HIM 410 Final Exam || Most Recent Exam 2026|2027 Actual
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Which entity oversees the licensors of Health care facilities -
ANSWER-State
government
How did the PPS (prospective payment system) based on
DRC's lead to hospitals downsizing in the United States? -
ANSWER-It created financial incentives to minimize the length
of patients stay.
Which ownership type constitutes the largest group of
hospitals and hospital
beds? - ANSWER-Private
Nonprofit
The patient belongs to a managed care plan. The patient wants
to make an appointment
with an out of network specialist. The plan has approved the
appointment as
"out of plan". What should the patient expect: - ANSWER-The
patient's out of pocket costs will be increased.
All of the following types of service of populations are
consumer examples of
,"carve outs" except - ANSWER-Immunizations and
well-baby care
In the accounting system of the physician's office, the account
is categorized as
"self-pay" How should the insurance analyst interpret
this category? -
ANSWER-The guarantor will pay the
entire bill
Gatekeeping____secondary care service. - ANSWER-Requires a
referral
Which entity in hospital governance is legally responsible
for the hospitals -
ANSWER-Board of
trustees
What are the 2 major categories for pay-for-performace models
- ANSWER-1.
reward
based
2. penalty
based
Medical cost inflation is influenced by all of the following
factors except: -
,ANSWER-Decrease in
uninsured
Which is the primary purpose of certificate- of-need statutes?
- ANSWER-To
control capital expenditures by
health facilities
What targets should be the focus of pay-for- performance
and value-based
purchasing systems? - ANSWER-All of
the above
In the hospital Value Based Purchasing programs a facility's
total performance
score
(TPS) is
used to determine the amount of kickback dollars the facility
has earned back.
In regards to
the
TPS which is better? - ANSWER-A higher
TPS is better
What is the term for a model of primary care that seeks to meet
the health care
needs
of
, patients and to improve patient and staff experiences,
outcomes, safety and
system efficiency? - ANSWER-Patient-centered
medical home
Which component of Medicare's Value Based Purchasing
plan mentions the
action of
reporting
data in the proper format within the given timeframe? -
ANSWER-Pay for
reporting
Value-based purchasing and pay-for- performance and systems
typically link all
of the
following
components except: - ANSWER-
Setting of care
What is the main reason for the lack of success of health
care cost control
efforts in the U.S.? - ANSWER-Cost shifting
by providers
Which of the following statements about the Hospital
Readmission Reduction
Complete Real Exam Questions And Correct Answers (Verified
Answers) Already Graded A+ | Guaranteed Success!! Newest
Exam | Just Released!!
Which entity oversees the licensors of Health care facilities -
ANSWER-State
government
How did the PPS (prospective payment system) based on
DRC's lead to hospitals downsizing in the United States? -
ANSWER-It created financial incentives to minimize the length
of patients stay.
Which ownership type constitutes the largest group of
hospitals and hospital
beds? - ANSWER-Private
Nonprofit
The patient belongs to a managed care plan. The patient wants
to make an appointment
with an out of network specialist. The plan has approved the
appointment as
"out of plan". What should the patient expect: - ANSWER-The
patient's out of pocket costs will be increased.
All of the following types of service of populations are
consumer examples of
,"carve outs" except - ANSWER-Immunizations and
well-baby care
In the accounting system of the physician's office, the account
is categorized as
"self-pay" How should the insurance analyst interpret
this category? -
ANSWER-The guarantor will pay the
entire bill
Gatekeeping____secondary care service. - ANSWER-Requires a
referral
Which entity in hospital governance is legally responsible
for the hospitals -
ANSWER-Board of
trustees
What are the 2 major categories for pay-for-performace models
- ANSWER-1.
reward
based
2. penalty
based
Medical cost inflation is influenced by all of the following
factors except: -
,ANSWER-Decrease in
uninsured
Which is the primary purpose of certificate- of-need statutes?
- ANSWER-To
control capital expenditures by
health facilities
What targets should be the focus of pay-for- performance
and value-based
purchasing systems? - ANSWER-All of
the above
In the hospital Value Based Purchasing programs a facility's
total performance
score
(TPS) is
used to determine the amount of kickback dollars the facility
has earned back.
In regards to
the
TPS which is better? - ANSWER-A higher
TPS is better
What is the term for a model of primary care that seeks to meet
the health care
needs
of
, patients and to improve patient and staff experiences,
outcomes, safety and
system efficiency? - ANSWER-Patient-centered
medical home
Which component of Medicare's Value Based Purchasing
plan mentions the
action of
reporting
data in the proper format within the given timeframe? -
ANSWER-Pay for
reporting
Value-based purchasing and pay-for- performance and systems
typically link all
of the
following
components except: - ANSWER-
Setting of care
What is the main reason for the lack of success of health
care cost control
efforts in the U.S.? - ANSWER-Cost shifting
by providers
Which of the following statements about the Hospital
Readmission Reduction
