CMN 260 STUDY GUIDE 2026/2027 QUESTIONS AND
SOLUTIONS RATED A+
✔✔Cons of Managed Care - ✔✔For Patients:
• Costs continue to rise
• Prevention still not a priority
• Limited Choices
For Providers:
• Incentive to limit care
• Red Tape Overload (too much energy diverted to bureaucracy;
e.g., paperwork)
✔✔universal coverage - ✔✔System that provides health care and financial protection to
all citizens of particular country
Support: Untreated diseases may spread to others and escalate costs;
Patients won't face financial hardship if they become sick; A health society
is more prosperous; May result in more resources, jobs, and health
services...
Opposition: Healthy people may pay for unhealthy ones; People may be
lax about maintaining their health; Health system may be overtaxed...
✔✔multi-payer - ✔✔competing insurers in country that people choose from
- Lower overall tax burden, More marketplace
competition, Less government involvement...
✔✔single-payer - ✔✔one insurer in place for country
- People pay throughout their lives; No high charges
at the time of service; An incentive to maintain public health;
Administrative demands are lessened
✔✔Iron Triangle of Health Care - ✔✔Access, Cost, Quality
✔✔Strengths of the U.S. Health Care System - ✔✔- High quality care is available for
those who can afford it
- "Best healthcare system in the world"
- The nation is willing to spend money on healthcare
- E.g., technology and innovation
✔✔Weaknesses of the U.S. Health Care System - ✔✔- Limited care for the uninsured
- Minimal emphasis on prevention and health maintenance
- Large budget, but lots of waste
- Health disparities by age, race, income, and literacy level
- The most expensive medical training programs
✔✔Affordable Care Act (ACA) (main ideas) - ✔✔- Regulates the current industry
, - Goal of increasing quality, affordability, availability of private insurance
- No change for the majority of people with coverage
- Uninsured may sign up through health insurance marketplaces
- Young people can stay on their parents plans
- Medicaid expansion
✔✔3 legged stool - ✔✔Individual/Employer mandate, Guarenteed insurance, expand
Medicaid
✔✔Individual mandate - ✔✔requires all citizens and legal residents to buy health
insurance
- Individuals can buy plans from the health insurance marketplace
✔✔Employer mandate - ✔✔requires 50+ full-time employee companies to
offer coverage
✔✔Guaranteed Issue - ✔✔Insurance companies can no longer turn away people with
preexisting conditions
- no rescission
✔✔Health Care Administration (goals) - ✔✔1. to the quality of health care experiences
2. To improve people's health across the board
3. To lower costs
✔✔Bureaucracy - ✔✔a highly structured organization where
teams of individuals perform specialized functions
under the authority of more powerful individuals and
the policies they design and implement
Two features:
◼ Hierarchical (role-based)
◼ Governed by policy (rule-based)
✔✔Inverting the Hierarchy - ✔✔This approach empowers employees to make
decisions, enhances customer satisfaction, and fosters a culture of trust and agility.
✔✔Theory of personal causation (de Charms, 1977) - ✔✔People resist being treated as
pawns, but want to be
treated as origins
✔✔Theory X and Theory Y model (McGregor, 1960) - ✔✔Managers' attitudes are
influential in bringing out
either the worst or the best in people
(X lazy)
(Y effective when appreciated)
SOLUTIONS RATED A+
✔✔Cons of Managed Care - ✔✔For Patients:
• Costs continue to rise
• Prevention still not a priority
• Limited Choices
For Providers:
• Incentive to limit care
• Red Tape Overload (too much energy diverted to bureaucracy;
e.g., paperwork)
✔✔universal coverage - ✔✔System that provides health care and financial protection to
all citizens of particular country
Support: Untreated diseases may spread to others and escalate costs;
Patients won't face financial hardship if they become sick; A health society
is more prosperous; May result in more resources, jobs, and health
services...
Opposition: Healthy people may pay for unhealthy ones; People may be
lax about maintaining their health; Health system may be overtaxed...
✔✔multi-payer - ✔✔competing insurers in country that people choose from
- Lower overall tax burden, More marketplace
competition, Less government involvement...
✔✔single-payer - ✔✔one insurer in place for country
- People pay throughout their lives; No high charges
at the time of service; An incentive to maintain public health;
Administrative demands are lessened
✔✔Iron Triangle of Health Care - ✔✔Access, Cost, Quality
✔✔Strengths of the U.S. Health Care System - ✔✔- High quality care is available for
those who can afford it
- "Best healthcare system in the world"
- The nation is willing to spend money on healthcare
- E.g., technology and innovation
✔✔Weaknesses of the U.S. Health Care System - ✔✔- Limited care for the uninsured
- Minimal emphasis on prevention and health maintenance
- Large budget, but lots of waste
- Health disparities by age, race, income, and literacy level
- The most expensive medical training programs
✔✔Affordable Care Act (ACA) (main ideas) - ✔✔- Regulates the current industry
, - Goal of increasing quality, affordability, availability of private insurance
- No change for the majority of people with coverage
- Uninsured may sign up through health insurance marketplaces
- Young people can stay on their parents plans
- Medicaid expansion
✔✔3 legged stool - ✔✔Individual/Employer mandate, Guarenteed insurance, expand
Medicaid
✔✔Individual mandate - ✔✔requires all citizens and legal residents to buy health
insurance
- Individuals can buy plans from the health insurance marketplace
✔✔Employer mandate - ✔✔requires 50+ full-time employee companies to
offer coverage
✔✔Guaranteed Issue - ✔✔Insurance companies can no longer turn away people with
preexisting conditions
- no rescission
✔✔Health Care Administration (goals) - ✔✔1. to the quality of health care experiences
2. To improve people's health across the board
3. To lower costs
✔✔Bureaucracy - ✔✔a highly structured organization where
teams of individuals perform specialized functions
under the authority of more powerful individuals and
the policies they design and implement
Two features:
◼ Hierarchical (role-based)
◼ Governed by policy (rule-based)
✔✔Inverting the Hierarchy - ✔✔This approach empowers employees to make
decisions, enhances customer satisfaction, and fosters a culture of trust and agility.
✔✔Theory of personal causation (de Charms, 1977) - ✔✔People resist being treated as
pawns, but want to be
treated as origins
✔✔Theory X and Theory Y model (McGregor, 1960) - ✔✔Managers' attitudes are
influential in bringing out
either the worst or the best in people
(X lazy)
(Y effective when appreciated)
