Health Care Systems Final Exam Solved
Correctly To Score A+
Based on your knowledge of the "flat of the curve" model, how would increasing the
healthcare budget change the overall health of people?
A. People would be healthier; money spent directly relates to health.
B. People would be less healthy; generally high prices de-incentivizes providing quality
care.
C. People's health would not change
D. People would initially be healthier as money spent increases, but eventually, a
plateau would be reached where spending more money would not improve health
CORRECT ANSWERS D. People would initially be healthier as money spent increases,
but eventually, a plateau would be reached where spending more money would not
improve health
What percent of the population consumes 50% of healthcare spending?
A. The top 3% of the population
B. 50% of the population
C. 63% of the population
D. There is an equal distribution of healthcare spending across the population
CORRECT ANSWERS A. The top 3% of the population
A health system is the organization of all of the following EXCEPT...
A. People
B. Institutions
C. Law enforcement
D. Resources CORRECT ANSWERS C. Law enforcement
With lifestyle choices driving up to half the preventable deaths and disabilities in the US,
what area of healthcare delivery system should resources be allocated to improve the
overall lifestyle choices of the American public?
A. Public health
B. Primary care
C. Secondary care
D. Tertiary care CORRECT ANSWERS B. Primary care (should be correct per Dr.
Brown - SHE WILL RE-WRITE THIS QUESTION)
The "flat of the curve" medicine is the idea that in the US:
A. The more dollars spent the better the health outcomes
,B. The fewer dollars spent the worse the health outcomes
C. Once a certain level money is spent additional dollars will not improve healthcare
outcomes at the same rate that they did at the beginning
D. None of the above CORRECT ANSWERS C. Once a certain level money is spent
additional dollars will not improve healthcare outcomes at the same rate that they did at
the beginning
The US health system can be best described as:
A. Mixed
B. Fragmented
C. Market-driven
D. All of the above CORRECT ANSWERS D. all of the above
All of the following are examples of primary care EXCEPT:
A. Educating patients on smoking cessation
B. Ensuring patients are wearing helmets when riding bicycles and seat belts when
riding in a car
C. Care for patient in new acute renal failure requiring dialysis
D. Checking that the patient's vaccinations are up to date CORRECT ANSWERS C.
Care for patient in new acute renal failure requiring dialysis
Which of the following models is best for cost control?
A. Fee for service
B. Payment by episode of illness
C. Per diem payments to hospitals
D. Capitation payment CORRECT ANSWERS D. Capitation payment
Which example best depicts "pay for performance"?
A. A provider receives a bonus for implementing preventative care services within their
practice.
B. A provider receives bonuses based on the number of diabetic patients they see in a
day.
C. Physicians and other providers are paid based on the amount of patients they see in
a day.
D. A doctor gets paid every time a patient receives an MRI. CORRECT ANSWERS A. A
provider receives a bonus for implementing preventative care services within their
practice.
Which of the following unit of payment methods would shift the most risk onto the
provider?
A. Fee for Service (FFS)
,B. Capitation Payments
C. Per Diem Payments
D. Cost Reimbursement CORRECT ANSWERS B. Capitation Payments
Bill is an 87-year-old male who presents to the hospital with symptoms consistent with
pneumonia and urinary tract infection (UTI). He receives x-rays, urinalysis, antibiotics,
and a full metabolic workup. He is on continuous telemetry and receives continuous
oxygen. After a few days, Bill is discharged and the hospital stay costs $25,000. Based
on his diagnosis, Medicare paid a lump sum of $8,000 to the hospital for all the services
provided during his hospital stay. This form of payment is defined as:
A. Capitation
B. Pay-for-Performance
C. Diagnosis-Related Group (DRG)
D. Fee-for-Service CORRECT ANSWERS C. Diagnosis-Related Group (DRG)
Lindsay is a 52-year-old female who has new insurance coverage after starting a new
job. She wants to stay with her previous PCP, but they are out of the "preferred
network" and thus causing her to pay a higher share of cost. What care plan is this an
example of?
A. Preferred Provider Organization (PPO)
B. Health Maintenance Organization (HMO)
C. Medicare
D. Medicaid CORRECT ANSWERS A. Preferred Provider Organization (PPO)
Johnny Appleseed, a patient of Dr. Orchard, is seen for recent onset of diabetes. Dr.
Orchard spends 20 minutes performing an examination, finger-stick blood glucose test,
urinalysis, and ECG. Each service has a fee set by Dr. Orchard: $100 for a complex
visit, $10 for a finger-stick glucose test, $10 for a urinalysis, and $80 for an ECG.
