MHA 707 Exam 3 questions with verified answers
"cottage industry" Ans✓✓✓ •For-profit corporations contrast to
_________________ providers of the past [made Medicine a business]
•Same trend in medical care as local banks replaced by large national and
international banking corporations
"shortages" Ans✓✓✓ can be artificially induced in the physician labor market
through a hospital's limiting medical staff affiliations (closed panel PHO) or
insurers developing narrow provider networks that restrict participation by
physicians outside the network. Therefore, little wonder that the physician labor
market is anything but "free".
"truths" in motivating physician behavior Ans✓✓✓ Employed doctors are easier
to motivate than independent practitioners
Physicians identify themselves as "doctor" with a higher level of intensity than
"your employee"
(Ex: Doctors are considered "free agents" by the HR Department)
If ownership in an enterprise is possible, physicians will respond in a more "team
oriented" fashion
If they perceive themselves as owners
(Ex: physician employee vs. physician owned HMOs)
• Health care is a public good
• Health care is a private good Ans✓✓✓ The U.S. health care system exists within
a framework bounded by two ideological opposites:
•Outcomes (ala Donnabedian) Ans✓✓✓ earliest Dimensions of Quality
,-End results people experience and care about
-Ensure that there are no other, unmeasured factors intervening to produce poor
outcomes, even with good process scores
•Process (ala Donnabedian) Ans✓✓✓ earliest Dimensions of Quality
-Set of services provided
-Measuring process can bring you closer to the outcome, but does not guarantee
the outcome
•Structure (ala Donnabedian) Ans✓✓✓ earliest Dimensions of Quality
-Facilities and health care professionals providing care
-Measures are the easiest to conduct, but the most remote from outcome
$29,000
50% Ans✓✓✓ •With per household NHE at around ______, health care
expenditures would be more than _____of the median household income.
$3,700
$10,000 Ans✓✓✓ •Average cost per enrollee for Medicaid for each state varies
considerably by each state's rules: in 2014 from about $______ in South Carolina
to over $______ in North Dakota.
$8,000 Ans✓✓✓ •In 2017, the estimated average insurance cost per enrollee for
Medicaid (i.e., excluding out-of-pocket expenses) was just over $_____ nationally.
18%
,62% Ans✓✓✓ Medicaid programs totaled about ___% of HCE or $582 billion in
2017 and about ___% of that came from the federal government with the rest
split among the 50 states
1948 United Nations Declaration of Human Rights Ans✓✓✓ •"Everyone has the
right to a standard of living adequate for the health and well-being of himself and
of his family, including food, clothing, housing and medical care and necessary
social services. ... The Universal Declaration makes additional accommodations for
security in case of physical debilitation or disability, and makes special mention of
care given to those in motherhood or childhood fundamental human rights to be
universally protected"
2010 study of adverse events Ans✓✓✓ •in hospitals found that "The patient's
concept of adverse events was different from that of the physician. ... Patients
emphasized emotional consequences of the adverse events"
2017, the largest MCOs Ans✓✓✓ •UnitedHealth Group with almost 50 million
members and just over $201 billion in revenue
•Anthem with just over 40 million members and about $90 billion in revenue
•Aetna with just over 22 million members and $60 billion revenue
20M
24M Ans✓✓✓ •By 2018, "an estimated ____ million people (had) become newly
insured, and approximately ____ million people (had) gained access to subsidized
or free care through marketplace tax credits and Medicaid expansion"
21%
, $706B Ans✓✓✓ Medicare was the source of funds for _____% of HCE or about
$____ billion in 2017; estimated average cost per enrollee in Medicare was just
over $12,300 in 2017, the most of any of the major classes of payer (expensive!)
26.4 M Ans✓✓✓ uninsured 2019
36% Ans✓✓✓ •Private health insurance paid about ____% of Health
Consumption Expenditures (HCE) in 2017, an amount relatively constant since
1990
51 Cardiology Clinical Guidelines Ans✓✓✓ Level I - 11% of recommendations
Level II - 50% of recommendations
Level III or lower - 39% of recommendations
70% Ans✓✓✓ Physicians and other prescribers are responsible for directing
where _____% of all the money in health care is spent.
77%
23% Ans✓✓✓ In 2018, ___% of Medicaid enrollees were nonelderly adults and
children, while ___% were disabled and elderly adults
8% Ans✓✓✓ ____ % of people under the age of 65 were uninsured in 2019.
