HAP FINAL EXAM QUESTIONS & ANSWERS
Why was managed care organizations developed in the 90's - Answer -to control costs
What are DRG's - Answer -Diagnosis related groups- categorize patients with similar clinical
diagnosis to control hospital costs and determine payor reimbursement rates
What is a capitation - Answer -cap on how much can be paid- per member per month
What are the three groups that are covered under Medicare - Answer -elderly (65+), disabled, and
end stage renal failure
Medicare part A - Answer -covers hospitals - free
Medicare part B - Answer -covers physician and outpatient
Medicare part D - Answer -covers prescription drugs
Medicare part C - Answer -combines coverage for A, B, and D
What is the Hill-Burton Act - Answer -act to expand hospital beds
When were DRG's established - Answer -1983
Who has the bigger role in our healthcare system in the US - Answer -private sector
What is the social justice system in healthcare - Answer -healthcare that is based on the wellbeing
of our country
Are healthcare expenditures predicted to rise or fall in the future - Answer -rise
What are some examples of health determinants - Answer -using tobacco, gun violence, sexual
behaviors etc.
What are acute health conditions - Answer -conditions that are severe and sudden - ex: heart
attack, asthma attack
What are chronic health conditions - Answer -conditions that last a long time and require ongoing
medical attention- ex: diabetes
What is days of care - Answer -all the patients who were in the hospital at midnight
What are some strategies to help reduce disparities in our health at the micro and macro level -
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, Answer -vaccine clinics, preventative care type teaching, and creating standards
What are two ways to measure quality of life in healthcare - Answer -patient satisfaction surveys
and patient outcomes
What was a physician thought of in pre-industrial times - Answer -self-trained
What is a pesthouse - Answer -held patients with infectious diseases
What is an almshouse - Answer -held patients who were poor
What is an asylum - Answer -held patients that were mentally ill
What is voluntary health insurance - Answer -private insurance through employers or the
marketplace is voluntary- choosing to have health insurance
What is medicaid - Answer -health insurance for the poor administered by the states
Who administers Medicare - Answer -the federal government
What is blue cross - Answer -the first model of insurance made to cover hospital expenses
What is blue shield - Answer -insurance that covered physician visits
What are some reasons we have growing healthcare needs - Answer -aging population, focus on
treatment rather than prevention, and immigrants
What is market justice in healthcare - Answer -healthcare that is based on capitalism
What are the vulnerable populations - Answer -poor, uninsured women and children, disabled and
chronically ill, homeless, racial and ethnic minorities, rural populations, mentally ill, and HIV/AIDS
patients
What are health care settings for the vulnerable populations (safety nets) - Answer -community
health centers, ER's, and free clinics
What do physicians do - Answer -assess, diagnose, and treat
To become a specialist, what are the requirements post medical school - Answer -a fellowship or
advanced residency
What are physicians after the completion of their fellowship - Answer -board certified
What are the two different types of non-physician providers - Answer -Nurse practitioners and
physician assistants
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Why was managed care organizations developed in the 90's - Answer -to control costs
What are DRG's - Answer -Diagnosis related groups- categorize patients with similar clinical
diagnosis to control hospital costs and determine payor reimbursement rates
What is a capitation - Answer -cap on how much can be paid- per member per month
What are the three groups that are covered under Medicare - Answer -elderly (65+), disabled, and
end stage renal failure
Medicare part A - Answer -covers hospitals - free
Medicare part B - Answer -covers physician and outpatient
Medicare part D - Answer -covers prescription drugs
Medicare part C - Answer -combines coverage for A, B, and D
What is the Hill-Burton Act - Answer -act to expand hospital beds
When were DRG's established - Answer -1983
Who has the bigger role in our healthcare system in the US - Answer -private sector
What is the social justice system in healthcare - Answer -healthcare that is based on the wellbeing
of our country
Are healthcare expenditures predicted to rise or fall in the future - Answer -rise
What are some examples of health determinants - Answer -using tobacco, gun violence, sexual
behaviors etc.
What are acute health conditions - Answer -conditions that are severe and sudden - ex: heart
attack, asthma attack
What are chronic health conditions - Answer -conditions that last a long time and require ongoing
medical attention- ex: diabetes
What is days of care - Answer -all the patients who were in the hospital at midnight
What are some strategies to help reduce disparities in our health at the micro and macro level -
1/7
, Answer -vaccine clinics, preventative care type teaching, and creating standards
What are two ways to measure quality of life in healthcare - Answer -patient satisfaction surveys
and patient outcomes
What was a physician thought of in pre-industrial times - Answer -self-trained
What is a pesthouse - Answer -held patients with infectious diseases
What is an almshouse - Answer -held patients who were poor
What is an asylum - Answer -held patients that were mentally ill
What is voluntary health insurance - Answer -private insurance through employers or the
marketplace is voluntary- choosing to have health insurance
What is medicaid - Answer -health insurance for the poor administered by the states
Who administers Medicare - Answer -the federal government
What is blue cross - Answer -the first model of insurance made to cover hospital expenses
What is blue shield - Answer -insurance that covered physician visits
What are some reasons we have growing healthcare needs - Answer -aging population, focus on
treatment rather than prevention, and immigrants
What is market justice in healthcare - Answer -healthcare that is based on capitalism
What are the vulnerable populations - Answer -poor, uninsured women and children, disabled and
chronically ill, homeless, racial and ethnic minorities, rural populations, mentally ill, and HIV/AIDS
patients
What are health care settings for the vulnerable populations (safety nets) - Answer -community
health centers, ER's, and free clinics
What do physicians do - Answer -assess, diagnose, and treat
To become a specialist, what are the requirements post medical school - Answer -a fellowship or
advanced residency
What are physicians after the completion of their fellowship - Answer -board certified
What are the two different types of non-physician providers - Answer -Nurse practitioners and
physician assistants
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