healthcare exam 3
What are the main three objectives of the Patient and Affordable Care Act? (select all that apply) A. Expand health insurance coverage B. Limiting health coverage C. Controlling healthcare costs D. Improving the delivery system E. Increasing number of healthcare providers per capita
A,C,D
What are two ways that the ACA is financed? A. New taxes Higher copays B. Increasing the state matching share for C. Medicaid D. New industry fees
A,D
Between Acute and Extended hospital stays which don't have an emergency room or department? A. Acute B. Extended
B
Hospital accreditation is a ___________ process A. Involuntary B. Voluntary
B
Hospitals are the only facility/service that requires accreditation? A. True B. False
B
How do we measure success of a PCMH compared to standard care? Below is a list of outcomes measures. Which one does not belong? A Better patient satisfaction B Economic benefit to the neighborhood C Reduced cost D Fewer emergency department (ED) or hospital visits E Increased preventive care
B
What is the main way that Medicare pays hospitals? A. Per diem B. Diagnosis-related groups (DRG) rates C. Premium- based rates
B
What is the most common accrediting agency in the US? A. JAMA B. The Joint Commision C. P&T Committee D. JCAHO E. NCQA
B
Which of the following forms of reimbursement creates an incentive for hospitals to increase admissions but decrease length of stay and intensity of care? A Discounted fee for service B Diagnostic related groups (DRGs) C Per diem (per day) D Capitation
B
Which tax status hospital possibly has profits paid out to stakeholders? A. Nonprofit B. For-profit
B
Which type of hospital pharmacy requires more staff and resources? A. Centralized B. Decentralized C. Specialized D. Generalized
B
Will the health reform law create health insurance exchanges or marketplaces where small businesses and people who don't get coverage through their employers can shop for insurance and compare prices and benefits? A. No, the law will not do this. B. Yes, the law will do this.
B
Will the health reform law give states the option of expanding their existing Medicaid program to cover more low-income, uninsured adults? A. No, the law will not do this. B. Yes, the law will do this.
B
Will the health reform law increase the Medicare payroll tax on earnings for upper income Americans? A. No, the law will not do this. B. Yes, the law will do this.
B
Will the health reform law provide financial help to low- and moderate-income Americans who don't get insurance through their jobs to help them purchase coverage? A. No, the law will not do this. B. Yes, the law will do this.
B
Will the health reform law require employers with 50 or more employees to pay a fine if they don't offer health insurance? A. No, the law will not do this. B. Yes, the law will do this.
B
Will the health reform law require nearly all Americans to have health insurance starting in 2014 or else pay a fine? A. No, the law will not do this B. Yes, the law will do this
B
Who requires hospital accreditation? (select all that apply) A. Medicaid reimbursement B. Medicare reimbursement C. Possibly state licensure D. Some private third party insurances
B,C
What is true about Medical Homes? (select all that apply) A. It is a financing model B. It is a care model C. Primarily through Medicaid D. They are accountable for the quality and cost of patient care E. Team-based approach to comprehensive primary care coordinated by a personal physician (or other provider)
B,C,E
How does health insurance differ in 1920s-1940s compared to pre-1920s? (select all that apply) A. Very few had insurance B. More employers were offering health insurance C. Insurance was associated with more than one hospital D. Labor shortages and wage freezes attracted employees E. Healthcare was primarily paid out of pocket or with trade
B,D
What are the two main integrated care models? A. MCOs B. ACOs C. IPAs D. Medical home
B,D
What are two types of service hospital categories? A. Primary B. General C. Secondary D. Specialty
B,D
What are ways that the state government can cost control? (select all that apply) A. Regulating Medicare B. Regulating private insurance C. Developing set drug lists where you can only choose from that list D. Negotiating lower drug prices
B,D
Below is a list of ways in which PCMHs routinely improve patient access to care. Which one does not belong? A group visits, e-consults, peer support B 24/7 access to care team (phone or e-consults with nurses, etc. C home visits (to the patient in his/her home) D electronic health records and patient portals
C
Below are characteristics of nonprofit and not-for-profit hospitals. Which one does not belong? A Most US hospitals are of this type. B They do not pay property taxes. C They do not pay corporate income taxes. D They pay dividends to shareholders.
