HADM 3000/ Mid Term Exam
Questions With Already Solved
Correctly Answers | Updated
Stark 1 CORRECT ANSWERS Anti-kick back, Doctors cant referrer a patient that will
financially benefit them.
HMO Act CORRECT ANSWERS health Maintenance Organization Act, introduced by
Kennedy, enhance the delivery care given to patients while controlling the cost.
ACA CORRECT ANSWERS Affordable Care Act, Makes health insurance more
affordable for more people. Medicaid expanded.
CHIP CORRECT ANSWERS Children's Health Insurance Program. A program like
medicare/medicaid that is paid for by federal taxes to give healthcare to children that
live in poverty.
Healthcare Quality Improvement Act of 1986 CORRECT ANSWERS To blacklist
physicians and surgeons that were found guilty of malpractices as described in this
legislation. One of the main methods of medical malpractice that surgeons and other
medical practitioners used to resort to was to simply move from the State in which he or
she committed misdemeanors to another in which the law was less punitive.
COBRA CORRECT ANSWERS Consolidated Omnibus Budget Reconciliation Act/
Passed by Ronald Reagan lets people continue using there health insurance after
leaving a job. They just have to pay what your employer was paying.
Who Finances Health Care CORRECT ANSWERS Employers, Individuals, and the
government
Private Health Insurance CORRECT ANSWERS A health policy that individuals and
families can purchase to cover health services (blue cross blue shield, atnea )
Public Insurance Programs CORRECT ANSWERS Medicare- for older people
meicaid- for people in poverty
CHIP - children in poverty
Uncompensated care CORRECT ANSWERS the costs of delivering health care for
which providers are not reimbursed
complexity of financing CORRECT ANSWERS - Many payers
- Many plans
- Many programs
, - Many payment mechanisms
Effects of Health Care Financing and Insurance CORRECT ANSWERS 1.Moral hazard
and provider-induced demand waste health care resources, and add to the rising cost of
health care.
2.National health insurance enables supply-side rationing; this has not been possible in
the US.
3.The ACA still leaves many uninsured ― indirect or demand-side rationing
insurance premium CORRECT ANSWERS amount paid on an insurance policy per a
given time period
Insurance Co-pay CORRECT ANSWERS out-of-pocket pay at time of visit to MD office,
Rx, hospital
Insurance Deductible CORRECT ANSWERS The set amount the policyholder must pay
before any benefits kick in.
Co-insurance CORRECT ANSWERS 80/20 (insurance pays 80% and patient pays 20%
Out-of-pocket maximum CORRECT ANSWERS limits max of out-of-pocket
$$ spent by insured
5 types of private insurance CORRECT ANSWERS 1. group insurance
2. self-insurance
3. individual private insurance
4. managed care plans
5. high-deductible health plans
Group Insurance CORRECT ANSWERS A type of health insurance in which all those
insured have the same coverage and pay a set premium
Self-insurance CORRECT ANSWERS Large employers become self-insured because
their workforce are large and diversified enough (Auburn University)
individual private health insurance CORRECT ANSWERS -nongroup plans
-premiums based on individual's health and demographics
-many lost coverage under the ACA
managed care plans CORRECT ANSWERS health insurance coverage that you pay for
in advance instead of paying for services as you use them
Questions With Already Solved
Correctly Answers | Updated
Stark 1 CORRECT ANSWERS Anti-kick back, Doctors cant referrer a patient that will
financially benefit them.
HMO Act CORRECT ANSWERS health Maintenance Organization Act, introduced by
Kennedy, enhance the delivery care given to patients while controlling the cost.
ACA CORRECT ANSWERS Affordable Care Act, Makes health insurance more
affordable for more people. Medicaid expanded.
CHIP CORRECT ANSWERS Children's Health Insurance Program. A program like
medicare/medicaid that is paid for by federal taxes to give healthcare to children that
live in poverty.
Healthcare Quality Improvement Act of 1986 CORRECT ANSWERS To blacklist
physicians and surgeons that were found guilty of malpractices as described in this
legislation. One of the main methods of medical malpractice that surgeons and other
medical practitioners used to resort to was to simply move from the State in which he or
she committed misdemeanors to another in which the law was less punitive.
COBRA CORRECT ANSWERS Consolidated Omnibus Budget Reconciliation Act/
Passed by Ronald Reagan lets people continue using there health insurance after
leaving a job. They just have to pay what your employer was paying.
Who Finances Health Care CORRECT ANSWERS Employers, Individuals, and the
government
Private Health Insurance CORRECT ANSWERS A health policy that individuals and
families can purchase to cover health services (blue cross blue shield, atnea )
Public Insurance Programs CORRECT ANSWERS Medicare- for older people
meicaid- for people in poverty
CHIP - children in poverty
Uncompensated care CORRECT ANSWERS the costs of delivering health care for
which providers are not reimbursed
complexity of financing CORRECT ANSWERS - Many payers
- Many plans
- Many programs
, - Many payment mechanisms
Effects of Health Care Financing and Insurance CORRECT ANSWERS 1.Moral hazard
and provider-induced demand waste health care resources, and add to the rising cost of
health care.
2.National health insurance enables supply-side rationing; this has not been possible in
the US.
3.The ACA still leaves many uninsured ― indirect or demand-side rationing
insurance premium CORRECT ANSWERS amount paid on an insurance policy per a
given time period
Insurance Co-pay CORRECT ANSWERS out-of-pocket pay at time of visit to MD office,
Rx, hospital
Insurance Deductible CORRECT ANSWERS The set amount the policyholder must pay
before any benefits kick in.
Co-insurance CORRECT ANSWERS 80/20 (insurance pays 80% and patient pays 20%
Out-of-pocket maximum CORRECT ANSWERS limits max of out-of-pocket
$$ spent by insured
5 types of private insurance CORRECT ANSWERS 1. group insurance
2. self-insurance
3. individual private insurance
4. managed care plans
5. high-deductible health plans
Group Insurance CORRECT ANSWERS A type of health insurance in which all those
insured have the same coverage and pay a set premium
Self-insurance CORRECT ANSWERS Large employers become self-insured because
their workforce are large and diversified enough (Auburn University)
individual private health insurance CORRECT ANSWERS -nongroup plans
-premiums based on individual's health and demographics
-many lost coverage under the ACA
managed care plans CORRECT ANSWERS health insurance coverage that you pay for
in advance instead of paying for services as you use them
