HC FINANCE TEST 1 WITH 100% CORRECT
ANSWERS
Which dof dthe dfollowing dstatements dabout dthe dfinancial drisk dto dproviders dunder
ddifferent dreimbursement dmethods dis dmost dcorrect?
A) dDifferent dpayers duse ddifferent dreimbursement dmethods, dso dproviders dface
dvarying dlevels dof drisk.
d
B) dProspective dpayment dtransfers dthe dcost drisk d(of deach dreimbursable depisode)
dfrom dinsurers dto dproviders.
d
C) dCapitation dtransfers dboth dcost drisk dand dutilization drisk dto dproviders.
d
D) dStatements da. db. dand dc. dare dall dcorrect. d- dCORRECT✅✅D) dStatements da. db.
dand dc. dare dall dcorrect
Which dof dthe dfollowing dreimbursement dmethods dcreates dthe dgreatest dincentive dfor
dproviders dto dcontrol dthe dcost dof ddelivering dhealth dservices?
A) dCost-based dreimbursement
d
B) dCharge-based dreimbursement
d
C) dDiscounted dcharge-based dreimbursement
d
D) dPer ddiagnosis dprospective dpayment d
E) dCapitation d- dCORRECT✅✅E) dCapitation
Which dof dthe dfollowing dpayment dinitiatives dare dincluded din dhealthcare dreform
dlegislation d(the dAffordable dCare dAct)?
A) dValue-based dpurchasing
d
B) dNew dmodels dof dbundled dpayment
d
C) dPatient dage-based dreimbursement
d
D) dInitiatives da. dand db. dare dboth dcorrect.
d
E) dInitiatives da., db., dand dc. dare dall dcorrect. d- dCORRECT✅✅D) dInitiatives da. dand
db. dare dboth dcorrect.
, Which dof dthe dfollowing dstatements dabout dcapitation dis dmost dcorrect?
A) dCapitation dcreates da ddelay dbetween dproviding dservices dand dreceiving dpayment.
B) dThe dcapitation dpayment damount dto dproviders dvaries dsignificantly dfrom dmonth dto
dmonth dand dhence dis ddifficult dto dpredict.
C) dCapitation dencourages dproviders dto dfocus don dprevention dand dwellness.
D) dCapitation dplaces da dgreater dadministrative dburden don dproviders dthan ddoes dfee-
for-service dpayment.
E) dCapitation duses da dper ddiagnosis dmethodology dto dset dhospital dpayment drates. d-
dCORRECT✅✅C) dCapitation dencourages dproviders dto dfocus don dprevention dand
dwellness.
Which dof dthe dfollowing dbasic dcharacteristics dare drequired dto dmake dhealth
dinsurance d"work"?
A) dPooling dof dlosses
B) dPayment donly dfor drandom dlosses
C) dRisk dtransfer
D) dIndemnification
E) dAll dof dthe dabove dcharacteristics dare drequired d- dCORRECT✅✅E) dAll dof dthe
dabove dcharacteristics dare drequired
Which dof dthe dfollowing dstatements dabout dMedicare's dpayment dsystem dfor
dphysicians' dservices dis dmost dcorrect?
A) dEach dpatient dis dassigned da dMedicare dPatient dIdentification dCode d(PIC) dthat
dreflects dthe dseverity dof dthe dpatient's ddiagnosis.
B) dPatients dare ddivided dinto dfive dgroups d(A-E) dbased don ddiagnosis, dwith dthe dE
dgroup dreimbursement dbeing dthe dgreatest.
C) dEach dservice dperformed dhas da drelative dvalue dunit d(RVU) dassigned dthat dreflects
dthe damount dof dphysician dwork, dpractice dexpenses, dand dliability dinsurance dcosts.
D) dPhysicians dare dpaid dusing dMedicare's dOutpatient dObservation dPayment dSystem
d(OOPS).
E) dPhysicians dare dpaid dusing dMedicare's dAmbulatory dPatient dPayment dSystem
d(APPS). d- dCORRECT✅✅C) dEach dservice dperformed dhas da drelative dvalue dunit
d(RVU) dassigned dthat dreflects dthe damount dof dphysician dwork, dpractice dexpenses,
dand dliability dinsurance dcosts.