D
Below is a list of the roles of a hospital pharmacy and therapeutics committee. Which one does not belong? A Cost control and management of the hospital budget . B Review of new medications for effectiveness and value C Determining step therapy and prior authorization requirements for drugs D Oversight of randomized controlled trials for new drug products in the hospital setting
D
The primary purpose of the hospital formulary is which one of these? A To ensure appropriate drug therapy B To encourage use of the newest drug products C To promote bulk purchasing of generically available drug products from only a few manufacturers D To control drug costs
D
What is the average length of stay in an Acute Stay Hospital? A. >30 and <90 days B. 120 days C. 2 days D. >2 and <30 days
D
Which one of the following groups was explicitly excluded from the expansion of health insurance under the Patient Protection and Affordable Care Act (2010)? A None, all will be insured B Children, ages 6-18 C Low-income childless adults D Undocumented immigrants
D
Which one of the following is true about hospital accreditation? A Standards are set by each state's board of health. B Accreditation is required by law. C Accreditation is only for acute care hospitals and does not apply to facilities such as long-term care facilities. D Accreditation is required for Medicare reimbursement.
D
Which one of the following is true about the Patient Protection and Affordable Care Act (2010)? A It started lifetime limits on health insurance coverage. B It was modeled after a socialized medicine system. C It imitated the Canadian system of health care and health insurance. D It was designed to end the problem of underinsurance.
D
What are factors specific to vertical integration? (select all that apply) A. Everything is always in the same location B. Affiliations between institutions C. Rapid expansion to accommodate ACOs, competition D. Foundation of integrated health care system E. Not necessarily in the same location
D,E
What is true about ACOs? (select all that apply) A. It is a care model B. Team-based approach to comprehensive primary care coordinated by a personal physician (or other provider) C. Primarily through Medicaid D. Primarily through Medicare E. It is a financing model
D,E
PCMHs typically include diverse patients and caregivers as advisors to the PCMH, including sometimes as paid advisors. True False
FALSE
A hospital buys a long-term care facility and a physician group practice. This type of acquisition is an example of expansion of what type? A Vertical integration B Horizontal integration C Panel integration D Bidirectional integration
A
Below is a list of characteristics of acute care hospitals. Select the one that does not belong. A Average length of stay is typically about 21 days. B High service intensity, technology, and cost. C They are not designed to provide rehabilitation, for example, after joint replacement. D They are often a part of large health systems.
A
Between Acute and Extended hospital stays which offers high tech, acute care and a wide range of services and professions? A. Acute B. Extended
A
Health insurance was more widely used due to which factor? A. Labor shortages and wage freezes B. Increased hygiene C. Prescribers wanted more patients D. The US was attempting to better healthcare E. Companies wanted to make more money
A
The 1949 Hill-Burton Act resulted in which one of the following changes? Choose the single best answer. A Significant increases in the number of hospitals and hospital beds B Greater professionalism in pharmacy practice, for example, through licensing C Limitations in Schedule C drug distribution D Expansion of FDA oversight to include agriculture and supplements
A
The cost of the Affordable Care Act (ACA) was designed to be covered, in part, by all of the following mechanisms EXCEPT which one? A Raising the Medicare eligibility age to 67 B Cutting payments to hospitals for preventable readmissions and health care associated infections C Freezing the "high income" threshold for Part B premium payments such that more Americans will pay the higher premiums over time D Cutting disproportionate share hospital (DSH) payments by 75%
