HCMG 1010 MIDTERM ACTUAL EXAM
QUESTIONS BANK; COMPLETE
ACCURATE QUIZZES WITH VERIFIED
ANSWERS
% of people in private plans - correct answer- 66%
% of people in public plans - correct answer- 35.7%
% of people with health insurance - correct answer-
91.7%
% of people without health insurance - correct answer-
8.3%
2 requirements for ex post moral hazard - correct
answer- 1. Price distortion: don't feel full cost of
treatment when covered
2. Price sensitivity: increase consumption of health care if costs
go down
,2 varieties of ESHI - correct answer- Fully insured vs
self insured
3 approaches to pricing risk - correct answer- 1.
Individual risk rated -- pre ACA individual market, life insurance,
auto insurance
2. Experience rated -- ESHI plans -- varies by health status and
health care use
3. Community rated (uniform prices) -- Medicare advantage,
Medicare Part D, post ACA individual market -- offer people the
same price but can change based on zip code, age, and smoking
3 eligibility requirements for Medicare (ADD) - correct
answer- 1. Elderly: 65+ and have paid social security taxes
x 10 years (age)
2. Fully disabled x 24 months (disability)
3. End stage renal disease (disease)
3 hospital payment systems - correct answer- Fee for
service (fixed amount for each service)
-- Incentive to do as much as possible as first then get rid of
them
Diagnosis related groups (per diagnosis)
,-- Incentive to do as little as possible
-- Hard to adjust for severity
-- Hard to deal with extreme cases
-- Address differences inherent to different types of hospitals
Per diem (per days in hospital)
-- Incentive to over provide care
3 parts of evidence based practice - correct answer-
Clinical experience
Scientific evidence
Patient values
3 pronged plan of ACA - correct answer- 1. Fix
problems with non-group insurance market that leave uninsured
with no place to turn (GUARANTEED ISSUE)
- Rules that prevent insurers from denying coverage or raising
premiums based on preexisting conditions
- Modified community rating, age bands/smoking
2. Requirements that everyone buy insurance, employers offer it
(INDIVIDUAL MANDATE)
, - Tax penalty if they do not comply
- Insurers can price at average risk if everyone is required to be
covered
3. Financial assistance to make insurance affordable
- Lowest income = Medicaid expansion
- Middle income = subsidies to purchase private insurance
3rd leading cause of death in US - correct answer-
Medical error (25%)
10 Essential Benefits of ACA - correct answer- -
Ambulatory care
-Emergency care
-Hospitalization
-Maternal/newborn care
-Mental health/substance abuse
-Prescription drugs
-Rehab centers for disabled/chronic conditions
-Lab services
-Preventive wellness services
QUESTIONS BANK; COMPLETE
ACCURATE QUIZZES WITH VERIFIED
ANSWERS
% of people in private plans - correct answer- 66%
% of people in public plans - correct answer- 35.7%
% of people with health insurance - correct answer-
91.7%
% of people without health insurance - correct answer-
8.3%
2 requirements for ex post moral hazard - correct
answer- 1. Price distortion: don't feel full cost of
treatment when covered
2. Price sensitivity: increase consumption of health care if costs
go down
,2 varieties of ESHI - correct answer- Fully insured vs
self insured
3 approaches to pricing risk - correct answer- 1.
Individual risk rated -- pre ACA individual market, life insurance,
auto insurance
2. Experience rated -- ESHI plans -- varies by health status and
health care use
3. Community rated (uniform prices) -- Medicare advantage,
Medicare Part D, post ACA individual market -- offer people the
same price but can change based on zip code, age, and smoking
3 eligibility requirements for Medicare (ADD) - correct
answer- 1. Elderly: 65+ and have paid social security taxes
x 10 years (age)
2. Fully disabled x 24 months (disability)
3. End stage renal disease (disease)
3 hospital payment systems - correct answer- Fee for
service (fixed amount for each service)
-- Incentive to do as much as possible as first then get rid of
them
Diagnosis related groups (per diagnosis)
,-- Incentive to do as little as possible
-- Hard to adjust for severity
-- Hard to deal with extreme cases
-- Address differences inherent to different types of hospitals
Per diem (per days in hospital)
-- Incentive to over provide care
3 parts of evidence based practice - correct answer-
Clinical experience
Scientific evidence
Patient values
3 pronged plan of ACA - correct answer- 1. Fix
problems with non-group insurance market that leave uninsured
with no place to turn (GUARANTEED ISSUE)
- Rules that prevent insurers from denying coverage or raising
premiums based on preexisting conditions
- Modified community rating, age bands/smoking
2. Requirements that everyone buy insurance, employers offer it
(INDIVIDUAL MANDATE)
, - Tax penalty if they do not comply
- Insurers can price at average risk if everyone is required to be
covered
3. Financial assistance to make insurance affordable
- Lowest income = Medicaid expansion
- Middle income = subsidies to purchase private insurance
3rd leading cause of death in US - correct answer-
Medical error (25%)
10 Essential Benefits of ACA - correct answer- -
Ambulatory care
-Emergency care
-Hospitalization
-Maternal/newborn care
-Mental health/substance abuse
-Prescription drugs
-Rehab centers for disabled/chronic conditions
-Lab services
-Preventive wellness services
