BHA3001
Essentials of the Healthcare System
MIDTERM READINESS EXAM
GUIDE
Q&S
©2024/2025
,1. Multiple Choice: What is the primary purpose of a
healthcare system?
a) Providing educational resources
b) Ensuring public safety
c) Delivering health services
d) Promoting pharmaceutical sales
Answer: c) Delivering health services
Rationale: The primary purpose of a healthcare system is
to deliver services that promote, restore, and maintain
health.
2. Fill-in-the-Blank: The ________ model is a framework for
understanding the complex forces that affect health and the
delivery of care.
Answer: Biopsychosocial
Rationale: The biopsychosocial model considers
biological, psychological, and social factors in health and
healthcare.
3. True/False: Capitation is a payment arrangement where
a physician is paid per visit or service.
Answer: False
Rationale: Capitation is a payment arrangement where a
physician is paid a set amount for each enrolled patient
regardless of the number of services provided.
4. Multiple Response: Which of the following are key
components of a Managed Care Organization (MCO)?
a) Provider networks
b) Fee-for-service payments
c) Quality assurance programs
©2024/2025
, d) Utilization review
Answers: a) Provider networks, c) Quality assurance
programs, d) Utilization review
Rationale: MCOs typically have networks of providers,
quality assurance programs, and utilization reviews to
manage costs and care quality, not fee-for-service
payments.
5. Multiple Choice: In the context of healthcare, what does
'P4P' stand for?
a) Pay for Performance
b) Plan for Prevention
c) Prescription for Pharmacists
d) Program for Patients
Answer: a) Pay for Performance
Rationale: P4P stands for Pay for Performance, a
healthcare payment model that rewards providers for
meeting certain performance measures.
6. Fill-in-the-Blank: The Triple Aim of healthcare includes
improving the patient experience, improving the health of
populations, and reducing the ________ of care.
Answer: cost
Rationale: The Triple Aim focuses on enhancing patient
care experiences, improving population health, and
reducing costs.
7. True/False: Health Maintenance Organizations (HMOs)
require referrals for specialists.
Answer: True
Rationale: HMOs typically require primary care physician
referrals for specialist services to control costs and
coordinate care.
©2024/2025
Essentials of the Healthcare System
MIDTERM READINESS EXAM
GUIDE
Q&S
©2024/2025
,1. Multiple Choice: What is the primary purpose of a
healthcare system?
a) Providing educational resources
b) Ensuring public safety
c) Delivering health services
d) Promoting pharmaceutical sales
Answer: c) Delivering health services
Rationale: The primary purpose of a healthcare system is
to deliver services that promote, restore, and maintain
health.
2. Fill-in-the-Blank: The ________ model is a framework for
understanding the complex forces that affect health and the
delivery of care.
Answer: Biopsychosocial
Rationale: The biopsychosocial model considers
biological, psychological, and social factors in health and
healthcare.
3. True/False: Capitation is a payment arrangement where
a physician is paid per visit or service.
Answer: False
Rationale: Capitation is a payment arrangement where a
physician is paid a set amount for each enrolled patient
regardless of the number of services provided.
4. Multiple Response: Which of the following are key
components of a Managed Care Organization (MCO)?
a) Provider networks
b) Fee-for-service payments
c) Quality assurance programs
©2024/2025
, d) Utilization review
Answers: a) Provider networks, c) Quality assurance
programs, d) Utilization review
Rationale: MCOs typically have networks of providers,
quality assurance programs, and utilization reviews to
manage costs and care quality, not fee-for-service
payments.
5. Multiple Choice: In the context of healthcare, what does
'P4P' stand for?
a) Pay for Performance
b) Plan for Prevention
c) Prescription for Pharmacists
d) Program for Patients
Answer: a) Pay for Performance
Rationale: P4P stands for Pay for Performance, a
healthcare payment model that rewards providers for
meeting certain performance measures.
6. Fill-in-the-Blank: The Triple Aim of healthcare includes
improving the patient experience, improving the health of
populations, and reducing the ________ of care.
Answer: cost
Rationale: The Triple Aim focuses on enhancing patient
care experiences, improving population health, and
reducing costs.
7. True/False: Health Maintenance Organizations (HMOs)
require referrals for specialists.
Answer: True
Rationale: HMOs typically require primary care physician
referrals for specialist services to control costs and
coordinate care.
©2024/2025
