HCMG-: FINAL EXAM QUESTIONS AND
ANSWERS 100% CORRECT
Why has the number of hospitals been decreasing since 1980? - ANSWER-Shifting
care from inpatient to outpatient
Focus on home care
Why have rural hospitals been closing? - ANSWER-Medical schools located in cities, so
physicians remain in cities
Overlaps with states without Medicaid expansion --> lots of uninsured people --> lower
demand for care and hard to sustain hospitals
What is driving the decrease in hospital usage? - ANSWER-the # of admissions
driven by shifting from inpatient to outpatient
Cost Shifting - ANSWER-The practice of shifting costs to some payers to offset losses
from other payers
Using privately-covered patients to cover the cost of publicly-insured patients
Cross-Subsidization - ANSWER-use of high prices and profits on one product to
subsidize low prices on another product
overcharging for profitable services to pay for unprofitable ones
Non-Profit Hospitals - ANSWER-IRS tax exemptions
Have mission statements
No substantial part of activities can consist of propaganda, influencing legislation, or
involvement in political campaigns
Community Benefit Standard - ANSWER-The charitable organization must benefit the
public or the community
Operate an emergency room open to all
Board of directors from the community
Care for all patients able to pay
, Surplus used to improve facilities, equipment, patient care, advancing medical training,
education, and research
Patient-Centered Medical Home - ANSWER-Patient treatment is coordinated through
their primary care physician to ensure they receive the necessary care when and where
they need it, in a manner they can understand
Must be accredited and approved by National Committee for Quality Assurance (very
expensive process)
Concierge Medicine - ANSWER-Relationship between a patient and a primary care
physician in which the patient pays an annual fee or retainer
can reduce the # of patients a physician cares for
New Research: increase in spending and no reductions in mortality
Why does concierge medicine result in an increase in spending but no reductions in
mortality? - ANSWER-Sorting: those that go into concierge medicine aren't necessarily
the ones that will benefit the most from enhanced PCP
Safety-Net Hospitals - ANSWER-hospitals that provide a significant level of care to low-
income, uninsured, and vulnerable populations
Tend to have a higher rate of Medicaid-funded and uncompensated care
No standard definition
Often perform poorly on quality measures
Financial constraints → lower performance
Principal-Agent Problem: Physicians - ANSWER-Physicians = agents on behalf of
patients and insurers
Technologic Imperative - ANSWER-prescribe the best care, regardless of costs
RUC Committee - ANSWER-A volunteer group of 31 physicians
Advise Medicare on how to value physician work
most seats assigned to a specific medical specialty society
Disproportionate representation of each specialty
ANSWERS 100% CORRECT
Why has the number of hospitals been decreasing since 1980? - ANSWER-Shifting
care from inpatient to outpatient
Focus on home care
Why have rural hospitals been closing? - ANSWER-Medical schools located in cities, so
physicians remain in cities
Overlaps with states without Medicaid expansion --> lots of uninsured people --> lower
demand for care and hard to sustain hospitals
What is driving the decrease in hospital usage? - ANSWER-the # of admissions
driven by shifting from inpatient to outpatient
Cost Shifting - ANSWER-The practice of shifting costs to some payers to offset losses
from other payers
Using privately-covered patients to cover the cost of publicly-insured patients
Cross-Subsidization - ANSWER-use of high prices and profits on one product to
subsidize low prices on another product
overcharging for profitable services to pay for unprofitable ones
Non-Profit Hospitals - ANSWER-IRS tax exemptions
Have mission statements
No substantial part of activities can consist of propaganda, influencing legislation, or
involvement in political campaigns
Community Benefit Standard - ANSWER-The charitable organization must benefit the
public or the community
Operate an emergency room open to all
Board of directors from the community
Care for all patients able to pay
, Surplus used to improve facilities, equipment, patient care, advancing medical training,
education, and research
Patient-Centered Medical Home - ANSWER-Patient treatment is coordinated through
their primary care physician to ensure they receive the necessary care when and where
they need it, in a manner they can understand
Must be accredited and approved by National Committee for Quality Assurance (very
expensive process)
Concierge Medicine - ANSWER-Relationship between a patient and a primary care
physician in which the patient pays an annual fee or retainer
can reduce the # of patients a physician cares for
New Research: increase in spending and no reductions in mortality
Why does concierge medicine result in an increase in spending but no reductions in
mortality? - ANSWER-Sorting: those that go into concierge medicine aren't necessarily
the ones that will benefit the most from enhanced PCP
Safety-Net Hospitals - ANSWER-hospitals that provide a significant level of care to low-
income, uninsured, and vulnerable populations
Tend to have a higher rate of Medicaid-funded and uncompensated care
No standard definition
Often perform poorly on quality measures
Financial constraints → lower performance
Principal-Agent Problem: Physicians - ANSWER-Physicians = agents on behalf of
patients and insurers
Technologic Imperative - ANSWER-prescribe the best care, regardless of costs
RUC Committee - ANSWER-A volunteer group of 31 physicians
Advise Medicare on how to value physician work
most seats assigned to a specific medical specialty society
Disproportionate representation of each specialty
