MHA 707 CH 6 questions with verified answers
___ is a needs-based program that provides coverage for some health services for
some of the poor on a means-tested basis. T Ans✓✓✓ Medicaid
___ is behaving differently when you know someone else is taking the risk
(induced demand). ex. people don't stop smoking even though they know it leads
to cancer bc they know the health insurance will pay for it. Ans✓✓✓ moral
hazard
___ is Hospital Insurance , which also covers skilled nursing facility care on a very
limited basis, as well as hospice and home health care; Ans✓✓✓ medicare part a
___ is Medicare Advantage in which members enroll with a plan administered by
an MCO and medicare pays the premium to the mco instead of paying their
providers directly under Part A and B and optionally Part D Ans✓✓✓ medicare
Part C)
___ is Medicare Prescription Drug Coverage, which was designed to lower the
costs of prescription medication for Medicare benefi ciaries Ans✓✓✓ medicare
(Part D)
___ is the idea that sharing risk proportionately among many is a basic insurance
concept. Ans✓✓✓ pooling of risk
___ is the single largest payer for most providers, particularly hospitals and
hospital based providers, also most gps. Ans✓✓✓ medicare
,___ was The fi rst national social insurance program to finance medical care in the
United States was established by Congress in 1965 as part of President Lyndon
Johnson's Great Society programs. Ans✓✓✓ medicare
____ are common in casualty insurance to minimize claims for minor incidents
where the expectation is that adverse events are rare and transaction costs are
high. Ans✓✓✓ Deductibles
____ are defined broadly as conditions that last 1 year or more and require
ongoing medical attention or limit activities of daily living or both. Ans✓✓✓
Chronic diseases
____ are the notable exception and have the second-highest total expenditures of
the conditions ranked. Ans✓✓✓ Trauma-related disorders (ex. car accidents,
suicide, homicide)
____ includes all medical goods and services that are used to diagnose, treat, and
prevent health problems in a specific person. Ans✓✓✓ personal healthcare
expenditures
____ is A fixed amount ($20, for example) you pay for a covered health care
service after you've paid your deductible. Ans✓✓✓ copayment
____ is a fixed prepayment per person to the health care provider for an agreed-
on array of services. Ans✓✓✓ Capitation
____ is a share of the cost—for example, 20% of the payment for each service
covered by insurance—for which the beneficiary is responsible. Ans✓✓✓
Coinsurance
, ____ is before the visit. Ans✓✓✓ copays
____ is how hospitals describe payment received for services they have already
provided. Ans✓✓✓ "Reimbursement"
____ is intended to steer patients towards providers with lower rates and or less
intense treatment encouraging patients to seek treatment with lower total costs
rather than fewer visits. Ans✓✓✓ coinsurance
____ is like no other sector of the economy. Ans✓✓✓ healthcare
____ is Medical Insurance, which covers physician and certain other health
professional services, hospital outpatient care, and certain other services;
Ans✓✓✓ medicare part b
____ is the idea that sicker people likely want more insurance (the healthier, want
less insurance). Ans✓✓✓ adverse selection
____ is the payment model in which the performing organization is rewarded for
the value delivered. Ans✓✓✓ "Value-based compensation"
____ provides health coverage for uninsured children who are not eligible for
Medicaid. It is jointly financed by the federal and state governments and
administered by the states Ans✓✓✓ CHIP
___ is a needs-based program that provides coverage for some health services for
some of the poor on a means-tested basis. T Ans✓✓✓ Medicaid
___ is behaving differently when you know someone else is taking the risk
(induced demand). ex. people don't stop smoking even though they know it leads
to cancer bc they know the health insurance will pay for it. Ans✓✓✓ moral
hazard
___ is Hospital Insurance , which also covers skilled nursing facility care on a very
limited basis, as well as hospice and home health care; Ans✓✓✓ medicare part a
___ is Medicare Advantage in which members enroll with a plan administered by
an MCO and medicare pays the premium to the mco instead of paying their
providers directly under Part A and B and optionally Part D Ans✓✓✓ medicare
Part C)
___ is Medicare Prescription Drug Coverage, which was designed to lower the
costs of prescription medication for Medicare benefi ciaries Ans✓✓✓ medicare
(Part D)
___ is the idea that sharing risk proportionately among many is a basic insurance
concept. Ans✓✓✓ pooling of risk
___ is the single largest payer for most providers, particularly hospitals and
hospital based providers, also most gps. Ans✓✓✓ medicare
,___ was The fi rst national social insurance program to finance medical care in the
United States was established by Congress in 1965 as part of President Lyndon
Johnson's Great Society programs. Ans✓✓✓ medicare
____ are common in casualty insurance to minimize claims for minor incidents
where the expectation is that adverse events are rare and transaction costs are
high. Ans✓✓✓ Deductibles
____ are defined broadly as conditions that last 1 year or more and require
ongoing medical attention or limit activities of daily living or both. Ans✓✓✓
Chronic diseases
____ are the notable exception and have the second-highest total expenditures of
the conditions ranked. Ans✓✓✓ Trauma-related disorders (ex. car accidents,
suicide, homicide)
____ includes all medical goods and services that are used to diagnose, treat, and
prevent health problems in a specific person. Ans✓✓✓ personal healthcare
expenditures
____ is A fixed amount ($20, for example) you pay for a covered health care
service after you've paid your deductible. Ans✓✓✓ copayment
____ is a fixed prepayment per person to the health care provider for an agreed-
on array of services. Ans✓✓✓ Capitation
____ is a share of the cost—for example, 20% of the payment for each service
covered by insurance—for which the beneficiary is responsible. Ans✓✓✓
Coinsurance
, ____ is before the visit. Ans✓✓✓ copays
____ is how hospitals describe payment received for services they have already
provided. Ans✓✓✓ "Reimbursement"
____ is intended to steer patients towards providers with lower rates and or less
intense treatment encouraging patients to seek treatment with lower total costs
rather than fewer visits. Ans✓✓✓ coinsurance
____ is like no other sector of the economy. Ans✓✓✓ healthcare
____ is Medical Insurance, which covers physician and certain other health
professional services, hospital outpatient care, and certain other services;
Ans✓✓✓ medicare part b
____ is the idea that sicker people likely want more insurance (the healthier, want
less insurance). Ans✓✓✓ adverse selection
____ is the payment model in which the performing organization is rewarded for
the value delivered. Ans✓✓✓ "Value-based compensation"
____ provides health coverage for uninsured children who are not eligible for
Medicaid. It is jointly financed by the federal and state governments and
administered by the states Ans✓✓✓ CHIP
