Health Policy & Management (HPM101) – Evolution of American Healthcare (65 Questions) | Insurance History, Reform Acts, Payment Models

This expertly verified document offers 65 comprehensive exam questions and answers covering the Evolution of American Healthcare, tailored for the 2025/2026 Health Policy and Management (HPM101) course. It traces the transformation of the U.S. healthcare system from early individual practitioners to modern value-based models, capturing major milestones in insurance policy, legislation, care delivery systems, and economic shifts. Topics include the development of solo and group practices, emergence of nonprofit and multi-unit hospital systems, early insurance models like BCBS, and landmark policies such as Medicare, Medicaid, CHIP, HIPAA, EMTALA, and the Affordable Care Act (Obamacare). The document also examines proposals for National Health Insurance (NHI) from Bismarck to the Clinton era, detailing reforms like the Health Security Act, individual mandates, and managed care strategies. Additional focus areas include cost control mechanisms such as capitation, indemnity plans, fee-for-service (FFS), value-based payments, and federal innovations like the Center for Medicare & Medicaid Innovation and Prevention & Public Health Fund. It also covers societal factors influencing health spending and outcomes, including chronic illness, tobacco use, alcoholism, and the need for predictive analytics in healthcare planning. This document is highly relevant for students in Public Health, Health Administration, Health Policy, Healthcare Economics, Medical Sociology, and Pre-Med pathways. It is also valuable for graduate-level learners in MPH, MHA, and Health Systems Management programs aiming to understand the historical context of modern healthcare structures and policies. Keywords: solo practitioners, nonprofit hospitals, long-term care, pharmaceutical history, AMA standards, Code of Ethics, anesthetic agents, patent medicine, vital statistics, nursing corps, ambulance corps, ICD history, health insurance forerunners, Blue Cross Blue Shield, community rating, experience rating, Medicare, Medicaid, CHIP, HIPAA, EMTALA, health expenditure, capitation, indemnity insurance, group practice, value equation, hospital systems, NHI, Health Security Act, Clinton reform, managed care, HMO, PPO, FFS, individual mandate, Obamacare, chronic illness, tobacco, alcoholism, per capita costs, death spiral, payment innovation, predictive analytics, Triple Aim