•Uninsured patients are termed "self-pay" or "self-insured"
•Often "unassigned" as well
"cottage industry" Ans✓✓✓ •For-profit corporations contrast to
_________________ providers of the past [made Medicine a business]
•Same trend in medical care as local banks replaced by large national and
international banking corporations
"shortages" Ans✓✓✓ can be artificially induced in the physician labor market
through a hospital's limiting medical staff affiliations (closed panel PHO) or
insurers developing narrow provider networks that restrict participation by
physicians outside the network. Therefore, little wonder that the physician labor
market is anything but "free".
"truths" in motivating physician behavior Ans✓✓✓ Employed doctors are easier
to motivate than independent practitioners
Physicians identify themselves as "doctor" with a higher level of intensity than
"your employee"
(Ex: Doctors are considered "free agents" by the HR Department)
If ownership in an enterprise is possible, physicians will respond in a more "team
oriented" fashion
If they perceive themselves as owners
(Ex: physician employee vs. physician owned HMOs)
• Health care is a public good
• Health care is a private good Ans✓✓✓ The U.S. health care system exists within
a framework bounded by two ideological opposites:
•Outcomes (ala Donnabedian) Ans✓✓✓ earliest Dimensions of Quality
,-End results people experience and care about
-Ensure that there are no other, unmeasured factors intervening to produce poor
outcomes, even with good process scores
•Process (ala Donnabedian) Ans✓✓✓ earliest Dimensions of Quality
-Set of services provided
-Measuring process can bring you closer to the outcome, but does not guarantee
the outcome
•Structure (ala Donnabedian) Ans✓✓✓ earliest Dimensions of Quality
-Facilities and health care professionals providing care
-Measures are the easiest to conduct, but the most remote from outcome
$29,000
50% Ans✓✓✓ •With per household NHE at around ______, health care
expenditures would be more than _____of the median household income.
$3,700
$10,000 Ans✓✓✓ •Average cost per enrollee for Medicaid for each state varies
considerably by each state's rules: in 2014 from about $______ in South Carolina
to over $______ in North Dakota.
$8,000 Ans✓✓✓ •In 2017, the estimated average insurance cost per enrollee for
Medicaid (i.e., excluding out-of-pocket expenses) was just over $_____ nationally.
18%
,62% Ans✓✓✓ Medicaid programs totaled about ___% of HCE or $582 billion in
2017 and about ___% of that came from the federal government with the rest
split among the 50 states
1948 United Nations Declaration of Human Rights Ans✓✓✓ •"Everyone has the
right to a standard of living adequate for the health and well-being of himself and
of his family, including food, clothing, housing and medical care and necessary
social services. ... The Universal Declaration makes additional accommodations for
security in case of physical debilitation or disability, and makes special mention of
care given to those in motherhood or childhood fundamental human rights to be
universally protected"
2010 study of adverse events Ans✓✓✓ •in hospitals found that "The patient's
concept of adverse events was different from that of the physician. ... Patients
emphasized emotional consequences of the adverse events"
2017, the largest MCOs Ans✓✓✓ •UnitedHealth Group with almost 50 million
members and just over $201 billion in revenue
•Anthem with just over 40 million members and about $90 billion in revenue
•Aetna with just over 22 million members and $60 billion revenue
20M
24M Ans✓✓✓ •By 2018, "an estimated ____ million people (had) become newly
insured, and approximately ____ million people (had) gained access to subsidized
or free care through marketplace tax credits and Medicaid expansion"
21%
, $706B Ans✓✓✓ Medicare was the source of funds for _____% of HCE or about
$____ billion in 2017; estimated average cost per enrollee in Medicare was just
over $12,300 in 2017, the most of any of the major classes of payer (expensive!)
26.4 M Ans✓✓✓ uninsured 2019
36% Ans✓✓✓ •Private health insurance paid about ____% of Health
Consumption Expenditures (HCE) in 2017, an amount relatively constant since
1990
51 Cardiology Clinical Guidelines Ans✓✓✓ Level I - 11% of recommendations
Level II - 50% of recommendations
Level III or lower - 39% of recommendations
70% Ans✓✓✓ Physicians and other prescribers are responsible for directing
where _____% of all the money in health care is spent.
77%
23% Ans✓✓✓ In 2018, ___% of Medicaid enrollees were nonelderly adults and
children, while ___% were disabled and elderly adults
8% Ans✓✓✓ ____ % of people under the age of 65 were uninsured in 2019.
•Uninsured patients are termed "self-pay" or "self-insured"
•Often "unassigned" as well
