MHA 707 Exam C
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)
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
Pooling of Risk - ANS Allows individuals to share risk, i.e., insurance companies
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.
DHEA 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
Accounts in the NHS - ANS National Health Expenditures: NHE
Health Consumption Expenditures: HCE
Personal Health Care: PHC
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)
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
, 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
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
Largest contributors to the Personal Health Care (PHC) - ANS hospitalization, physician
services, Rx, other health care goods and services
What accounted for the largest share of NHE? - ANS Hospital Care: 33% of spending
Professional Services: 20% doctors NHE
Retail Rx: 10.5%
Three Categories of PHC increased as a share of NSE - 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
Chronic Disease and Mental Health Diseases in NHE (percentage) - ANS 90%
Among the top 5% of users account for about half of the spending
Medical Conditions and Percentages on Americans - ANS 90% of Americans have 1 risk factor,
52% have 2 or more highest proportion in impoverished and racial/ethnic minorities
Americans Stay on Health Ins Coverage - ANS 92% of the US population have some sort of ins
(8% or 26.4 M uninsured)
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)
How Money is Paid to Health Care Providers - ANS Cost/Cost Plus
Time and Materials
Fee for Service
Fixed Price
Capitation
Value
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
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)
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
Pooling of Risk - ANS Allows individuals to share risk, i.e., insurance companies
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.
DHEA 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
Accounts in the NHS - ANS National Health Expenditures: NHE
Health Consumption Expenditures: HCE
Personal Health Care: PHC
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)
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
, 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
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
Largest contributors to the Personal Health Care (PHC) - ANS hospitalization, physician
services, Rx, other health care goods and services
What accounted for the largest share of NHE? - ANS Hospital Care: 33% of spending
Professional Services: 20% doctors NHE
Retail Rx: 10.5%
Three Categories of PHC increased as a share of NSE - 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
Chronic Disease and Mental Health Diseases in NHE (percentage) - ANS 90%
Among the top 5% of users account for about half of the spending
Medical Conditions and Percentages on Americans - ANS 90% of Americans have 1 risk factor,
52% have 2 or more highest proportion in impoverished and racial/ethnic minorities
Americans Stay on Health Ins Coverage - ANS 92% of the US population have some sort of ins
(8% or 26.4 M uninsured)
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)
How Money is Paid to Health Care Providers - ANS Cost/Cost Plus
Time and Materials
Fee for Service
Fixed Price
Capitation
Value
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