Because Mr. Appleseed is uninsured, Dr. Orchard reduces the total bill from $200 to
$100. Which method of physician payment is exemplified in this scenario?
A. Fee-for service
B. Capitation
C. Salary
D. Payment per episode of illness CORRECT ANSWERS a. Fee-for service
Which of these systems of physician payment produces risk that is completely absorbed
by insurance companies, governing agencies, or patients?
A. Capitation
B. Fee for service
C. Payment per episode of illness
D. Per diem CORRECT ANSWERS B. fee for service
, Medicare pays Simmons Hospital $7,699 for their beneficiary's total knee replacement.
This payment was made up front to cover services rendered from the orthopedic
surgeon, anesthesiologists, nursing, physical therapists and more. This is an example of
a(n) ________ payment.
A. Fee for service
B. Bundled
C. Out of pocket
D. Pay for performance CORRECT ANSWERS B. bundled
Private insurers, Medicare, and Medicaid are replacing fee-for-service payment, which
encourages use of more services. Does this tend to:
A. Shift financial risk away from payers toward physicians and hospitals in an effort to
control costs.
B. Shift financial risk from hospitals and physicians towards patients in effort to control
patient spending.
C. Create no shift at all.
D. Shift financial risk away from hospitals, physicians, and payers in an effort to control
costs. CORRECT ANSWERS A. Shift financial risk away from payers toward physicians
and hospitals in an effort to control costs.
Which model uses an insurance system where insurers are called "sickness funds,"
where these funds are jointly financed by employers and employees through payroll
deduction?
a. Beveridge Model
b. Bismarck Model
c. National Insurance Model
d. Out-of-Pocket Model CORRECT ANSWERS b. Bismarck Model
What type of international healthcare system does Medicare correspond with?
a. Beveridge Model
b. Bismarck Model
c. National Insurance Model
d. Out-of-Pocket Model CORRECT ANSWERS c. National Insurance Model
Which of the following countries utilizes an insurance method in which all citizens are
covered by a national insurance and private insurance may be purchased individually
that could cover services that are also covered by the national health insurance?
a. United States
b. Germany
c. Canada
d. United Kingdom CORRECT ANSWERS d. United Kingdom
Correctly To Score A+
Based on your knowledge of the "flat of the curve" model, how would increasing the
healthcare budget change the overall health of people?
A. People would be healthier; money spent directly relates to health.
B. People would be less healthy; generally high prices de-incentivizes providing quality
care.
C. People's health would not change
D. People would initially be healthier as money spent increases, but eventually, a
plateau would be reached where spending more money would not improve health
CORRECT ANSWERS D. People would initially be healthier as money spent increases,
but eventually, a plateau would be reached where spending more money would not
improve health
What percent of the population consumes 50% of healthcare spending?
A. The top 3% of the population
B. 50% of the population
C. 63% of the population
D. There is an equal distribution of healthcare spending across the population
CORRECT ANSWERS A. The top 3% of the population
A health system is the organization of all of the following EXCEPT...
A. People
B. Institutions
C. Law enforcement
D. Resources CORRECT ANSWERS C. Law enforcement
With lifestyle choices driving up to half the preventable deaths and disabilities in the US,
what area of healthcare delivery system should resources be allocated to improve the
overall lifestyle choices of the American public?
A. Public health
B. Primary care
C. Secondary care
D. Tertiary care CORRECT ANSWERS B. Primary care (should be correct per Dr.
Brown - SHE WILL RE-WRITE THIS QUESTION)
The "flat of the curve" medicine is the idea that in the US:
A. The more dollars spent the better the health outcomes
,B. The fewer dollars spent the worse the health outcomes
C. Once a certain level money is spent additional dollars will not improve healthcare
outcomes at the same rate that they did at the beginning
D. None of the above CORRECT ANSWERS C. Once a certain level money is spent
additional dollars will not improve healthcare outcomes at the same rate that they did at
the beginning
The US health system can be best described as:
A. Mixed
B. Fragmented
C. Market-driven
D. All of the above CORRECT ANSWERS D. all of the above
All of the following are examples of primary care EXCEPT:
A. Educating patients on smoking cessation
B. Ensuring patients are wearing helmets when riding bicycles and seat belts when
riding in a car
C. Care for patient in new acute renal failure requiring dialysis
D. Checking that the patient's vaccinations are up to date CORRECT ANSWERS C.
Care for patient in new acute renal failure requiring dialysis
Which of the following models is best for cost control?