A
The majority of hospitals work with a _______ formulary. A. Closed B. Open
A
The medical home encompasses five functions and attributes. Which one does not belong? A Focus on telemedicine B Comprehensive Care C Accessible Services D Coordinated Care E Patient-centered
A
What is the average length of stay in an Extended Stay Hospital? A. > 30 days B. 30 days C. < 30 days
A
What is the main reason for accreditation for hospitals? A. To ensure hospitals meet standards for safe and proper patient care B. To score the highest in the area C. To solely receive extra money from the government D. To rank among hospitals across the country
A
What is the main way that Medicaid pays hospitals? A. Per diem B. Diagnosis-related groups (DRG) rates C. Premium- based rates
A
Which hospital distribution system does NOT require a pharmacist to review a medication before it is administered to a patient? Choose the single best answer. A Floor stock distribution system B Satellite pharmacies C IV admixture services D Decentralized pharmacy systems
A
Which of the following federal programs or providers allows qualifying hospitals to purchase outpatient drugs at substantial discounts and to dispense or administer them to eligible patients at full price? Choose the single best answer. A 340B B Medicare C US Department of Veterans Affairs D The Ryan White HIV/AIDS drug discount program
A
Which of the following is critical to making a medical neighborhood work? A Health information technology B Everyone has to be a healthcare provider C A sense of community and purpose D People of similar race, class and income
A
Which report was pivotal in raising standards in the medical community specifically in regards to physicians? A. Flexner Report B. Johnson Report C, Hopkins Report D. AMA Report
A
Which stocking method doesn't require the doses to be verified by pharmacy before being administered? A. Floor stock B. Multi-dose C. Unit dose D. Unit stock
A
Which stocking method has an increased risk of medication error since nurses have a variety of medications to choose from? A. Floor stock B. Multi-dose C. Unit dose D. Unit stock
A
Which stocking method provides each nursing unit with a specific number of doses and nursing dispenses doses as needed? A. Floor stock B. Multi-dose C. Unit dose D. Unit stock
A
Which tax status hospital has a board of trustees? A. Nonprofit B. For-profit
A
Which tax status hospital has all profit reinvested in the organization? A. Nonprofit B. For-profit
A
Which type of hospital pharmacy is also labeled a "classic" hospital pharmacy model? A. Centralized B. Decentralized C. Specialized D. Generalized
A
Which type of hospital pharmacy is more common in smaller hospitals? A. Centralized B. Decentralized C. Specialized D. Generalized
A
Why are Medicare Stars important to hospitals? A. It may define reimbursement rate B. It is a bragging right C. More third parties will direct patients to that hospital D. Medicare directly pays the hospital more
A
Why might uninsured patients be more likely than others to seek care for nonurgent conditions in hospital emergency departments (EDs)? Select the single best answer. A Federal law requires emergency departments to evaluate patients for emergency health needs regardless of ability to pay. B Uninsured patients are not required to see any particular provider, such as a primary care gatekeeper, so the ED is an option for them. C Uninsured patients get all care for free in any setting so there is no financial reason to avoid the ED. D The ED is designed to serve as the hub for uninsured patients. From here patients can be routed to free care in the appropriate setting.
A
Will the health reform law allow undocumented immigrants to receive financial help from the government to buy health insurance? a. No, the law will not do this. b. Yes, the law will do this.
A
Will the health reform law create a new government-run insurance plan to be offered along with private plans? A. No, the law will not do this. B. Yes, the law will do this.
A
Will the health reform law cut benefits for people in the traditional Medicare program? A. No, the law will not do this. B. Yes, the law will do this.
