Correct
Answers are stationed in 25 countries
*work to prevent and control infectious disease
* provide a system of health surveillance to monitor and prevent
disease outbreaks
CDSS Correct Answers -allow for administrative ease
-assist in making patient-specific decisions
-decrease costs by monitoring therapy and intervention use
eg. Pathways or protocols, drug interaction or dosage checks
CDSS stands for Correct Answers Clinical Decision Support
System
Centers for Medicare and Medicaid (CMS) Correct Answers
1/4 of Americans are covered by CMS
There are 3 divisions
Initiate outreach and education programs
Challenges of Smart Pump Technology Include: Correct
Answers - Cost
- Maintaining drug databases
