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HSA 3111 Exam 2 | 60+ Practice Questions and Correct Answers | Health Insurance, Managed Care, Reimbursement, Healthcare Financing & Risk Management

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Subido en
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Escrito en
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Ace HSA 3111 Exam 2 with this comprehensive collection of 60+ exam-style questions and verified answers covering the fundamental principles of health insurance, healthcare financing, reimbursement methodologies, managed care organizations (MCOs), risk management, and healthcare economics. This study guide provides an in-depth review of high-yield topics including moral hazard, adverse selection, deductibles, copayments, coinsurance, premiums, self-insured health plans, occurrence and claims-made insurance policies, tort liability, tort reform, fee-for-service reimbursement, prospective and retrospective reimbursement, Prospective Payment System (PPS), Diagnosis-Related Groups (DRGs), capitation, Preferred Provider Organizations (PPOs), Health Maintenance Organizations (HMOs), case management, concurrent utilization review, Health Care Effectiveness Data and Information Set (HEDIS), National Committee for Quality Assurance (NCQA), Hill-Burton Act, Health Maintenance Organization Act of 1973, community-oriented primary care (COPC), hospice and palliative care, tertiary care, average daily census, and healthcare cost containment strategies. Presented in a structured question-and-answer format, this resource is ideal for reinforcing classroom concepts, testing knowledge retention, and preparing for university examinations. Beyond insurance and reimbursement, this document explores the evolution of managed care, provider payment incentives, healthcare quality measurement, utilization management, employer-sponsored insurance, risk sharing between insurers and providers, healthcare liability, and the legal and economic principles governing the U.S. healthcare system. It also reviews important historical legislation that shaped modern healthcare financing and examines how payment systems influence provider behavior, healthcare utilization, and patient access to care. As a comprehensive revision guide, this document is valuable for mastering both theoretical concepts and exam-focused applications within healthcare administration and health services management courses. The content closely aligns with concepts presented in Shi, L., & Singh, D. A. Delivering Health Care in America: A Systems Approach (Jones & Bartlett Learning), one of the leading references in healthcare administration education. It also reflects principles outlined by the Centers for Medicare & Medicaid Services (CMS) regarding Prospective Payment Systems (PPS), National Committee for Quality Assurance (NCQA) quality measurement through HEDIS, and foundational healthcare financing concepts discussed in Kongstvedt, P. R. Health Insurance and Managed Care: What They Are and How They Work (Jones & Bartlett Learning). Together, these authoritative resources provide the academic foundation for understanding healthcare reimbursement, managed care, quality improvement, and health insurance policy in the United States. Relevant Students: Healthcare Administration students, Health Services Administration students, Healthcare Management students, Health Sciences students, Public Health students, Nursing students, Allied Health students, Health Policy students, Medical students, Pre-Med students, MHA students, MPH students, MBA Healthcare Management students, Hospital Administration students, Undergraduate Healthcare Administration students, Graduate Healthcare Management students. Keywords: HSA 3111, HSA 3111 Exam 2, health insurance, healthcare financing, managed care, managed care organizations, MCO, HMO, PPO, capitation, fee for service, prospective payment system, PPS, retrospective reimbursement, prospective reimbursement, DRGs, Diagnosis Related Groups, reimbursement methods, healthcare economics, moral hazard, adverse selection, deductible, copayment, coinsurance, premium, self-insured plans, risk sharing, risk management, tort liability, tort reform, occurrence policy, claims made policy, HEDIS, NCQA, Hill-Burton Act, Health Maintenance Organization Act, case management, utilization review, concurrent utilization, community-oriented primary care, COPC, hospice care, palliative care, tertiary care, healthcare quality, healthcare policy, healthcare administration, healthcare management, study guide, practice questions, exam questions, university exam preparation

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HSA 3111
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HSA 3111

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HSA 3111 EXAM 2 2026 Exam
Questions and Correct
Answers | New Update



In this chapter the phenomenon called 'moral hazard' results directly

from ________________.

(remember the examples of the young guy and the car or the building on

fire and how similar types of issues happen in the healthcare industry.) -

ANSWER ✔✔health insurance coverage


A health insurance plan pays for medical care only after the insured has

first paid $1,000 out of pocket on an annual basis. The $1,000 annual

cost is called _________. - ANSWER ✔✔deductible


Four fundamental principles that underlie the concept of insurance: -

ANSWER ✔✔1. Risk can be unpredictable for the individual insured.

, 2. Risk can be predicted with a reasonable degree of accuracy for a

large group or a population.

3. Insurance provides a mechanism for transferring or shifting risk from

the individual to the group through the pooling of resources.

4. All members of the insured group share actual losses on some

equitable basis.

A copayment is generally paid ___________. Remember our example in

class that each time an individual went to see a doctor they had to pay

$10. - ANSWER ✔✔each time the insured receives health care

services

In a general sense, what is the primary purpose of insurance? -

ANSWER ✔✔Protection against risk


Typically, tertiary care: - ANSWER ✔✔is highly specialized.


Hospice services are primarily for people with: - ANSWER

✔✔terminal illnesses.


How is community-orientated primary care (COPC) different from

primary care? - ANSWER ✔✔COPC adds a population-based

approach to identifying and addressing community health problems.


What is palliation? - ANSWER ✔✔Pain and symptom management

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Institución
HSA 3111
Grado
HSA 3111

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Subido en
17 de julio de 2026
Número de páginas
11
Escrito en
2025/2026
Tipo
Examen
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