Update 2026 | Exam Prep | High-Yield Review Guide
1. Describe how the Pay for Performance model impacts healthcare providers
and patient care.
The model encourages providers to focus on increasing the number of
patients seen.
It has no significant impact on patient care or provider behavior.
The model primarily benefits insurance companies rather than patients.
The Pay for Performance model incentivizes providers to improve
the quality of care, leading to better patient outcomes.
2. What does HMO stand for in the context of healthcare models?
Health Management Organization
Health Medical Organization
Health Maintenance Organization
Health Monitoring Organization
3. What type of healthcare coverage does Medicare Part A provide?
Prescription drugs
Long-term care
Hospital insurance
Outpatient services
4. Describe the purpose of the MS-DRG system in healthcare payment.
The MS-DRG system is used to track patient outcomes after treatment.
, The MS-DRG system categorizes hospital cases to determine
payment rates based on diagnosis and severity.
The MS-DRG system is a method for hospitals to report their financial
performance.
The MS-DRG system is designed to improve patient satisfaction
scores.
5. Describe the significance of Medicare Part B in the context of the US
healthcare system.
Medicare Part B provides essential outpatient medical services,
contributing to preventive care and access to necessary treatments.
Medicare Part B is a private insurance plan.
Medicare Part B covers only prescription medications.
Medicare Part B is focused solely on inpatient hospital care.
6. What is the largest payer for home health insurance in the US?
Private Insurance
Medicare
Veterans Affairs
Medicaid
7. Medicare Part D provides coverage for:
Outpatient prescription drugs
Hospital visits
Inpatient hospitalization
,8. In Donabedian's model, what are the three main categories used to assess
healthcare quality?
Funding, education, research
Accessibility, affordability, efficiency
Personnel, technology, facilities
Structure, process, outcomes
9. Which ownership type constitutes the largest group of hospitals and hospital
beds in the United States?
Federal
Proprietary (private for-profit)
State and local government
Voluntary (private nonprofit)
10. Describe the impact of the HMO Act of 1973 on healthcare delivery in the
United States.
The HMO Act of 1973 encouraged the growth of managed care
organizations, promoting preventive care and cost containment.
The HMO Act of 1973 mandated universal healthcare coverage for all
citizens.
The HMO Act of 1973 restricted access to healthcare services for
low-income individuals.
The HMO Act of 1973 eliminated private insurance options for
patients.
11. What is the definition of Socialized Health Insurance?
, A model where healthcare is funded by charitable organizations.
A healthcare system based on employer-sponsored insurance.
A system where the government provides healthcare services and
pays for them through taxation.
A private insurance model where individuals pay premiums for
coverage.
12. Increased scrutiny of healthcare costs and quality have led to pay-for-
performance initiatives. What does this mean?
Healthcare providers are reimbursed for costs incurred to meet
certain performance criteria.
Healthcare providers are rewarded for meeting certain
performance measures for quality and efficiency.
Healthcare providers are paid a fee for each service performed.
Quality report cards will establish benchmarks for globalization of
care standards.
13. Under Fee-for-Service, providers have incentives to
Provide unnecessary care.
Focus on prevention and wellness.
Not provide needed care.
14. Describe the primary source of funding for Medicare Part A.
Medicare Part A is funded by private insurance premiums.
Medicare Part A is funded by donations from healthcare providers.
Medicare Part A is primarily financed through payroll taxes
collected from employees and employers.