ANSWERS
Which dof dthe dfollowing dstatements dabout dthe dfinancial drisk dto dproviders dunder
ddifferent dreimbursement dmethods dis dmost dcorrect?
A) dDifferent dpayers duse ddifferent dreimbursement dmethods, dso dproviders dface
dvarying dlevels dof drisk.
d
B) dProspective dpayment dtransfers dthe dcost drisk d(of deach dreimbursable depisode)
dfrom dinsurers dto dproviders.
d
C) dCapitation dtransfers dboth dcost drisk dand dutilization drisk dto dproviders.
d
D) dStatements da. db. dand dc. dare dall dcorrect. d- dCORRECT✅✅D) dStatements da. db.
dand dc. dare dall dcorrect
Which dof dthe dfollowing dreimbursement dmethods dcreates dthe dgreatest dincentive dfor
dproviders dto dcontrol dthe dcost dof ddelivering dhealth dservices?
A) dCost-based dreimbursement
d
B) dCharge-based dreimbursement
d
C) dDiscounted dcharge-based dreimbursement
d
D) dPer ddiagnosis dprospective dpayment d
E) dCapitation d- dCORRECT✅✅E) dCapitation
Which dof dthe dfollowing dpayment dinitiatives dare dincluded din dhealthcare dreform
dlegislation d(the dAffordable dCare dAct)?
A) dValue-based dpurchasing
d
B) dNew dmodels dof dbundled dpayment
d
C) dPatient dage-based dreimbursement
d
D) dInitiatives da. dand db. dare dboth dcorrect.
d
E) dInitiatives da., db., dand dc. dare dall dcorrect. d- dCORRECT✅✅D) dInitiatives da. dand
db. dare dboth dcorrect.
, Which dof dthe dfollowing dstatements dabout dcapitation dis dmost dcorrect?
A) dCapitation dcreates da ddelay dbetween dproviding dservices dand dreceiving dpayment.
B) dThe dcapitation dpayment damount dto dproviders dvaries dsignificantly dfrom dmonth dto
dmonth dand dhence dis ddifficult dto dpredict.
C) dCapitation dencourages dproviders dto dfocus don dprevention dand dwellness.
D) dCapitation dplaces da dgreater dadministrative dburden don dproviders dthan ddoes dfee-
for-service dpayment.
E) dCapitation duses da dper ddiagnosis dmethodology dto dset dhospital dpayment drates. d-
dCORRECT✅✅C) dCapitation dencourages dproviders dto dfocus don dprevention dand
dwellness.
Which dof dthe dfollowing dbasic dcharacteristics dare drequired dto dmake dhealth
dinsurance d"work"?
A) dPooling dof dlosses
B) dPayment donly dfor drandom dlosses
C) dRisk dtransfer
D) dIndemnification
E) dAll dof dthe dabove dcharacteristics dare drequired d- dCORRECT✅✅E) dAll dof dthe
dabove dcharacteristics dare drequired
Which dof dthe dfollowing dstatements dabout dMedicare's dpayment dsystem dfor
dphysicians' dservices dis dmost dcorrect?
A) dEach dpatient dis dassigned da dMedicare dPatient dIdentification dCode d(PIC) dthat
dreflects dthe dseverity dof dthe dpatient's ddiagnosis.
B) dPatients dare ddivided dinto dfive dgroups d(A-E) dbased don ddiagnosis, dwith dthe dE
dgroup dreimbursement dbeing dthe dgreatest.
C) dEach dservice dperformed dhas da drelative dvalue dunit d(RVU) dassigned dthat dreflects
dthe damount dof dphysician dwork, dpractice dexpenses, dand dliability dinsurance dcosts.
D) dPhysicians dare dpaid dusing dMedicare's dOutpatient dObservation dPayment dSystem
d(OOPS).
E) dPhysicians dare dpaid dusing dMedicare's dAmbulatory dPatient dPayment dSystem
d(APPS). d- dCORRECT✅✅C) dEach dservice dperformed dhas da drelative dvalue dunit
d(RVU) dassigned dthat dreflects dthe damount dof dphysician dwork, dpractice dexpenses,
dand dliability dinsurance dcosts.
