HCMG Study Guide Exams Questions/Answer 2025/2026
Graded A+
PostIndustrial Era - -XRAYs discovered 1895
-cities more centralized
-lay people could no longer deliver medical care
-fewer house calls
-PROFESSIONALIZATION of healthcare
Flexner Report - Examination of medical schools. Closure of a lot of schools came
about.
Medicare - One of the largest sources of public health insurance. Serves people over
65, disabled and people with End stage Renal disease.
Medicare Part A - Social Security funds to finance hospital care
Medicare Part B - covers physician services
Medicaid - The third largest source of health insurance in the US. provides coverage for
low-income adults, children and elderly and individuals with disabilities.
Blue Cross - hospital insurance
Blue Shield - physican fees (both merges in the 1970's)
Corporate Era - -1970's to present
-Managed care- control physician and hospital fees
-Integrated delivery system
-Information revolutions(telemedicine, e-health)
-Globilization-crossborder activities
3 Cornerstones of Healthcare delivery - -High in COST
-Unequal in ACCESS
-Average in QUALITY
3 Reasons for High Health Care Costs - 1- Growth of technology- inexpensive
technology makes people live longer.
2- Increased Elderly Population- Elderly consume more health care costs than the
general population
3- Multipayer system & Administrative Costs- its takes a lot of time and effort to keep up
with all payers, single payer would cut administrative costs.
Ways to contain costs - -EHRs should make it easier to share information between
physicians
, -A new focus on prevention and chronic disease management should keep costs from
rising
-ACA
Moral Hazard - consumer behavior that leads to higher utilization of health care services
when services are covered by insurance.
Single payer system - _____________ systems are usually financed more
progressively, and rely on existing taxation systems; they effectively distribute risks
throughout one large risk pool; and they offer governments a high degree of control over
the total expenditure on health.
Multi payer system - In this system two or more providers administer the UHC and
usually do so in competition with each other. The government, or its nominee, may or
may not be an active participant, but usually is expected to set the rules of the
competition and monitor the system to ensure fair and equitable service.
Patients without insurance - -Less likely to have a source of ongoing care
-less likely to have preventative care like flu-shots and cancer screening
-more likely to utilize expensive emergency care
Health Care Quality - the degree to which health services for individuals and
populations increase the likelihood of desired health outcomes
DONABEDIAN FRAMEWORK - Structure-available resources, infrastructure
(technology,personnel), financing
-Accreditation
-# of trained employees
-Technological competencies and devices
DONABEDIAN FRAMEWORK - Process- care delivery, strategies, communication
-correct diagnostic test
-correct prescriptions
-accurate drug admin
DONABEDIAN FRAMEWORK - Outcome- Patient, organizational, Community of
environmental
-infection rates
-rates of rehospitalization
-patient satisfaction
Vulnerable porpulations - -racial and ethnic minorities
-children
-women
-unisured
-people living in rural areas
Graded A+
PostIndustrial Era - -XRAYs discovered 1895
-cities more centralized
-lay people could no longer deliver medical care
-fewer house calls
-PROFESSIONALIZATION of healthcare
Flexner Report - Examination of medical schools. Closure of a lot of schools came
about.
Medicare - One of the largest sources of public health insurance. Serves people over
65, disabled and people with End stage Renal disease.
Medicare Part A - Social Security funds to finance hospital care
Medicare Part B - covers physician services
Medicaid - The third largest source of health insurance in the US. provides coverage for
low-income adults, children and elderly and individuals with disabilities.
Blue Cross - hospital insurance
Blue Shield - physican fees (both merges in the 1970's)
Corporate Era - -1970's to present
-Managed care- control physician and hospital fees
-Integrated delivery system
-Information revolutions(telemedicine, e-health)
-Globilization-crossborder activities
3 Cornerstones of Healthcare delivery - -High in COST
-Unequal in ACCESS
-Average in QUALITY
3 Reasons for High Health Care Costs - 1- Growth of technology- inexpensive
technology makes people live longer.
2- Increased Elderly Population- Elderly consume more health care costs than the
general population
3- Multipayer system & Administrative Costs- its takes a lot of time and effort to keep up
with all payers, single payer would cut administrative costs.
Ways to contain costs - -EHRs should make it easier to share information between
physicians
, -A new focus on prevention and chronic disease management should keep costs from
rising
-ACA
Moral Hazard - consumer behavior that leads to higher utilization of health care services
when services are covered by insurance.
Single payer system - _____________ systems are usually financed more
progressively, and rely on existing taxation systems; they effectively distribute risks
throughout one large risk pool; and they offer governments a high degree of control over
the total expenditure on health.
Multi payer system - In this system two or more providers administer the UHC and
usually do so in competition with each other. The government, or its nominee, may or
may not be an active participant, but usually is expected to set the rules of the
competition and monitor the system to ensure fair and equitable service.
Patients without insurance - -Less likely to have a source of ongoing care
-less likely to have preventative care like flu-shots and cancer screening
-more likely to utilize expensive emergency care
Health Care Quality - the degree to which health services for individuals and
populations increase the likelihood of desired health outcomes
DONABEDIAN FRAMEWORK - Structure-available resources, infrastructure
(technology,personnel), financing
-Accreditation
-# of trained employees
-Technological competencies and devices
DONABEDIAN FRAMEWORK - Process- care delivery, strategies, communication
-correct diagnostic test
-correct prescriptions
-accurate drug admin
DONABEDIAN FRAMEWORK - Outcome- Patient, organizational, Community of
environmental
-infection rates
-rates of rehospitalization
-patient satisfaction
Vulnerable porpulations - -racial and ethnic minorities
-children
-women
-unisured
-people living in rural areas
