LSUS MHA 706 UPDATED COMPLETE
QUESTIONS AND ANSWERS GRADED A+
●● Corporations: Pros & Cons
Answer: Pros: Unlimited life, easy transfer of ownership, limited
liability, ease of raising capital.
Cons: Cost of formation and reporting, double or triple taxes must be
paid.
●● Non-profit Organization
Answer: Exempt from taxes. Goal is to improve community.
●● For-profit Organizations
Answer: (Investor Owned) Goal is to maximize shareholder return. Owe
taxes.
●● Agency Problem
Answer: the possibility of conflict of interest between the stockholders
and management of a firm.
Example: Hire someone to carry out a job function, but they go out of
their interests instead of best interests of company/organization.
,●● Third-party payor system in the US (i.e. private vs public)
Answer: Private: Blue Cross Blue Shield, Commercial Insurers, Self-
Insurers. (AETNA)
Public: Medicare and Medicaid-both offer services to different levels.
"Safety net" Lowest reimbursement rates.
●● Reimbursement methods (fee-for-service vs. capitation)
Answer: Fee for Service: payment is tied to amount of services
provided. (Decades ago) *Dental industry*
Capitation: payment is tied to the size of the covered population (number
of enrollees) Payment is based on per # per month. *Decreasing
utilization* Population is healthier.
●● Medicare reimbursement for different types of providers
Answer: Medicare parts A, B & C.
●● Medicare Part A (aka Hospital Insurance or HI)
Answer: Provides hospital insurance automatically at age 65 (if FICA
qualified) at no fee but may have deductible & co-pay.
●● Medicare Part B
, Answer: The part of the Medicare program that pays for physician
services, outpatient hospital services, durable medical equipment, and
other services and supplies.
●● Medicare Part C (Medicare Advantage)
Answer: •Replaces and covers expenses found in Part A and B
•Medicare private fee-for-service plans (PFFS)
•Medicare managed care plans (HMOs and PPOs)
•Medicare specialty plans
●● Medicare—Part D Prescription Drug Coverage
Answer: a United States federal-government program to subsidize the
costs of prescription drugs and prescription drug insurance premiums for
Medicare beneficiaries.
●● Impact of the Affordable Care Act (what the bill changed about the
healthcare environment)
Answer: Created new standards, individual mandates, exchanges, and
Medicaid expansion.
Focused on quality through clinical compensation, bundled payment,
value-based purchasing.
●● Regulations and standards of financial accounting (e.g. SEC, GAAP,
FASB)
QUESTIONS AND ANSWERS GRADED A+
●● Corporations: Pros & Cons
Answer: Pros: Unlimited life, easy transfer of ownership, limited
liability, ease of raising capital.
Cons: Cost of formation and reporting, double or triple taxes must be
paid.
●● Non-profit Organization
Answer: Exempt from taxes. Goal is to improve community.
●● For-profit Organizations
Answer: (Investor Owned) Goal is to maximize shareholder return. Owe
taxes.
●● Agency Problem
Answer: the possibility of conflict of interest between the stockholders
and management of a firm.
Example: Hire someone to carry out a job function, but they go out of
their interests instead of best interests of company/organization.
,●● Third-party payor system in the US (i.e. private vs public)
Answer: Private: Blue Cross Blue Shield, Commercial Insurers, Self-
Insurers. (AETNA)
Public: Medicare and Medicaid-both offer services to different levels.
"Safety net" Lowest reimbursement rates.
●● Reimbursement methods (fee-for-service vs. capitation)
Answer: Fee for Service: payment is tied to amount of services
provided. (Decades ago) *Dental industry*
Capitation: payment is tied to the size of the covered population (number
of enrollees) Payment is based on per # per month. *Decreasing
utilization* Population is healthier.
●● Medicare reimbursement for different types of providers
Answer: Medicare parts A, B & C.
●● Medicare Part A (aka Hospital Insurance or HI)
Answer: Provides hospital insurance automatically at age 65 (if FICA
qualified) at no fee but may have deductible & co-pay.
●● Medicare Part B
, Answer: The part of the Medicare program that pays for physician
services, outpatient hospital services, durable medical equipment, and
other services and supplies.
●● Medicare Part C (Medicare Advantage)
Answer: •Replaces and covers expenses found in Part A and B
•Medicare private fee-for-service plans (PFFS)
•Medicare managed care plans (HMOs and PPOs)
•Medicare specialty plans
●● Medicare—Part D Prescription Drug Coverage
Answer: a United States federal-government program to subsidize the
costs of prescription drugs and prescription drug insurance premiums for
Medicare beneficiaries.
●● Impact of the Affordable Care Act (what the bill changed about the
healthcare environment)
Answer: Created new standards, individual mandates, exchanges, and
Medicaid expansion.
Focused on quality through clinical compensation, bundled payment,
value-based purchasing.
●● Regulations and standards of financial accounting (e.g. SEC, GAAP,
FASB)
