FIPP 2 Final Exam Questions And Accurate Answers
Latest Update 100% Correct
Infant mortality rate - ANSWER Children that die beofre 1 year
Child mortality rate - ANSWER Children that die before 5 years
Beveridge Healthcare Model - ANSWER Financed by tax payments, single payer
controls prices and services, most providers are government
Bismarck healthcare model - ANSWER Financed by employers and employees, tight
government regulation of non-profit sickness funds, private providers and non-profit
sickness funds
National Health Insurance model - ANSWER Financed by tax payments, single payer has
power to negotiate prices, private providers and governments run national insurance
Out of pocket model - ANSWER Financed by individual payments, based on individual
ability to pay, all private and limited gov intervention
What percent of people understand health insurance terms - ANSWER 9%
How does US pay for healthcare? - ANSWER Private- employer based, individual
purchase of insurance
Public- Medicare, medicaid, CHIP, Tricare
Half of spending is for - ANSWER 5% of people
,Employer private insurance - ANSWER Costs split between employer and employee,
common for individuals younger than 65
Non-group/individual private insurance - ANSWER Private sector plans, individuals
purchase on non-group insurance market, expensive
Managed care organization (MCOs) - ANSWER Most insurance provided using these
Out of pocket expenses - ANSWER Amounts paid by individuals for healthcare, MCOs
cap the OOP for beneficiaries
Indigent care - ANSWER Free services for people who can't pay for care
Premium - ANSWER Amount individuals pays for healthcare coverage/benefits
Deductible - ANSWER Amount individual pays before receiving partial coverage for
medical costs
Co-payment - ANSWER Fixed amount people pay
Co-insurance - ANSWER Pay a certain percentage of cost
Fee for service provider payment - ANSWER Providers get pre-determined fee based on
service rendered
Risk sharing provider payment - ANSWER Burden on providers to be cost conscious
Capitation - ANSWER Provider paid fixed amount through prospective reimbursement
regardless of quality
, Pay for performance - ANSWER Provider reimbursed on patient outcomes, quality,
effectiveness
Patient centered medical home - ANSWER Primary care emphasizes coordination
Accountable care organization - ANSWER Integrate doctors and hospitals to make info
more available
MCO - ANSWER Provides healthcare in return for preset monthly payments
MCO goals - ANSWER Care is medically necessary, appropriate, high quality and cost
effective
PPO MCO - ANSWER Less restrictive, higher out of pocket costs
POS MCO - ANSWER Vary choice of providers, arrangement for delivery of services,
payment and risk sharing
HMO MCO - ANSWER More restrictive, lower out of pocket costs
HMO description - ANSWER Pay doctors with capitation model, primary care
gatekeeper, network of care givers, more control over cost and quality
HMO - ANSWER Advantage- lower OOP costs
Disadvantage- most restrictive
PPO description - ANSWER Doctors in a single organization owned by them that
contracts with payer, more choice of providers, no gatekeeper
Latest Update 100% Correct
Infant mortality rate - ANSWER Children that die beofre 1 year
Child mortality rate - ANSWER Children that die before 5 years
Beveridge Healthcare Model - ANSWER Financed by tax payments, single payer
controls prices and services, most providers are government
Bismarck healthcare model - ANSWER Financed by employers and employees, tight
government regulation of non-profit sickness funds, private providers and non-profit
sickness funds
National Health Insurance model - ANSWER Financed by tax payments, single payer has
power to negotiate prices, private providers and governments run national insurance
Out of pocket model - ANSWER Financed by individual payments, based on individual
ability to pay, all private and limited gov intervention
What percent of people understand health insurance terms - ANSWER 9%
How does US pay for healthcare? - ANSWER Private- employer based, individual
purchase of insurance
Public- Medicare, medicaid, CHIP, Tricare
Half of spending is for - ANSWER 5% of people
,Employer private insurance - ANSWER Costs split between employer and employee,
common for individuals younger than 65
Non-group/individual private insurance - ANSWER Private sector plans, individuals
purchase on non-group insurance market, expensive
Managed care organization (MCOs) - ANSWER Most insurance provided using these
Out of pocket expenses - ANSWER Amounts paid by individuals for healthcare, MCOs
cap the OOP for beneficiaries
Indigent care - ANSWER Free services for people who can't pay for care
Premium - ANSWER Amount individuals pays for healthcare coverage/benefits
Deductible - ANSWER Amount individual pays before receiving partial coverage for
medical costs
Co-payment - ANSWER Fixed amount people pay
Co-insurance - ANSWER Pay a certain percentage of cost
Fee for service provider payment - ANSWER Providers get pre-determined fee based on
service rendered
Risk sharing provider payment - ANSWER Burden on providers to be cost conscious
Capitation - ANSWER Provider paid fixed amount through prospective reimbursement
regardless of quality
, Pay for performance - ANSWER Provider reimbursed on patient outcomes, quality,
effectiveness
Patient centered medical home - ANSWER Primary care emphasizes coordination
Accountable care organization - ANSWER Integrate doctors and hospitals to make info
more available
MCO - ANSWER Provides healthcare in return for preset monthly payments
MCO goals - ANSWER Care is medically necessary, appropriate, high quality and cost
effective
PPO MCO - ANSWER Less restrictive, higher out of pocket costs
POS MCO - ANSWER Vary choice of providers, arrangement for delivery of services,
payment and risk sharing
HMO MCO - ANSWER More restrictive, lower out of pocket costs
HMO description - ANSWER Pay doctors with capitation model, primary care
gatekeeper, network of care givers, more control over cost and quality
HMO - ANSWER Advantage- lower OOP costs
Disadvantage- most restrictive
PPO description - ANSWER Doctors in a single organization owned by them that
contracts with payer, more choice of providers, no gatekeeper