A
Will the health reform law establish a government panel to make decisions about end-of-life care for people on Medicare? A. No, the law will not do this B. Yes, the law will do this
A
__________ integration is synonymous with a continuum of services (cradle to grave) A. Vertical integration B. Horizontal
A
For your IPPE hospital rotation, you have been assigned to a hospital that describes itself as "open to everyone, locally owned, and capable of treating all illnesses and injuries, with 100% of profits going toward hospital improvements." Which of the following describe this hospital? (Select all that apply.) A Community hospital B Nonprofit C Federal D For profit
A, B
Who became eligible to gain Medicaid coverage beginning in 2014 through the Affordable Care Act (2010)? Select all that apply. A Children up to the age of 26 B Many low-income adults C Undocumented immigrants D The permanently disabled
A, B
What are the two main types of hospital pharmacies? A. Centralized B. Decentralized C. Specialized D. Generalized
A,B
What are the two phases of CMS Innovation? A. Test payment and service delivery models B. Spread new systems that work C. Directly control healthcare costs D. Directly end underinsurance
A,B
What are two key purposes of medical staff governance in hospitals? A. Establish mechanism for controlling the QOL provided by physician and others with clinical privileges B. Provide physician input into institution decision-making C. Create a hierarchy to control certain physicians D. To reduce hospital costs overall through cost-control measures
A,B
What are examples of a government-run hospital? A. VA B. Indian Health Services C. Monroe County Hospital D. Kaiser Permanente E. Rochester General Hospital
A,B,C
What are ways that hospitals can be categorized? (select all that apply) A Type of Service B Non-profit or For Profit C Length of stay D Payment type E Type of Integration
A,B,C,E
What are examples of health information technology (HIT)? (select all that apply) A. EMR B. CPOE C. eMAR D. CMS E. IHI F. Pyxis
A,B,C,F
What are some of the responsibilities of the P&T Committee? (select all that apply) A. Review literature on new medications to determine possible inclusion B. Determine if specific medications should have restricted use C. Determine the cost of certain medications D. Possible therapeutic interchange of medications E. Directly create incentives for physicians to use certain medications over other ones
A,B,D
In what ways were the ACA components legally challenged? (select all that apply) A. Constitutionality of the ACAs B. State subsidies C. Applicability of the contraceptive coverage requirement D. Applicability of ACAs
A,C
What are the two local health systems? A. UR Medicine B. Ellis Medicine Rochester C. Regional Health System D. Rochester Atlantic Health System
A,C
What are some examples of cost-control mechanisms that help to make healthcare more affordable? (select all that apply) A. Pay for Performance (P4P) B. MCOs C. Utilization management D. Selective provider contracting ("pay to play")
A,C,D
The mother of a pediatric cancer patient presents at the outpatient pharmacy of your hospital for a prescription for her child. Her copay to pick up the prescription is $290. She is in tears. She enrolled in a high-deductible health plan through her employer before her child's diagnosis and has not yet hit the $10,000 out-of-pocket family maximum for the year. She tells you that her credit card is maxed out with hospital bills already. She is asking you if there is anything you can do about the copay. You ask your manager, who suggests she see the charity care office in case there are federal charity care dollars that can cover the copay. Which of the following best represents the most truthful response? A The insurance company requires us to hold this prescription until you pay. B The law requires us to hold this prescription until you pay. C The copay is part of my pharmacy's compensation for this product, and we are unwilling to accept a lower payment. D The 340B program already subsidizes your copay and reduces the cost substantially for you. You are already getting a big break.
C
The mother of a pediatric cancer patient presents at the outpatient pharmacy of your hospital for a prescription for her child. The system has marked it "340B." The mother's insurance covers 80% of her child's costs. How much will she pay compared to the actual cost of the drug product to the health system? A Less than 20% B Exactly 20% C More than 20%
C
Under the ACA (2010), mechanisms for insuring the uninsured included all of the following except which one? A Requiring that health plans offer coverage to dependents up to age 26 B Raising Medicaid eligibility to 133% of the federal poverty level for everyone, including childless adults C Providing a free, government-administered health plan for anyone who cannot afford private insurance D Eliminating pre-existing conditions exclusions for children
C
What is an important website used to compare hospital quality? A. FDA.gov B. WHO.int C. Medicare.gov
C
Which stocking method has each medication in an individual container and barcoded? A. Floor stock B. Multi-dose C. Unit dose D. Unit stock
C
Which stocking method has the pharmacy receiving orders to be verified before administration to the patient? A. Floor stock B. Multi-dose C. Unit dose D. Unit stock
C
Which stocking method includes Pyxis machines and eMAR which know the barcode of each medication to be administered? A. Floor stock B. Multi-dose C. Unit dose D. Unit stock
C
Who is in charge of the hospital formulary? A. JAMA B. The Joint Commision C. P&T Committee D. JCAHO E. NCQA
C
The Hill-Burton Act was important for what reasons? (select all that apply) A. Prescribers were able to bill more for services B. Third party insurance companies became more prevalent C. There was a massive investment in building hospitals nationwide D. Expansion of healthcare in rural areas
C,D