A. Fee for service
B. Payment by episode of illness
C. Per diem payments to hospitals
D. Capitation payment CORRECT ANSWERS D. Capitation payment
Which example best depicts "pay for performance"?
A. A provider receives a bonus for implementing preventative care services within their
practice.
B. A provider receives bonuses based on the number of diabetic patients they see in a
day.
C. Physicians and other providers are paid based on the amount of patients they see in
a day.
D. A doctor gets paid every time a patient receives an MRI. CORRECT ANSWERS A. A
provider receives a bonus for implementing preventative care services within their
practice.
Which of the following unit of payment methods would shift the most risk onto the
provider?
A. Fee for Service (FFS)
,B. Capitation Payments
C. Per Diem Payments
D. Cost Reimbursement CORRECT ANSWERS B. Capitation Payments
Bill is an 87-year-old male who presents to the hospital with symptoms consistent with
pneumonia and urinary tract infection (UTI). He receives x-rays, urinalysis, antibiotics,
and a full metabolic workup. He is on continuous telemetry and receives continuous
oxygen. After a few days, Bill is discharged and the hospital stay costs $25,000. Based
on his diagnosis, Medicare paid a lump sum of $8,000 to the hospital for all the services
provided during his hospital stay. This form of payment is defined as:
A. Capitation
B. Pay-for-Performance
C. Diagnosis-Related Group (DRG)
D. Fee-for-Service CORRECT ANSWERS C. Diagnosis-Related Group (DRG)
Lindsay is a 52-year-old female who has new insurance coverage after starting a new
job. She wants to stay with her previous PCP, but they are out of the "preferred
network" and thus causing her to pay a higher share of cost. What care plan is this an
example of?
A. Preferred Provider Organization (PPO)
B. Health Maintenance Organization (HMO)
C. Medicare
D. Medicaid CORRECT ANSWERS A. Preferred Provider Organization (PPO)
Johnny Appleseed, a patient of Dr. Orchard, is seen for recent onset of diabetes. Dr.
Orchard spends 20 minutes performing an examination, finger-stick blood glucose test,
urinalysis, and ECG. Each service has a fee set by Dr. Orchard: $100 for a complex
visit, $10 for a finger-stick glucose test, $10 for a urinalysis, and $80 for an ECG.
Because Mr. Appleseed is uninsured, Dr. Orchard reduces the total bill from $200 to
$100. Which method of physician payment is exemplified in this scenario?
A. Fee-for service
B. Capitation
C. Salary
D. Payment per episode of illness CORRECT ANSWERS a. Fee-for service
Which of these systems of physician payment produces risk that is completely absorbed
by insurance companies, governing agencies, or patients?
A. Capitation
B. Fee for service
C. Payment per episode of illness
D. Per diem CORRECT ANSWERS B. fee for service
, Medicare pays Simmons Hospital $7,699 for their beneficiary's total knee replacement.
This payment was made up front to cover services rendered from the orthopedic
surgeon, anesthesiologists, nursing, physical therapists and more. This is an example of
a(n) ________ payment.
A. Fee for service
B. Bundled
C. Out of pocket
D. Pay for performance CORRECT ANSWERS B. bundled
Private insurers, Medicare, and Medicaid are replacing fee-for-service payment, which
encourages use of more services. Does this tend to:
A. Shift financial risk away from payers toward physicians and hospitals in an effort to
control costs.
B. Shift financial risk from hospitals and physicians towards patients in effort to control
patient spending.
C. Create no shift at all.
D. Shift financial risk away from hospitals, physicians, and payers in an effort to control
costs. CORRECT ANSWERS A. Shift financial risk away from payers toward physicians
and hospitals in an effort to control costs.
Which model uses an insurance system where insurers are called "sickness funds,"
where these funds are jointly financed by employers and employees through payroll
deduction?
a. Beveridge Model
b. Bismarck Model
c. National Insurance Model
d. Out-of-Pocket Model CORRECT ANSWERS b. Bismarck Model
What type of international healthcare system does Medicare correspond with?
a. Beveridge Model
b. Bismarck Model
c. National Insurance Model
d. Out-of-Pocket Model CORRECT ANSWERS c. National Insurance Model
Which of the following countries utilizes an insurance method in which all citizens are
covered by a national insurance and private insurance may be purchased individually
that could cover services that are also covered by the national health insurance?
a. United States
b. Germany
c. Canada
d. United Kingdom CORRECT ANSWERS d. United Kingdom
