Chapter 6: Financing & Reimbursement
Methods Questions and Answers
1. An individual who had a hip replacement surgery received separate bills for each
individual services such as an admission kit, surgeon fees, operating room fees,
anesthesia fees, lab fees, etc, is an example of bundled payments method. - ANS-False
2. For health insurance purposes, the threshold for full-time work under the Affordable Care
Act is 36 hours per week. - ANS-False
3. Health care financing includes purchasing health insurance and paying for the services
delivered to insured patients. - ANS-True
4. Health care insurance enables consumers to use more health care services than they
would if they had to pay the entire price out of their own pocket. - ANS-True
5. Medicare is designes specifically for three categories of people. Those with chronic heart
disease are specifically covered. - ANS-False
6. Medicare Part D eliminates the need for Medigap coverage for Medicare beneficiaries. -
ANS-False
7. Risk is generally predictable for insurance underwriters. - ANS-False
8. Self insurance refers to large employers who assume risks and budget for medical
claims. - ANS-True
9. Supply-side rationing has been used by the United States to control the rising cost of
health caused by moral hazards and povider- induced demand. - ANS-False
10. The majority of total US health care expenditure isfinanced by governement. -
ANS-False
11. The purpose of a stop-loss provision in a health insurance plan is to limit total
out-of-pocket costs. - ANS-True
12. The purpose of a stop-loss provision in a health insurance plan is to limit total
out-of-pocket costs. - ANS-True
13. The Rand Health Insurance Experiment demonstrated that utilization could be lowered
through cost sharing. - ANS-True
14. The United States does not have publicly financed health insurance specifically for the
unemployed. - ANS-True
15. The United States has publicly financed heath insurance specifically for the unemployed.
- ANS-False
16. Under Medicare Part A, a beneficiary can have an unlimited number of benefit periods. -
ANS-True
Methods Questions and Answers
1. An individual who had a hip replacement surgery received separate bills for each
individual services such as an admission kit, surgeon fees, operating room fees,
anesthesia fees, lab fees, etc, is an example of bundled payments method. - ANS-False
2. For health insurance purposes, the threshold for full-time work under the Affordable Care
Act is 36 hours per week. - ANS-False
3. Health care financing includes purchasing health insurance and paying for the services
delivered to insured patients. - ANS-True
4. Health care insurance enables consumers to use more health care services than they
would if they had to pay the entire price out of their own pocket. - ANS-True
5. Medicare is designes specifically for three categories of people. Those with chronic heart
disease are specifically covered. - ANS-False
6. Medicare Part D eliminates the need for Medigap coverage for Medicare beneficiaries. -
ANS-False
7. Risk is generally predictable for insurance underwriters. - ANS-False
8. Self insurance refers to large employers who assume risks and budget for medical
claims. - ANS-True
9. Supply-side rationing has been used by the United States to control the rising cost of
health caused by moral hazards and povider- induced demand. - ANS-False
10. The majority of total US health care expenditure isfinanced by governement. -
ANS-False
11. The purpose of a stop-loss provision in a health insurance plan is to limit total
out-of-pocket costs. - ANS-True
12. The purpose of a stop-loss provision in a health insurance plan is to limit total
out-of-pocket costs. - ANS-True
13. The Rand Health Insurance Experiment demonstrated that utilization could be lowered
through cost sharing. - ANS-True
14. The United States does not have publicly financed health insurance specifically for the
unemployed. - ANS-True
15. The United States has publicly financed heath insurance specifically for the unemployed.
- ANS-False
16. Under Medicare Part A, a beneficiary can have an unlimited number of benefit periods. -
ANS-True
