HCMG Midterm Exam 100% Solved!!
What are the 3 major characteristics of the US healthcare system? -
ANSWERSdecentralized structure, acute/episodic care focus, significant real cost
growth
What percentage of all healthcare expenditures are insured - ANSWERS90 percent
What are the 3 major reasons behind significant real cost growth in healthcare
expenditures in the US? - ANSWERS1. rapid advances in medical technology, 2.
increased demand for treatments, and 3. misalignment of financial incentives that
produce excessive costs
What are the 3 major healthcare stakeholders - ANSWERSpayers, providers and
patients
What are 4 types of payers in the healthcare system -
ANSWERSgovernment/taxpayers, employers, individual insurance, out of pocket
What percentage of healthcare spending is undertaken by the government? -
ANSWERS45-46%
What percent of GDP do we spend on healthcare? - ANSWERS17.6%
What percent of healthcare spending is to private providers? - ANSWERS80%
What is the healthcare system like in most developed countries? - ANSWERSNear
universal access where case is available to almost all residents
What is healthcare access in the US dependent on - ANSWERSinsurance/ability to pay
What are the 2 types of public programs that give the needy insurance? -
ANSWERSMedicare (65 or older, categorically disabled). Medicaid (low income)
How do we pay for medicare and medicaid? - ANSWERSTaxes from paycheck
What percent of medicare recipients pay for supplemental coverage? - ANSWERS80-
90%
what percent of medicare costs is paid by the government - ANSWERS85%
What are the 4 buckets of insurance? - ANSWERSMedicare, medicaid, no insurance,
private insurance
,What percent of non-elderly population in the US have no insurance? - ANSWERS18-
19%
What are the three components of the iron triangle? - ANSWERScost, access, and
quality
What are the principal drivers of the US healthcare system? - ANSWERSincentives and
costs
What are the trends and issues in US today? - ANSWERS1. aging population with more
chronic diseases
2. rising demand for healthcare
3. increased pressure for cost containment
4. advances in technology will face more intense competition for resources
5. will the emphasis on healthcare vs. health persist?
6. more responsibility in the hands of consumers or government? what will be the
effects?
What is national health expenditures? - ANSWERSTotal value of all spending on health
care in the US ($2486 billion in 2009)
What are the main components of NHE? - ANSWERShealth consumption expenditures,
government administration and net cost of private health insurance, public health, and
investment
What was the amount of health consumption expenditures in 2009 - ANSWERS$2330
billion
What was the amount of government administration and net cost of private HI? -
ANSWERS$163 billion
What was the amount of spending on public health? - ANSWERS$77 billion
what was the amount of healthcare research in 2009? - ANSWERS$156 billion
What was the health expenditure per capita in the US in 2009? - ANSWERS$8086
million
What was GDP in 2009? - ANSWERS14,119 billion
What was the trend in US health expenditures from 1961 to 2007? - ANSWERSUS
healthcare expenditures as a proportion of GDP has grown much more than nomainal
and real GDP growth
What is the trend in NHE per capita over time? - ANSWERSHas grown 3-fold from 1970
to 2007
,What was significant about US healthcare spending in 2008? - ANSWERSUS
healthcare spending growth slowed to 4.4 percent - the slowest rate of growth over the
past 48 years.
What was national health spending in 2008? - ANSWERS$2.3 trillion
What is the general pattern of healthcare spending as a share of GDP? -
ANSWERSLarger increases in health spending share of GDP generally occur during or
just after periods of economic recession
What was the growth rate of US healthcare spending in 2009? What was the absolute
amount? - ANSWERS4 percent. 2.5 trillion.
What happened to healthcare spending in the government from 2008 to 2009? -
ANSWERSincreased from 37.6 percent of total federal revenue in 2008 to 54.2 percent
in 2009.
How did the recession affect the different payers in the healthcare system -
ANSWERSslowed private health insurance spending growth, reduced capital
investment by healthcare providers, decreased out of pocket spending by consumers,
increased federal health spending growth
What provider category accounts for the top US health consumption expenditures in
2009? - ANSWERS30% = hospital care, 25% = physicians, 14% = nursing home, 11%
= prescription drugs
What percent of total US healthcare expenditure goes to administrative costs -
ANSWERS7%
What has the trend been in provider expenditures - ANSWERSHospital category has
gone down while physician category has gone up
What has the expenditure by type growth been like between 1997 and 2006? -
ANSWERSpercentage spending in each category has been consistent, with small spike
in prescription drugs. From 6.9% - 10.3% - probably caused by government program for
prescription drugs for old people beginning in 2006.
