UHC Study guides, Class notes & Summaries

The work we do in the year 2023 regarding STAR measures will result in payment in what year? - Answer 2026 Star ratings is the program that CMS (centers for Medicare and Medicaid services) uses to compare Medicare advantage plans? - Answer True Quality bonus payments and rebates will only be paid to plant scoring/performing at what star rating? - Answer 4+ Improving star ratings is an enterprise wide effort, and we all play a part in improving our scores. Select all the ways that ...

what filipinos can expect from the universal health care law? - Answer all filipinos will be granted health coverage but not everything will be free universal health care law - Answer - all Filipinos are covered - it is not completely free - PhilHealth will become the "national purchaser" of health goods and services - DOH will still be in charge of "population-based" health services - health systems will become city-wide and province-wide - A "Health Technology and Assessm...

1) What are the major challenges of measuring progress toward and achievement of Universal Health Coverage (UHC)? What solutions might the global health community use to overcome these? - Answer The major challenges that confront the achievement of UHC are in defining factors that constitute the initiative, making it equitable, and figuring out how to measure and mediate factors that are ambiguous. In fact, one of the most difficult aspects of UHC is that, by definition, it is ambiguous by nat...

aims to improve health equity - Answer universal coverage reforms hallmark of a govt to improve the well-being of its citizens - Answer Universal health care WHO declared UHC as a basic human right - Answer 1948 aims to make health systems people-centered - Answer service delivery reforms aims to promote and protect health of the community - Answer policy reforms aims to make health care providers more reliable and responsible - Answer leadership reforms one of the ...

What does Universal health coverage mean? 3 - Answer means that all people receive the health services THEY NEED W/O SUFFERING FINANCIAL HARDSHIP when paying for them What are the three fundamental concerns that UHC addresses? - Answer 1) fairness of access to services, regardless of people's ability to pay for them 2) services are quality 3) financial arrangements protect people from suffering financial hardship What services fall under universal health coverage? - Answer ESSENTI...

Which of the following is a correct statement about in-network provider services? - Answer HMO Plans cover only in-network services. In most cases, members pay the full cost of any out-of-network services received, with a few important exceptions. Which of the following are eligibility requirements for enrollment in a Medicare Advantage (MA) Plan? (Select 3) - Answer Resides in the plan's service area Is enrolled in Medicare Part B Is entitled to Medicare Part A Which statement ...

Agent John is planning to conduct a series of events. Some will be strictly educational, others will be formal presentations of specific UnitedHealthcare plans, and others will be informal marketing events where he can generate leads and schedule future in-home marketing appointments. Of the three types of events John plans to conduct, which need to be reported to UnitedHealthcare? - Answer ******* When completing an enrollment application in LEAN, why is an agent prohibited from entering h...

In which situation may the Medicare Advantage (MA) organization decide to disenroll a member from an MA plan? - Answer The member calls CMS at 1-800-MEDICARE (Wrong) On October 20, Aries decides to switch his PDP to a Medicare Advantage plan. Aries would like this change to be effective November 1. Which statement is true for Aries? - Answer He may be able to use a Special Election Period to change plans if he qualifies for one. Janine, currently enrolled in a 3-star plan, discovers th...

What type of event must an agent conduct when they want to be able to collect consumer information, schedule future appointments, and accept enrollment applications? -Marketing/sales event -Member event -Educational event - Answer Marketing/sales event What type of event is an agent conducting when they inform Medicare consumers about Original Medicare, Medicare Advantage, Prescription Drug, or other Medicare programs? -Informal Marketing/sales event -Educational event -Fo...

What are Dual Special Needs Plans (D-SNP)? - Answer Medicare Advantage Plans uniquely designed for consumers enrolled in both Medicare and Medicaid. When does the Special Election Period for Dual/LIS Change in Status begin for D-SNP members that lose Medicaid eligibility? - Answer After the grace period ends Which statement describes the primary characteristic of a consumer who may benefit from a D-SNP? - Answer Is enrolled in their state Medicaid program, typically as a Full Dual, w...