LSUS MHA 706 MIDTERM PRACTICE EXAM
2026 FULL CASE STUDIES AND STRATEGIC
DECISION MAKING FRAMEWORK
◉ Not for profit
Answer: is to ensure the financial viability of the organization
◉ Characteristics for insurance
Answer: pooling of losses, payment only for random losses, risk
transfer, and indemnification
◉ Adverse selection
Answer: those with greater risk are more likely to purchase
insurance
◉ moral hazard
Answer: the risk risk of overuse of health services because of the
insured does not bear the full cost of consequences
◉ Managed care plans
Answer: HMO, PPO, and POS
, ◉ Charge master
Answer: rate schedule
◉ Prospective payment
Answer: per procedure basis, per diagnosis basis, per diem basis,
and bundled pricing basis
◉ 3 types of medical codes used
Answer: IDC codes, CPT codes, and HCPCS codes
◉ ICD Code
Answer: codes are used to specify diseases, symptoms, or injuries.
The codes currently consist up to 7 digits- with the seventh digit
representing visit encounter or sequelae for injuries and external
causes
◉ Current Procedural Terminology (CPT)
Answer: codes are used to specify medical procedures (treatments).
The codes are 5 digits.
◉ Healthcare Common Procedure Coding System (HCPCS)
2026 FULL CASE STUDIES AND STRATEGIC
DECISION MAKING FRAMEWORK
◉ Not for profit
Answer: is to ensure the financial viability of the organization
◉ Characteristics for insurance
Answer: pooling of losses, payment only for random losses, risk
transfer, and indemnification
◉ Adverse selection
Answer: those with greater risk are more likely to purchase
insurance
◉ moral hazard
Answer: the risk risk of overuse of health services because of the
insured does not bear the full cost of consequences
◉ Managed care plans
Answer: HMO, PPO, and POS
, ◉ Charge master
Answer: rate schedule
◉ Prospective payment
Answer: per procedure basis, per diagnosis basis, per diem basis,
and bundled pricing basis
◉ 3 types of medical codes used
Answer: IDC codes, CPT codes, and HCPCS codes
◉ ICD Code
Answer: codes are used to specify diseases, symptoms, or injuries.
The codes currently consist up to 7 digits- with the seventh digit
representing visit encounter or sequelae for injuries and external
causes
◉ Current Procedural Terminology (CPT)
Answer: codes are used to specify medical procedures (treatments).
The codes are 5 digits.
◉ Healthcare Common Procedure Coding System (HCPCS)