How does US healthcare spending break down by socioeconomic levels? - ANSWERSa
small proportion of the US population accounts for half of all US healthcare spending.
The 5% of the population with highest health expenses ($14601 annually) was
responsible for 47.7% of total healthcare spending. The 50% of the population with the
lowest expenses (less than $776) accounted for only 3.2% of total spending
What percentage of total healthcare spending in the US is done by private insurers? Is
this normal? - ANSWERS35%. No.
, What percentage of total healthcare spending in the US is out-of-pocket? Is this
normal? - ANSWERS12%. Yes.
What are the causes of growth in healthcare expenditures in the US? - ANSWERS1.
prices, quantities, and quality all increased
2. new and expensive technologies
3. demographics and lifestyles
4. most funding is through government or private insurance
5. fee-for-service and cost-based reimbursement
Which contributes the most to health expenditure growth per capita - ANSWERSprice
increases
How was medicare enacted? - ANSWERSenacted in 1965 as part of LBJ's "Great
Society" program
what does medicare cover - ANSWERSthose 65 & over, disabled people, renal disease
patients
what are the 4 parts of medicare - ANSWERSPart A: Hospital Care
Part B: Physician Services
Part C: Medicare Advantage ("Private" Plans)
Part D: Prescription Drugs
How is medicare financed? - ANSWERSThere is a medicare tax on working population
(payroll tax). Parts B and D receive patient and government funding. 75% those are
covered by general tax revenues and 25% are from premiums.
What is Medicare Advantage? - ANSWERSmedicare pays private insurers but
insurance is through private companies.
How much do we spend per medicare enrollee? - ANSWERS$11000
When was medicaid enacted? - ANSWERSenacted in 1965
how does one qualify for medicaid? - ANSWERSin 2014, those with incomes up to
133% of federal poverty line will qualify
what is medcaid for children? - ANSWERSState Children's health Insurance Program
(SCHIP)
how is medicaid financed? - ANSWERSadministered by state governments, but the
federal government covers half of the costs
What are the 3 major characteristics of the US healthcare system? -
ANSWERSdecentralized structure, acute/episodic care focus, significant real cost
growth
What percentage of all healthcare expenditures are insured - ANSWERS90 percent
What are the 3 major reasons behind significant real cost growth in healthcare
expenditures in the US? - ANSWERS1. rapid advances in medical technology, 2.
increased demand for treatments, and 3. misalignment of financial incentives that
produce excessive costs
What are the 3 major healthcare stakeholders - ANSWERSpayers, providers and
patients
What are 4 types of payers in the healthcare system -
ANSWERSgovernment/taxpayers, employers, individual insurance, out of pocket
What percentage of healthcare spending is undertaken by the government? -
ANSWERS45-46%
What percent of GDP do we spend on healthcare? - ANSWERS17.6%
What percent of healthcare spending is to private providers? - ANSWERS80%
What is the healthcare system like in most developed countries? - ANSWERSNear
universal access where case is available to almost all residents
What is healthcare access in the US dependent on - ANSWERSinsurance/ability to pay
What are the 2 types of public programs that give the needy insurance? -
ANSWERSMedicare (65 or older, categorically disabled). Medicaid (low income)
How do we pay for medicare and medicaid? - ANSWERSTaxes from paycheck
What percent of medicare recipients pay for supplemental coverage? - ANSWERS80-
90%
what percent of medicare costs is paid by the government - ANSWERS85%
What are the 4 buckets of insurance? - ANSWERSMedicare, medicaid, no insurance,
private insurance
,What percent of non-elderly population in the US have no insurance? - ANSWERS18-
19%
What are the three components of the iron triangle? - ANSWERScost, access, and
quality
What are the principal drivers of the US healthcare system? - ANSWERSincentives and
costs
What are the trends and issues in US today? - ANSWERS1. aging population with more
chronic diseases
2. rising demand for healthcare
3. increased pressure for cost containment
4. advances in technology will face more intense competition for resources
5. will the emphasis on healthcare vs. health persist?
6. more responsibility in the hands of consumers or government? what will be the
effects?
