CSBI HFMA ACTUAL EXAM QUESTIONS WITH ANSWERS
2025/2026
Provider-centric - This approach is the traditional viewpoint for the healthcare delivery
continuum. In this environment, the patient being cared for is guided along a care path
that is largely predetermined and/or promoted by the provider. Includes the thought that
patient being served do not have the necessary level of comprehension or
understanding of their situation.
Patient-centric - The healthcare industry is shifting towards this approach. Based on the
patient's condition and prospects for improvement, services are rendered in relation to
the situation, as opposed to only considering how an individual progress through a
series of facilities.
HIPAA Act - Health Insurance Portability and Accountability Act
HITECH Act - Health Information Technology Economic and Clinical Health Act
HIPAA - Covers how PHI is protected and handled.
HITECH - To promote and expand adoption of HIT, spells meaningful use requirements.
BI is a prime source of data information for MU rules. Now promoting interoperability.
Professionalism - Basic values: Honesty and integrity, accountability, self regulation,
specialized knowledge, building expertise, competency, image.
The obligation to use one's specialized knowledge and expertise to add value
What are the components of Healthcare delivery services? - 1-What is provided - the
healthcare care services
2-What ways it is provided - types of services
3-Whom/Where? Providers and locations, payment providers
4-How - components of effective operations - providers, locations, supplier, payors,
insurers
5-Influencers - education, government, research
What are internal components of healthcare service delivery? - Medical care services,
types of health services, providers and locations, ACA providers, Provider organization
ownership status, supplier supply chain, payors, education/research, government.
What are external components of healthcare service delivery? - Economic factors,
social values, global influences, population characteristics, political climate, technology
developments, physical environment
SDoH - social determinants of health ( where people live, learn, work. and play) Their
socioeconomic status, education, age, and access to health care.
, Healthcare Care Services - How the patient is served and is the mission of the
healthcare industry. Examples are: preventive, treatment-curative, treatment-chronic,
restorative
Types of Health Services - Refer to locations, care settings or providers of care.
Examples are: preventive, primary care, acute, specialty, subacute, chronic, long term,
rehabilitative, end of life care
Providers & Locations - Adds complexity to the healthcare delivery service that patients
must navigate. Patients must have contacts with these touch points are required for
care.
CPP Constrained Payment Providers - Method in which payments for services paid are
defined in advance of care. Examples are Accountable Care Organizations (ACO),
Patient Centered Medical Homes (PCMHs), Medicare Advantage Plans, and service
specific bundled payments
Bundled Payments - service programs where payment is made on the basis of expected
costs for clinically defined episodes of care. Also known as global payments, case rate,
episodic payment.
Provider Organization Ownership Status - Refers to Not For Profit or For Profit.
Historically, physician entities were largely for profit, but now many are changing to not
for profit status. Tax issues are affecting this area where efforts must be taken to ensure
community service requirements are maintained for tax-exemptions.
Supplier and supply chain - Comprised of all for-profit entities, manufacturers of all kind,
distributions organizations, purchasing entities. Examples are - pharmaceuticals,
biomedical, life sciences, comsumables
Government - Key system component at the federal level. Has vast influence -
Medicare, ACA implementation, FDA, Public health service, and general health
regulations. examples are - public insurance financing, health regulations/policy,
research funding, public health
Economic Factors - general economy, consumer sentiments and demand elasticity,
economic development, demand elasticity by service, labor market/union strength,
employer strength, demand elasticity, market liquidity
Social Values - Diversity, social cohesion, established precedents, religious preferences
Global Influences - Immigration, vacation travel, tourism, epidemics, terrorism, demands
for equity in medication distribution
2025/2026
Provider-centric - This approach is the traditional viewpoint for the healthcare delivery
continuum. In this environment, the patient being cared for is guided along a care path
that is largely predetermined and/or promoted by the provider. Includes the thought that
patient being served do not have the necessary level of comprehension or
understanding of their situation.
Patient-centric - The healthcare industry is shifting towards this approach. Based on the
patient's condition and prospects for improvement, services are rendered in relation to
the situation, as opposed to only considering how an individual progress through a
series of facilities.
HIPAA Act - Health Insurance Portability and Accountability Act
HITECH Act - Health Information Technology Economic and Clinical Health Act
HIPAA - Covers how PHI is protected and handled.
HITECH - To promote and expand adoption of HIT, spells meaningful use requirements.
BI is a prime source of data information for MU rules. Now promoting interoperability.
Professionalism - Basic values: Honesty and integrity, accountability, self regulation,
specialized knowledge, building expertise, competency, image.
The obligation to use one's specialized knowledge and expertise to add value
What are the components of Healthcare delivery services? - 1-What is provided - the
healthcare care services
2-What ways it is provided - types of services
3-Whom/Where? Providers and locations, payment providers
4-How - components of effective operations - providers, locations, supplier, payors,
insurers
5-Influencers - education, government, research
What are internal components of healthcare service delivery? - Medical care services,
types of health services, providers and locations, ACA providers, Provider organization
ownership status, supplier supply chain, payors, education/research, government.
What are external components of healthcare service delivery? - Economic factors,
social values, global influences, population characteristics, political climate, technology
developments, physical environment
SDoH - social determinants of health ( where people live, learn, work. and play) Their
socioeconomic status, education, age, and access to health care.
, Healthcare Care Services - How the patient is served and is the mission of the
healthcare industry. Examples are: preventive, treatment-curative, treatment-chronic,
restorative
Types of Health Services - Refer to locations, care settings or providers of care.
Examples are: preventive, primary care, acute, specialty, subacute, chronic, long term,
rehabilitative, end of life care
Providers & Locations - Adds complexity to the healthcare delivery service that patients
must navigate. Patients must have contacts with these touch points are required for
care.
CPP Constrained Payment Providers - Method in which payments for services paid are
defined in advance of care. Examples are Accountable Care Organizations (ACO),
Patient Centered Medical Homes (PCMHs), Medicare Advantage Plans, and service
specific bundled payments
Bundled Payments - service programs where payment is made on the basis of expected
costs for clinically defined episodes of care. Also known as global payments, case rate,
episodic payment.
Provider Organization Ownership Status - Refers to Not For Profit or For Profit.
Historically, physician entities were largely for profit, but now many are changing to not
for profit status. Tax issues are affecting this area where efforts must be taken to ensure
community service requirements are maintained for tax-exemptions.
Supplier and supply chain - Comprised of all for-profit entities, manufacturers of all kind,
distributions organizations, purchasing entities. Examples are - pharmaceuticals,
biomedical, life sciences, comsumables
Government - Key system component at the federal level. Has vast influence -
Medicare, ACA implementation, FDA, Public health service, and general health
regulations. examples are - public insurance financing, health regulations/policy,
research funding, public health
Economic Factors - general economy, consumer sentiments and demand elasticity,
economic development, demand elasticity by service, labor market/union strength,
employer strength, demand elasticity, market liquidity
Social Values - Diversity, social cohesion, established precedents, religious preferences
Global Influences - Immigration, vacation travel, tourism, epidemics, terrorism, demands
for equity in medication distribution
