Exam 1) MHA 710 Exam 1: MHA 710 Exam 1 Study Guide: Questions & Answers: Updated Solution

How much of healthcare provider revenue is from insurance payments? (Ans – In 2016, they represented 88 percent of payments to hospitals, 81 percent of payments to physicians, and 66 percent of payments to nursing homes How does insurance affect consumers in a way not experienced by consumers in other markets? (Ans – • It protects them against high healthcare expenses, which is the main goal. • It encourages them to use more healthcare services, which is a side effect. • It limits their autonomy in healthcare decision making, which is not a goal. How do the eligibility requirements for Medicare and Medicaid differ? (Ans - Medicare = elderly and disabled vs Medicaid = low income How do the differences between fee-for-service plans and managed care plans affect the incentives of the insured and the provider? (Ans - Managed care is a varied collection of insurance plans with only one common denominator: They are different from FFS insurance plans. Traditionally, FFS plans covered all services if they were included in the contract and if a provider, typically a physician, was willing to certify that they were medically necessary. The FFS plans had no features that tried to influence the decisions of patients or physicians (aside from the effects of subsidizing higher spending). What is capitation? (Ans - Flat payment per consumer What is a high deductible plan? (Ans - Plan that has a deductible of at least $1,000 and may be combined with a health savings account. What is a health savings account? (Ans - An account that employees and employers can contribute to and employees can use to pay medical bills. Employees' contributions and payments are not taxable.