2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
MHA 706 Midterm- Lord Questions & 100%
Correct Answers- Latest Test | Graded A+ |
Passed
Proprietorships & Partnerships: Pros & Cons
✓ -:- Pros: Ease of Information, Subject to a few regulations, no corporation income
taxes.
Cons: Limited life, difficult to transfer, unlimited life, difficult to raise capital.
Corporations: Pros & Cons
✓ -:- Pros: Unlimited life, easy transfer of ownership, limited liability, ease of raising
capital.
Cons: Cost of formation and reporting, double or triple taxes must be paid.
Non-profit Organization
✓ -:- Exempt from taxes. Goal is to improve community.
For-profit Organizations
✓ -:- (Investor Owned) Goal is to maximize shareholder return. Owe taxes.
Agency Problem
1|Page | Grade A+| 2024/2025
,2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
✓ -:- the possibility of conflict of interest between the stockholders and management
of a firm.
Example: Hire someone to carry out a job function, but they go out of their interests instead
of best interests of company/organization.
Third-party payor system in the US (i.e. private vs public)
✓ -:- Private: Blue Cross Blue Shield, Commercial Insurers, Self-Insurers. (AETNA)
Public: Medicare and Medicaid-both offer services to different levels. "Safety net" Lowest
reimbursement rates.
Reimbursement methods (fee-for-service vs. capitation)
✓ -:- Fee for Service: payment is tied to amount of services provided. (Decades ago)
*Dental industry*
Capitation: payment is tied to the size of the covered population (number of enrollees)
Payment is based on per # per month. *Decreasing utilization* Population is healthier.
Medicare reimbursement for different types of providers
2|Page | Grade A+| 2024/2025
, 2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
✓ -:- Medicare parts A, B & C.
Medicare Part A (aka Hospital Insurance or HI)
✓ -:- Provides hospital insurance automatically at age 65 (if FICA qualified) at no fee
but may have deductible & co-pay.
Medicare Part B
✓ -:- The part of the Medicare program that pays for physician services, outpatient
hospital services, durable medical equipment, and other services and supplies.
Medicare Part C (Medicare Advantage)
✓ -:- •Replaces and covers expenses found in Part A and B
•Medicare private fee-for-service plans (PFFS)
•Medicare managed care plans (HMOs and PPOs)
•Medicare specialty plans
Medicare—Part D Prescription Drug Coverage
3|Page | Grade A+| 2024/2025
MHA 706 Midterm- Lord Questions & 100%
Correct Answers- Latest Test | Graded A+ |
Passed
Proprietorships & Partnerships: Pros & Cons
✓ -:- Pros: Ease of Information, Subject to a few regulations, no corporation income
taxes.
Cons: Limited life, difficult to transfer, unlimited life, difficult to raise capital.
Corporations: Pros & Cons
✓ -:- Pros: Unlimited life, easy transfer of ownership, limited liability, ease of raising
capital.
Cons: Cost of formation and reporting, double or triple taxes must be paid.
Non-profit Organization
✓ -:- Exempt from taxes. Goal is to improve community.
For-profit Organizations
✓ -:- (Investor Owned) Goal is to maximize shareholder return. Owe taxes.
Agency Problem
1|Page | Grade A+| 2024/2025
,2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
✓ -:- the possibility of conflict of interest between the stockholders and management
of a firm.
Example: Hire someone to carry out a job function, but they go out of their interests instead
of best interests of company/organization.
Third-party payor system in the US (i.e. private vs public)
✓ -:- Private: Blue Cross Blue Shield, Commercial Insurers, Self-Insurers. (AETNA)
Public: Medicare and Medicaid-both offer services to different levels. "Safety net" Lowest
reimbursement rates.
Reimbursement methods (fee-for-service vs. capitation)
✓ -:- Fee for Service: payment is tied to amount of services provided. (Decades ago)
*Dental industry*
Capitation: payment is tied to the size of the covered population (number of enrollees)
Payment is based on per # per month. *Decreasing utilization* Population is healthier.
Medicare reimbursement for different types of providers
2|Page | Grade A+| 2024/2025
, 2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
✓ -:- Medicare parts A, B & C.
Medicare Part A (aka Hospital Insurance or HI)
✓ -:- Provides hospital insurance automatically at age 65 (if FICA qualified) at no fee
but may have deductible & co-pay.
Medicare Part B
✓ -:- The part of the Medicare program that pays for physician services, outpatient
hospital services, durable medical equipment, and other services and supplies.
Medicare Part C (Medicare Advantage)
✓ -:- •Replaces and covers expenses found in Part A and B
•Medicare private fee-for-service plans (PFFS)
•Medicare managed care plans (HMOs and PPOs)
•Medicare specialty plans
Medicare—Part D Prescription Drug Coverage
3|Page | Grade A+| 2024/2025
