PUBH 302 UPDATED FINAL EXAM QUESTIONS AND
ANSWERS SURE A+
✔✔What is defensive medicine? - ✔✔Medical practices done not for the patient's
benefits but in order to protect physicians from malpractice suits
✔✔T or F: a majority of the uninsured make below the poverty level - ✔✔False; majority
of those uninsured make ABOVE the poverty level
✔✔List the government insurance programs - ✔✔- medicare
- medicaid
- VA programs
✔✔How does medicaid benefit low income families? - ✔✔- Pregnant women: prenatal
care and delivery costs
- Children: routine and specialized care for childhood development (immunizations,
dental, vision, speech therapy)
- Families: affordable coverage to prepare for the unexpected (emergency, dental,
hospitalization, antibiotics)
✔✔How does medicaid benefit individuals with disabilities? - ✔✔- Child with autism: in-
home therapy, speech/occupational therapy
- Cerebral palsy: assistance to gain independence (personal care, case management
and assistive technology)
- HIV/AIDS: physician services, prescription drugs
- Mental illness: prescription drugs, physician services
✔✔How does medicaid benefit elderly individuals? - ✔✔- Medicare beneficiary: help
paying for medicare premiums and cost sharing
- Community waiver participant: community based care and personal care
- Nursing home resident: care paid by medicaid since medicare does not cover
institutional care
, ✔✔What is medicare part A? - ✔✔Covers inpatient hospital care, as well as care
provided in skilled nursing facilites, hospice care, and home health care
✔✔What is medicare part B? - ✔✔Covers medically necessary doctors' services,
outpatient care, other medical services (including some preventive service not covered
under Medicare Part A)
✔✔What is medicare part D? - ✔✔Prescription drug coverage
✔✔Characteristics of the medicare population - ✔✔- 32% functional impairment (1+
ADL limitations)
ADL = activities of daily living
- 25% fair/poor self-reported health
- 22% 5+ chronic conditions
- 15% under age 65
- 12% age 85+
- 3% long term care facility resident
✔✔How much of health expenditure goes towards prevention and population based
health? Why? - ✔✔- Just a tiny slice of the pie goes to public health initiatives
- Hard for private sectors to make money on public health initiatives
✔✔What is a core component of the ACA coverage expansions? - ✔✔- Expanding
medicaid to low-income adults is a core component of the ACA coverage expansions
- Prior to ACA, medicaid eligibility was limited to specific low-income groups
- Pregnant women, children, elderly & persons with disabilities
- As enacted, the ACA medicaid expansion would cover adults up to 138% FPL in all
states, filling long-standing gaps in coverage
- Gap in coverage for adults in states that do not expand medicaid under the ACA
✔✔What is HOP? - ✔✔South Carolina's Health Outcome Plan
- Incentivizes hospitals to partner with safety net providers and community organizations
to build or expand service delivery models aimed at coordinating care for chronically ill,
uninsured, high utilizers of emergency department (ED) services
- Size of the hospital determines the target number of participants that HOPs are
required to identity and serve
✔✔What is CHIP? - ✔✔Children's Health Insurance Program
- Created by the Balanced Budget Act of 1997 and enacted Title XXI of the Social
Security Act
- Partnership and funding between the federal and state governments that provides low-
cost health coverage to children in families that earn too much money to qualify for
medicaid
- Requirement for benefits and scope of services determined by states
- All states provide immunizations and well-baby/well-childcare
ANSWERS SURE A+
✔✔What is defensive medicine? - ✔✔Medical practices done not for the patient's
benefits but in order to protect physicians from malpractice suits
✔✔T or F: a majority of the uninsured make below the poverty level - ✔✔False; majority
of those uninsured make ABOVE the poverty level
✔✔List the government insurance programs - ✔✔- medicare
- medicaid
- VA programs
✔✔How does medicaid benefit low income families? - ✔✔- Pregnant women: prenatal
care and delivery costs
- Children: routine and specialized care for childhood development (immunizations,
dental, vision, speech therapy)
- Families: affordable coverage to prepare for the unexpected (emergency, dental,
hospitalization, antibiotics)
✔✔How does medicaid benefit individuals with disabilities? - ✔✔- Child with autism: in-
home therapy, speech/occupational therapy
- Cerebral palsy: assistance to gain independence (personal care, case management
and assistive technology)
- HIV/AIDS: physician services, prescription drugs
- Mental illness: prescription drugs, physician services
✔✔How does medicaid benefit elderly individuals? - ✔✔- Medicare beneficiary: help
paying for medicare premiums and cost sharing
- Community waiver participant: community based care and personal care
- Nursing home resident: care paid by medicaid since medicare does not cover
institutional care
, ✔✔What is medicare part A? - ✔✔Covers inpatient hospital care, as well as care
provided in skilled nursing facilites, hospice care, and home health care
✔✔What is medicare part B? - ✔✔Covers medically necessary doctors' services,
outpatient care, other medical services (including some preventive service not covered
under Medicare Part A)
✔✔What is medicare part D? - ✔✔Prescription drug coverage
✔✔Characteristics of the medicare population - ✔✔- 32% functional impairment (1+
ADL limitations)
ADL = activities of daily living
- 25% fair/poor self-reported health
- 22% 5+ chronic conditions
- 15% under age 65
- 12% age 85+
- 3% long term care facility resident
✔✔How much of health expenditure goes towards prevention and population based
health? Why? - ✔✔- Just a tiny slice of the pie goes to public health initiatives
- Hard for private sectors to make money on public health initiatives
✔✔What is a core component of the ACA coverage expansions? - ✔✔- Expanding
medicaid to low-income adults is a core component of the ACA coverage expansions
- Prior to ACA, medicaid eligibility was limited to specific low-income groups
- Pregnant women, children, elderly & persons with disabilities
- As enacted, the ACA medicaid expansion would cover adults up to 138% FPL in all
states, filling long-standing gaps in coverage
- Gap in coverage for adults in states that do not expand medicaid under the ACA
✔✔What is HOP? - ✔✔South Carolina's Health Outcome Plan
- Incentivizes hospitals to partner with safety net providers and community organizations
to build or expand service delivery models aimed at coordinating care for chronically ill,
uninsured, high utilizers of emergency department (ED) services
- Size of the hospital determines the target number of participants that HOPs are
required to identity and serve
✔✔What is CHIP? - ✔✔Children's Health Insurance Program
- Created by the Balanced Budget Act of 1997 and enacted Title XXI of the Social
Security Act
- Partnership and funding between the federal and state governments that provides low-
cost health coverage to children in families that earn too much money to qualify for
medicaid
- Requirement for benefits and scope of services determined by states
- All states provide immunizations and well-baby/well-childcare
