HAP FINAL EXAM QUESTIONS AND ACCURATE
ANSWERS
Why was managed care organizations developed in the 90's - Answers - to control costs
What are DRG's - Answers - Diagnosis related groups- categorize patients with similar
clinical diagnosis to control hospital costs and determine payor reimbursement rates
what is a capitation - Answers - cap on how much can be paid- per member per month
what are the three groups that are covered under Medicare - Answers - elderly (65+),
disabled, and end stage renal failure
Medicare part A - Answers - covers hospitals - free
Medicare part B - Answers - covers physician and outpatient
Medicare part D - Answers - covers prescription drugs
Medicare part C - Answers - combines coverage for A, B, and D
what is the Hill-Burton Act - Answers - act to expand hospital beds
when were DRG's established - Answers - 1983
Who has the bigger role in our healthcare system in the US - Answers - private sector
what is the social justice system in healthcare - Answers - healthcare that is based on
the wellbeing of our country
what is market justice in healthcare - Answers - healthcare that is based on capitalism
what are the vulnerable populations - Answers - poor, uninsured women and children,
disabled and chronically ill, homeless, racial and ethnic minorities, rural populations,
mentally ill, and HIV/AIDS patients
what are health care settings for the vulnerable populations (safety nets) - Answers -
community health centers, ER's, and free clinics
Are healthcare expenditures predicted to rise or fall in the future - Answers - rise
, what are some examples of health determinants - Answers - using tobacco, gun
violence, sexual behaviors etc.
what are acute health conditions - Answers - conditions that are severe and sudden -
ex: heart attack, asthma attack
what are chronic health conditions - Answers - conditions that last a long time and
require ongoing medical attention- ex: diabetes
what is days of care - Answers - all the patients who were in the hospital at midnight
what are some strategies to help reduce disparities in our health at the micro and macro
level - Answers - vaccine clinics, preventative care type teaching, and creating
standards
what are two ways to measure quality of life in healthcare - Answers - patient
satisfaction surveys and patient outcomes
what was a physician thought of in pre-industrial times - Answers - self-trained
what is a pesthouse - Answers - held patients with infectious diseases
what is an almshouse - Answers - held patients who were poor
what is an asylum - Answers - held patients that were mentally ill
what is voluntary health insurance - Answers - private insurance through employers or
the marketplace is voluntary- choosing to have health insurance
what is medicaid - Answers - health insurance for the poor administered by the states
who administers Medicare - Answers - the federal government
what is blue cross - Answers - the first model of insurance made to cover hospital
expenses
what is blue shield - Answers - insurance that covered physician visits
what are some reasons we have growing healthcare needs - Answers - aging
population, focus on treatment rather than prevention, and immigrants
what do physicians do - Answers - assess, diagnose, and treat
To become a specialist, what are the requirements post medical school - Answers - a
fellowship or advanced residency
ANSWERS
Why was managed care organizations developed in the 90's - Answers - to control costs
What are DRG's - Answers - Diagnosis related groups- categorize patients with similar
clinical diagnosis to control hospital costs and determine payor reimbursement rates
what is a capitation - Answers - cap on how much can be paid- per member per month
what are the three groups that are covered under Medicare - Answers - elderly (65+),
disabled, and end stage renal failure
Medicare part A - Answers - covers hospitals - free
Medicare part B - Answers - covers physician and outpatient
Medicare part D - Answers - covers prescription drugs
Medicare part C - Answers - combines coverage for A, B, and D
what is the Hill-Burton Act - Answers - act to expand hospital beds
when were DRG's established - Answers - 1983
Who has the bigger role in our healthcare system in the US - Answers - private sector
what is the social justice system in healthcare - Answers - healthcare that is based on
the wellbeing of our country
what is market justice in healthcare - Answers - healthcare that is based on capitalism
what are the vulnerable populations - Answers - poor, uninsured women and children,
disabled and chronically ill, homeless, racial and ethnic minorities, rural populations,
mentally ill, and HIV/AIDS patients
what are health care settings for the vulnerable populations (safety nets) - Answers -
community health centers, ER's, and free clinics
Are healthcare expenditures predicted to rise or fall in the future - Answers - rise
, what are some examples of health determinants - Answers - using tobacco, gun
violence, sexual behaviors etc.
what are acute health conditions - Answers - conditions that are severe and sudden -
ex: heart attack, asthma attack
what are chronic health conditions - Answers - conditions that last a long time and
require ongoing medical attention- ex: diabetes
what is days of care - Answers - all the patients who were in the hospital at midnight
what are some strategies to help reduce disparities in our health at the micro and macro
level - Answers - vaccine clinics, preventative care type teaching, and creating
standards
what are two ways to measure quality of life in healthcare - Answers - patient
satisfaction surveys and patient outcomes
what was a physician thought of in pre-industrial times - Answers - self-trained
what is a pesthouse - Answers - held patients with infectious diseases
what is an almshouse - Answers - held patients who were poor
what is an asylum - Answers - held patients that were mentally ill
what is voluntary health insurance - Answers - private insurance through employers or
the marketplace is voluntary- choosing to have health insurance
what is medicaid - Answers - health insurance for the poor administered by the states
who administers Medicare - Answers - the federal government
what is blue cross - Answers - the first model of insurance made to cover hospital
expenses
what is blue shield - Answers - insurance that covered physician visits
what are some reasons we have growing healthcare needs - Answers - aging
population, focus on treatment rather than prevention, and immigrants
what do physicians do - Answers - assess, diagnose, and treat
To become a specialist, what are the requirements post medical school - Answers - a
fellowship or advanced residency
