MHA 707 EXAM C 2026 EXAM PREPARATION
PACK KEY HEALTHCARE POLICY
MANAGEMENT AND SAMPLE QUESTIONS
WITH EXPLANATIONS
◉ Largest contributors to the Personal Health Care (PHC). Answer:
hospitalization, physician services, Rx, other health care goods and
services
◉ What accounted for the largest share of NHE?. Answer: Hospital
Care: 33% of spending
Professional Services: 20% doctors NHE
Retail Rx: 10.5%
◉ Three Categories of PHC increased as a share of NHE. Answer:
Health Residential and Personal Care: 5.2% of NHE
Net Cost of Private Health Ins: 6.6% of NHE
Home Health Care: 2.8% of NHE
◉ Chronic Disease and Mental Health Diseases in NHE (percentage).
Answer: 90%
Among the top 5% of users account for about half of the spending
,◉ Medical Conditions and Parentages on Americans. Answer: 90%
of Americans have 1 risk factor, 52% have 2 or more highest
proportion in impoverished and racial/ethnic minorities
◉ Americans Stat on Health Ins Coverage. Answer: 92% of the US
population have some sort of ins (8% or 26.4 M uninsured)
◉ Cost/Cost Plus. Answer: how hospitals/providers describe
payments received for services they have already provided. The
organization tracks all the costs associated with each customer and
then asks to be paid that amount. Contracts specific that the
organization will be reimbursed for actual cost plus an additional
percentage of cost (includes built in profit)
◉ How Money is Paid to Health Care Providers. Answer: Cost/Cost
Plus
Time and Materials
Fee for Service
Fixed Price
Capitation
Value
, ◉ Time and Materials. Answer: A contract type where the seller
charges the
buyer for the time and the materials for the
work completed. T&M contracts should have a
not-to-exceed clause (NTE) to contain costs.
◉ fee-for-service. Answer: a system under which doctors and
hospitals receive a payment for each service they provide
◉ Fixed Price. Answer: A price that stays the same; there is no
debate over price
◉ Capitation. Answer: fixed payment per person to the health care
provider for an agreed-on array of services during a contract period
(per member/per month). Payment is the same no matter the
amount or type of service. May put the physician at odds with the
patient
◉ Value. Answer: payment model in which the provider is rewarded
for the value delivered. Value based systems are most often used
when the value is easy to measure and indisputable. Value based
purchasing, bundled payments, and P4P are used by the CMS- top
performers make extra money that is taken from poorer performers
PACK KEY HEALTHCARE POLICY
MANAGEMENT AND SAMPLE QUESTIONS
WITH EXPLANATIONS
◉ Largest contributors to the Personal Health Care (PHC). Answer:
hospitalization, physician services, Rx, other health care goods and
services
◉ What accounted for the largest share of NHE?. Answer: Hospital
Care: 33% of spending
Professional Services: 20% doctors NHE
Retail Rx: 10.5%
◉ Three Categories of PHC increased as a share of NHE. Answer:
Health Residential and Personal Care: 5.2% of NHE
Net Cost of Private Health Ins: 6.6% of NHE
Home Health Care: 2.8% of NHE
◉ Chronic Disease and Mental Health Diseases in NHE (percentage).
Answer: 90%
Among the top 5% of users account for about half of the spending
,◉ Medical Conditions and Parentages on Americans. Answer: 90%
of Americans have 1 risk factor, 52% have 2 or more highest
proportion in impoverished and racial/ethnic minorities
◉ Americans Stat on Health Ins Coverage. Answer: 92% of the US
population have some sort of ins (8% or 26.4 M uninsured)
◉ Cost/Cost Plus. Answer: how hospitals/providers describe
payments received for services they have already provided. The
organization tracks all the costs associated with each customer and
then asks to be paid that amount. Contracts specific that the
organization will be reimbursed for actual cost plus an additional
percentage of cost (includes built in profit)
◉ How Money is Paid to Health Care Providers. Answer: Cost/Cost
Plus
Time and Materials
Fee for Service
Fixed Price
Capitation
Value
, ◉ Time and Materials. Answer: A contract type where the seller
charges the
buyer for the time and the materials for the
work completed. T&M contracts should have a
not-to-exceed clause (NTE) to contain costs.
◉ fee-for-service. Answer: a system under which doctors and
hospitals receive a payment for each service they provide
◉ Fixed Price. Answer: A price that stays the same; there is no
debate over price
◉ Capitation. Answer: fixed payment per person to the health care
provider for an agreed-on array of services during a contract period
(per member/per month). Payment is the same no matter the
amount or type of service. May put the physician at odds with the
patient
◉ Value. Answer: payment model in which the provider is rewarded
for the value delivered. Value based systems are most often used
when the value is easy to measure and indisputable. Value based
purchasing, bundled payments, and P4P are used by the CMS- top
performers make extra money that is taken from poorer performers
