IHOP Exam 2 Questions and Answers (Verified
Answers) (Latest Update 2025) UPDATE!!
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Terms in this set (277)
How We Pay for Health Insurance or Self Pay
Care
Complexity of US Health Many payers, many private plans, many government
Care System programs, many payment methods, many uninsured
Financing Influence on This determines who has access to care
Demand
lowers out-of-pocket costs, patient's consumer more,
Health Insurance
leads to a "moral hazard"
New services proliferate when they are covered by
health insurance, given rise to subindustries, influence
Financing Influence on
on technology diffusion and utilization, get more of
Supply
what is paid for and provide more of what they are
paid for
Various Management Decisions Influenced By
Consequences of Reimbursement, Financing affects supply &
Financing distribution of health professionals, financing
eventually affects total health care expenditures
Expenditures = Price *
Quantity
Expenditures are Increase Expansion of health insurance, increase in health
By insurance premiums
, Restricting Insurance, Restricting Reimbursement to
Expenditures Can Be Providers, Having Few Specialists, Spending Less on R
Reduced By & D, Direct control over utilization, Designating certain
services as not covered
Insurance Protects against risk
The possibility of substantial financial loss from some
Risk
event, where probability of occurrence is small
1. Risk is Unpredictable for the Individual 2. Risk can
Four Principles of be predicted with some accuracy in a large group 3.
Insurance Insurance pools resources to spread risk 4. Losses are
shared by all members
Process of using a large group to estimate total risk
Underwriting
for an individual and spread the risk
Is designed to be used, unlike homeowner's insurance,
Health Insurance
flood insurance, car insurance, life insurance etc.
amount charged by insurer to insure against risk,
Premiums
involves employer & employee cost sharing
deductibles, co-payments, coinsurance reduces moral
Cost sharing
hazard
Moral hazard using lots of resources because you have them
Rand Cost Sharing Identified the concept that cost sharing reduces
Experiment of 1980s moral hazard
amount paid before insurance covers costs, applied
Deductibles
annually
First dollar coverage plans plans without co-pays or deductibles, very rare
amount paid along with insurance payment for
Co-payments
services
another insurance plan besides primary plan to cover
Coinsurance
other uncovered costs
Answers) (Latest Update 2025) UPDATE!!
Save
Terms in this set (277)
How We Pay for Health Insurance or Self Pay
Care
Complexity of US Health Many payers, many private plans, many government
Care System programs, many payment methods, many uninsured
Financing Influence on This determines who has access to care
Demand
lowers out-of-pocket costs, patient's consumer more,
Health Insurance
leads to a "moral hazard"
New services proliferate when they are covered by
health insurance, given rise to subindustries, influence
Financing Influence on
on technology diffusion and utilization, get more of
Supply
what is paid for and provide more of what they are
paid for
Various Management Decisions Influenced By
Consequences of Reimbursement, Financing affects supply &
Financing distribution of health professionals, financing
eventually affects total health care expenditures
Expenditures = Price *
Quantity
Expenditures are Increase Expansion of health insurance, increase in health
By insurance premiums
, Restricting Insurance, Restricting Reimbursement to
Expenditures Can Be Providers, Having Few Specialists, Spending Less on R
Reduced By & D, Direct control over utilization, Designating certain
services as not covered
Insurance Protects against risk
The possibility of substantial financial loss from some
Risk
event, where probability of occurrence is small
1. Risk is Unpredictable for the Individual 2. Risk can
Four Principles of be predicted with some accuracy in a large group 3.
Insurance Insurance pools resources to spread risk 4. Losses are
shared by all members
Process of using a large group to estimate total risk
Underwriting
for an individual and spread the risk
Is designed to be used, unlike homeowner's insurance,
Health Insurance
flood insurance, car insurance, life insurance etc.
amount charged by insurer to insure against risk,
Premiums
involves employer & employee cost sharing
deductibles, co-payments, coinsurance reduces moral
Cost sharing
hazard
Moral hazard using lots of resources because you have them
Rand Cost Sharing Identified the concept that cost sharing reduces
Experiment of 1980s moral hazard
amount paid before insurance covers costs, applied
Deductibles
annually
First dollar coverage plans plans without co-pays or deductibles, very rare
amount paid along with insurance payment for
Co-payments
services
another insurance plan besides primary plan to cover
Coinsurance
other uncovered costs
