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MHA 707 Exam C Questions Answers

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MHA 707 Exam C Questions & Answers 2023/2024 Moral Hazard Adverse Selection Pooling of Risk National Health Expenditure Accounts (NHEA) NHEA Benefits Accounts in the NHEA National Health Expenditures: NHE Health Consumption Expenditures: HCE Personal Health Care: PHC How much NHE spent on Health Care? Largest contributors to the Personal Health Care (PHC) What accounted for the largest share of NHE? Three Categories of PHC increased as a share of NHE Chronic Disease and Mental Health Diseases in NHE (percentage) Medical Conditions and Percentage on Americans Americans Stat on Health Ins Coverage Cost/Cost Plus How Money is Paid to Health Care Providers Time and Materials fee-for-service Fixed Price Capitation Value Major Health Care Payers in the US Employer Managed Care Plans HMO (Health Maintenance Organization) PPO (Preferred Provider Organization) POS (Point of Service) EPO (Exclusive Provider Organization) Largest MCO (manager care org)

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MHA 707 Exam C Questions & Answers
2023/2024

1). Moral hazard

 Ans: When the act of insuring an event increases the likelihood that the event will
happen


behaving different when you know someone is taking the risk (induced demand)


2). Adverse selection

 Ans: the situation in which one party to a transaction takes advantage of knowing
more than the other party to the transaction

the sicker people likely want more insurance, compared to those who are healthy


3). Pooling of risk

 Ans: Allows individuals to share risk, i.e., insurance companies


4). National health expenditure accounts (nhea)

 Ans: Provides official estimates of health care spending in the US. It measures health
care consumption and health care investment.


5). Nhea benefits

 Ans: Comprehensive: includes all major components of health care system in unified,
mutually exclusive, and exhaustive structure

Multidimensional: encompasses expenditures as well as payers

Consistent: applies a common set of definitions that permits longitudinal comparisons
Published by DHHS


6). Accounts in the nhea




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,  Ans: National Health Expenditures: NHE
Health Consumption Expenditures: HCE
Personal Health Care: PHC


7). National health expenditures: nhe

 Ans: all health care consumption and investments in medical structures and
equipment and noncommercial health services and biomedical research

NHE - HCE = Amount of investment in the medical sector of economy (buildings,
research, equipment)


8). Health consumption expenditures: hce

 Ans: a subset of NHE, includes personal health care spending, government
administration and net cost of private health insurance and public health activities


9). Personal health care: phc

 Ans: subset of HCE, including all medical goods and service that's used to diagnose,
treat, and prevent health problems of a specific person


10). How much nhe spent on health care?

 Ans: $3.49 Trillion
Per capita amount: over $10k
% of GDP: 18%
Buying Power: $1,200 when adjusted by CPI


11). Largest contributors to the personal health care (phc)

 Ans: hospitalization, physician services, Rx, other health care goods and services


12). What accounted for the largest share of nhe?

 Ans: Hospital Care: 33% of spending
Professional Services: 20% doctors NHE
Retail Rx: 10.5%


13). Three categories of phc increased as a share of nhe




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,  Ans: Health Residential and Personal Care: 5.2% of NHE
Net Cost of Private Health Ins: 6.6% of NHE
Home Health Care: 2.8% of NHE


14). Chronic disease and mental health diseases in nhe (percentage)

 Ans: 90%
Among the top 5% of users account for about half of the spending


15). Medical conditions and percentage on americans

 Ans: 90% of Americans have 1 risk factor, 52% have 2 or more highest proportion in
impoverished and racial/ethnic minorities


16). Americans stat on health ins coverage

 Ans: 92% of the US population have some sort of ins (8% or 26.4 M uninsured)


17). Cost/cost plus

 Ans: how hospitals/providers describe payments received for services they have
already provided. The organization tracks all the costs associated with each customer
and then asks to be paid that amount. Contracts specific that the organization will be
reimbursed for actual cost plus an additional percentage of cost (includes built in profit)


18). How money is paid to health care providers

 Ans: Cost/Cost Plus
Time and Materials
Fee for Service
Fixed Price
Capitation
Value


19). Time and materials

 Ans: A contract type where the seller charges the
buyer for the time and the materials for the
work completed. T&M contracts should have a
not-to-exceed clause (NTE) to contain costs.




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Subido en
27 de marzo de 2024
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2023/2024
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