What is national health expenditures? - ANSWERSTotal value of all spending on health
care in the US ($2486 billion in 2009)
What are the main components of NHE? - ANSWERShealth consumption expenditures,
government administration and net cost of private health insurance, public health, and
investment
What was the amount of health consumption expenditures in 2009 - ANSWERS$2330
billion
What was the amount of government administration and net cost of private HI? -
ANSWERS$163 billion
What was the amount of spending on public health? - ANSWERS$77 billion
what was the amount of healthcare research in 2009? - ANSWERS$156 billion
What was the health expenditure per capita in the US in 2009? - ANSWERS$8086
million
What was GDP in 2009? - ANSWERS14,119 billion
What was the trend in US health expenditures from 1961 to 2007? - ANSWERSUS
healthcare expenditures as a proportion of GDP has grown much more than nomainal
and real GDP growth
What is the trend in NHE per capita over time? - ANSWERSHas grown 3-fold from 1970
to 2007
,What was significant about US healthcare spending in 2008? - ANSWERSUS
healthcare spending growth slowed to 4.4 percent - the slowest rate of growth over the
past 48 years.
What was national health spending in 2008? - ANSWERS$2.3 trillion
What is the general pattern of healthcare spending as a share of GDP? -
ANSWERSLarger increases in health spending share of GDP generally occur during or
just after periods of economic recession
What was the growth rate of US healthcare spending in 2009? What was the absolute
amount? - ANSWERS4 percent. 2.5 trillion.
What happened to healthcare spending in the government from 2008 to 2009? -
ANSWERSincreased from 37.6 percent of total federal revenue in 2008 to 54.2 percent
in 2009.
How did the recession affect the different payers in the healthcare system -
ANSWERSslowed private health insurance spending growth, reduced capital
investment by healthcare providers, decreased out of pocket spending by consumers,
increased federal health spending growth
What provider category accounts for the top US health consumption expenditures in
2009? - ANSWERS30% = hospital care, 25% = physicians, 14% = nursing home, 11%
= prescription drugs
What percent of total US healthcare expenditure goes to administrative costs -
ANSWERS7%
What has the trend been in provider expenditures - ANSWERSHospital category has
gone down while physician category has gone up
What has the expenditure by type growth been like between 1997 and 2006? -
ANSWERSpercentage spending in each category has been consistent, with small spike
in prescription drugs. From 6.9% - 10.3% - probably caused by government program for
prescription drugs for old people beginning in 2006.
How does US healthcare spending break down by socioeconomic levels? - ANSWERSa
small proportion of the US population accounts for half of all US healthcare spending.
The 5% of the population with highest health expenses ($14601 annually) was
responsible for 47.7% of total healthcare spending. The 50% of the population with the
lowest expenses (less than $776) accounted for only 3.2% of total spending
What percentage of total healthcare spending in the US is done by private insurers? Is
this normal? - ANSWERS35%. No.
, What percentage of total healthcare spending in the US is out-of-pocket? Is this
normal? - ANSWERS12%. Yes.
What are the causes of growth in healthcare expenditures in the US? - ANSWERS1.
prices, quantities, and quality all increased
2. new and expensive technologies
3. demographics and lifestyles
4. most funding is through government or private insurance
5. fee-for-service and cost-based reimbursement
Which contributes the most to health expenditure growth per capita - ANSWERSprice
increases
How was medicare enacted? - ANSWERSenacted in 1965 as part of LBJ's "Great
Society" program
what does medicare cover - ANSWERSthose 65 & over, disabled people, renal disease
patients
what are the 4 parts of medicare - ANSWERSPart A: Hospital Care
Part B: Physician Services
Part C: Medicare Advantage ("Private" Plans)
Part D: Prescription Drugs
How is medicare financed? - ANSWERSThere is a medicare tax on working population
(payroll tax). Parts B and D receive patient and government funding. 75% those are
covered by general tax revenues and 25% are from premiums.
What is Medicare Advantage? - ANSWERSmedicare pays private insurers but
insurance is through private companies.
How much do we spend per medicare enrollee? - ANSWERS$11000
When was medicaid enacted? - ANSWERSenacted in 1965
how does one qualify for medicaid? - ANSWERSin 2014, those with incomes up to
133% of federal poverty line will qualify
what is medcaid for children? - ANSWERSState Children's health Insurance Program
(SCHIP)
how is medicaid financed? - ANSWERSadministered by state governments, but the
federal government covers half of the costs
