MHA 706 Midterm- Lord Questions
and Answers (Graded A)
Proprietorships & Partnerships: Pros & Cons - ANSWER-Pros: Ease of
Information, Subject to a few regulations, no corporation income taxes.
Cons: Limited life, difficult to transfer, unlimited life, difficult to raise capital.
Corporations: Pros & Cons - ANSWER-Pros: Unlimited life, easy transfer of
ownership, limited liability, ease of raising capital.
Cons: Cost of formation and reporting, double or triple taxes must be paid.
Non-profit Organization - ANSWER-Exempt from taxes. Goal is to improve
community.
For-profit Organizations - ANSWER-(Investor Owned) Goal is to maximize
shareholder return. Owe taxes.
,Medicare reimbursement for different types of providers - ANSWER-Medicare
parts A, B & C.
Medicare Part A (aka Hospital Insurance or HI) - ANSWER-Provides hospital
insurance automatically at age 65 (if FICA qualified) at no fee but may have
deductible & co-pay.
Medicare Part B - ANSWER-The part of the Medicare program that pays for
physician services, outpatient hospital services, durable medical equipment,
and other services and supplies.
Medicare Part C (Medicare Advantage) - ANSWER-•Replaces and covers
expenses found in Part A and B
•Medicare private fee-for-service plans (PFFS)
•Medicare managed care plans (HMOs and PPOs)
•Medicare specialty plans
Medicare—Part D Prescription Drug Coverage - ANSWER-a United States
federal-government program to subsidize the costs of prescription drugs and
prescription drug insurance premiums for Medicare beneficiaries.
, Agency Problem - ANSWER-the possibility of conflict of interest between the
stockholders and management of a firm.
Example: Hire someone to carry out a job function, but they go out of their
interests instead of best interests of company/organization.
Third-party payor system in the US (i.e. private vs public) - ANSWER-Private:
Blue Cross Blue Shield, Commercial Insurers, Self-Insurers. (AETNA)
Public: Medicare and Medicaid-both offer services to different levels. "Safety
net" Lowest reimbursement rates.
Reimbursement methods (fee-for-service vs. capitation) - ANSWER-Fee for
Service: payment is tied to amount of services provided. (Decades ago)
*Dental industry*
Capitation: payment is tied to the size of the covered population (number of
enrollees) Payment is based on per # per month. *Decreasing utilization*
Population is healthier.
Accounting Equation - ANSWER-Assets = Liabilities + Equity
and Answers (Graded A)
Proprietorships & Partnerships: Pros & Cons - ANSWER-Pros: Ease of
Information, Subject to a few regulations, no corporation income taxes.
Cons: Limited life, difficult to transfer, unlimited life, difficult to raise capital.
Corporations: Pros & Cons - ANSWER-Pros: Unlimited life, easy transfer of
ownership, limited liability, ease of raising capital.
Cons: Cost of formation and reporting, double or triple taxes must be paid.
Non-profit Organization - ANSWER-Exempt from taxes. Goal is to improve
community.
For-profit Organizations - ANSWER-(Investor Owned) Goal is to maximize
shareholder return. Owe taxes.
,Medicare reimbursement for different types of providers - ANSWER-Medicare
parts A, B & C.
Medicare Part A (aka Hospital Insurance or HI) - ANSWER-Provides hospital
insurance automatically at age 65 (if FICA qualified) at no fee but may have
deductible & co-pay.
Medicare Part B - ANSWER-The part of the Medicare program that pays for
physician services, outpatient hospital services, durable medical equipment,
and other services and supplies.
Medicare Part C (Medicare Advantage) - ANSWER-•Replaces and covers
expenses found in Part A and B
•Medicare private fee-for-service plans (PFFS)
•Medicare managed care plans (HMOs and PPOs)
•Medicare specialty plans
Medicare—Part D Prescription Drug Coverage - ANSWER-a United States
federal-government program to subsidize the costs of prescription drugs and
prescription drug insurance premiums for Medicare beneficiaries.
, Agency Problem - ANSWER-the possibility of conflict of interest between the
stockholders and management of a firm.
Example: Hire someone to carry out a job function, but they go out of their
interests instead of best interests of company/organization.
Third-party payor system in the US (i.e. private vs public) - ANSWER-Private:
Blue Cross Blue Shield, Commercial Insurers, Self-Insurers. (AETNA)
Public: Medicare and Medicaid-both offer services to different levels. "Safety
net" Lowest reimbursement rates.
Reimbursement methods (fee-for-service vs. capitation) - ANSWER-Fee for
Service: payment is tied to amount of services provided. (Decades ago)
*Dental industry*
Capitation: payment is tied to the size of the covered population (number of
enrollees) Payment is based on per # per month. *Decreasing utilization*
Population is healthier.
Accounting Equation - ANSWER-Assets = Liabilities + Equity
