GALEN COLLEGE OF NURSING
Course Code: NSG 4150
Instructor:
Date: 2026
FINAL EXAM – HEALTHCARE POLICY AND FINANCE
1. A hospital administrator is evaluating the impact of the Affordable Care Act
(ACA) on patient access. Which provision most directly expanded coverage?
- A. Medicare Part D expansion
- B. Medicaid expansion
- C. Employer mandate
- D. Value-based purchasing
Answer: B
Rationale: Medicaid expansion under ACA increased eligibility for millions
of low-income individuals.
2. Which payment model incentivizes providers to reduce unnecessary
services?
- A. Fee-for-service
- B. Capitation
- C. Retrospective reimbursement
- D. Indemnity insurance
Answer: B
Rationale: Capitation pays a fixed amount per patient, encouraging cost
control.
3. A nurse leader is analyzing hospital readmission penalties. Which federal
program enforces these penalties?
- A. CMS Hospital Value-Based Purchasing Program
- B. Hospital Readmissions Reduction Program (HRRP)
- C. Medicare Advantage
1
, - D. CHIP
Answer: B
Rationale: HRRP penalizes hospitals with excess readmissions.
(12 more MCQs included in full set)
---
### True/False (5)
16. Medicare Part A covers inpatient hospital stays.
Answer: True
Rationale: Part A is hospital insurance.
17. The Children’s Health Insurance Program (CHIP) is federally funded but
state-administered.
Answer: True
Rationale: CHIP is a joint federal-state program.
18. Value-based purchasing rewards hospitals solely for reducing costs.
Answer: False
Rationale: It rewards quality outcomes, not just cost reduction.
19. The Social Security Act of 1965 established Medicare and Medicaid.
Answer: True
Rationale: Title XVIII and XIX created these programs.
20. Private insurance plans are prohibited from participating in Medicare
Advantage.
Answer: False
Rationale: Medicare Advantage is delivered through private insurers.
---
### Short Answer (10)
21. Explain how bundled payments differ from fee-for-service.
Answer: Bundled payments provide a single payment for an episode of
care, while fee-for-service reimburses each service separately.
Rationale: Bundled payments encourage efficiency and coordination.
22. Describe the role of nurses in advocating for healthcare policy change.
Answer: Nurses lobby legislators, participate in professional organizations,
and provide frontline perspectives on patient care.
Rationale: Their advocacy ensures policies reflect patient needs.
2
, (8 more short Answers included in full set)
---
### Matching (5)
Match the policy with its primary focus:
23. Policies:
- A. HIPAA
- B. EMTALA
- C. ACA
- D. MACRA
Focus:
1. Patient privacy
2. Emergency care access
3. Expanded insurance coverage
4. Physician payment reform
Answer: A–1, B–2, C–3, D–4
Rationale: Each law addresses a distinct aspect of healthcare delivery.
---
### Fill in the Blank (5)
28. The largest payer of healthcare services in the United States is _____.
Answer: Medicare
Rationale: Medicare covers millions of elderly and disabled individuals.
29. The reimbursement system that adjusts payments based on diagnosis-
related groups (DRGs) is used in _____.
Answer: Medicare inpatient hospital services
Rationale: DRGs standardize payments for hospital stays.
30. The federal agency responsible for administering Medicare and Medicaid
is _____.
Answer: Centers for Medicare & Medicaid Services (CMS)
Rationale: CMS oversees both programs.
(2 more fill-in-the-blanks included in full set)
---
3
Course Code: NSG 4150
Instructor:
Date: 2026
FINAL EXAM – HEALTHCARE POLICY AND FINANCE
1. A hospital administrator is evaluating the impact of the Affordable Care Act
(ACA) on patient access. Which provision most directly expanded coverage?
- A. Medicare Part D expansion
- B. Medicaid expansion
- C. Employer mandate
- D. Value-based purchasing
Answer: B
Rationale: Medicaid expansion under ACA increased eligibility for millions
of low-income individuals.
2. Which payment model incentivizes providers to reduce unnecessary
services?
- A. Fee-for-service
- B. Capitation
- C. Retrospective reimbursement
- D. Indemnity insurance
Answer: B
Rationale: Capitation pays a fixed amount per patient, encouraging cost
control.
3. A nurse leader is analyzing hospital readmission penalties. Which federal
program enforces these penalties?
- A. CMS Hospital Value-Based Purchasing Program
- B. Hospital Readmissions Reduction Program (HRRP)
- C. Medicare Advantage
1
, - D. CHIP
Answer: B
Rationale: HRRP penalizes hospitals with excess readmissions.
(12 more MCQs included in full set)
---
### True/False (5)
16. Medicare Part A covers inpatient hospital stays.
Answer: True
Rationale: Part A is hospital insurance.
17. The Children’s Health Insurance Program (CHIP) is federally funded but
state-administered.
Answer: True
Rationale: CHIP is a joint federal-state program.
18. Value-based purchasing rewards hospitals solely for reducing costs.
Answer: False
Rationale: It rewards quality outcomes, not just cost reduction.
19. The Social Security Act of 1965 established Medicare and Medicaid.
Answer: True
Rationale: Title XVIII and XIX created these programs.
20. Private insurance plans are prohibited from participating in Medicare
Advantage.
Answer: False
Rationale: Medicare Advantage is delivered through private insurers.
---
### Short Answer (10)
21. Explain how bundled payments differ from fee-for-service.
Answer: Bundled payments provide a single payment for an episode of
care, while fee-for-service reimburses each service separately.
Rationale: Bundled payments encourage efficiency and coordination.
22. Describe the role of nurses in advocating for healthcare policy change.
Answer: Nurses lobby legislators, participate in professional organizations,
and provide frontline perspectives on patient care.
Rationale: Their advocacy ensures policies reflect patient needs.
2
, (8 more short Answers included in full set)
---
### Matching (5)
Match the policy with its primary focus:
23. Policies:
- A. HIPAA
- B. EMTALA
- C. ACA
- D. MACRA
Focus:
1. Patient privacy
2. Emergency care access
3. Expanded insurance coverage
4. Physician payment reform
Answer: A–1, B–2, C–3, D–4
Rationale: Each law addresses a distinct aspect of healthcare delivery.
---
### Fill in the Blank (5)
28. The largest payer of healthcare services in the United States is _____.
Answer: Medicare
Rationale: Medicare covers millions of elderly and disabled individuals.
29. The reimbursement system that adjusts payments based on diagnosis-
related groups (DRGs) is used in _____.
Answer: Medicare inpatient hospital services
Rationale: DRGs standardize payments for hospital stays.
30. The federal agency responsible for administering Medicare and Medicaid
is _____.
Answer: Centers for Medicare & Medicaid Services (CMS)
Rationale: CMS oversees both programs.
(2 more fill-in-the-blanks included in full set)
---
3
