U.S. Healthcare System Exam 1 (quiz questions)
System thinking could be applied to health because the model recognized the interaction of which factors?
Biological Psychological Sociological All of these are correct.
As the Depression of 1929 shook the nation, it also threatened the financial security of both physicians and hospitals. Baylor University Hospital created the model which hospital insurance?
Blue Cross
The Centers for Medicare and Medicaid Services (CMS) typically uses which type of research to evaluate the outcome of policy implementation?
comparative effectiveness
Basic characteristics that differentiate the United States healthcare delivery system from that of other countries include which of the following?
- No central governing agency and little integration and coordination. - A technology-driven delivery system focusing on acute care - Delivery of health care under imperfect market conditions = All of these are correct.
Under the ACA, states' Medicaid program expansion is optional. For states opting to participate in expansion, the federal government provided which of the following levels of support?
100% of state expenses for new enrollees through 2016 and dropping gradually to 90% of state expenditures for new enrollees through 2020 and for future years
Between 2019 and 2028, the National Health Expenditure is projected to grow at an average annual growth rate of
5.2%
To ensure that premium dollars paid by consumers are spent primarily on health care, insurers are required to spend at least what percentage of all premium dollars on healthcare services and healthcare quality improvement?
85%
Which of the following statements illustrates that an uninsured population persists in the United States?
A lack of employer-sponsored insurance coverage options for some employees. Cost prohibitive or lack of affordable employer-sponsored insurance or other private insurance options for some employees. A lack of Medicaid expansion in some states. All of these are correct
Which of the following correctly describes National Health Expenditure projections?
A: Are based on the historical health care in the United States over the next decade B: Presented by type of good or service delivered C: Presented by a source of funding for those services D: All of these are correct Answer: D. All of these are correct
The explosion of science and technology in the 1970's resulted in which of the following?
A: Encouragement for physician specialization B: Higher healthcare costs C: Hospitals; major capital investments in high-technology imaging equipment D: All of these are correct Answer: D: All of these are correct
The Institute for Healthcare Improvement Triple Aim for Populations consists of which of the following dimensions?
A: Population Health B : Per Capita Cost C: Experience of care D: All of these are correct Answer: D. All of these are correct
Which of the following is one of the fundamental parts to public policymaking?
A: Problems B: Stakeholders C: Policy D: All of these are correct Answer: D. All of these are correct
Attributes of Complex Adaptive Systems include which of the following?
Agents, interconnections, self-organization, emergence, and co-evolution
The World Health Organization (WHO) describes systems thinking as:
An approach to problem-solving that views problems as a wider, dynamic system.
Blue Cross Hospital Insurance, the predominant form of health insurance for decades, was modeled after:
Baylor University Hospital's school teachers plan.
Major subsystems of the United States Health System include Managed Care System, Military and Veterans Systems, Vulnerable Population System, Indian Health System, Integrated Delivery Systems, Long-term Care System, Public Health System, and:
Behavioral Care System
How are agencies at every level of government embracing systems thinking as a means for achieving greater effectiveness?
By including health in all policies, within domains beyond the typical scope of health care or public health.
Which of the following is NOT one of the three major healthcare concerns?
Choice
One tool is often used by the Centers for Disease Control and Prevention (CDC) to evaluate the outcome of policy implementation is ?
Community-based participatory research
The incredible growth in scope and scale of the Cleveland Clinics over the last decade and how the Mayo Clinics are now multistate describe which concept of complex adaptive systems?
Complex systems are capable of replicating, maintaining, repairing, and organizing themselves.
The various units of the National Institutes of Health remaining on the cutting edge of research within their domain while also serving the larger purpose and mission of medical research describes which concept of complex adaptive systems?
Complex systems tend to be self-stabilizing
As defined and required by the ACA, health insurance marketplaces (HIMS) intend to
Create a competitive health insurance market by providing web-based, easily understandable comparative information to consumers on plan choices with standardized rules regarding health plan offers and pricing
The primary public health and social service agency of the United States is the:
Department of Health and Human Services (HHS).
In the United States, the delivery of health services is mostly in private hands, and so health care is fully governed by free-market forces.
False
Systems thinking is a straight forward approach to problem solving that relies on immediate reactions to present problems or situations.
False
The Affordable Care Act was the legislative foundation for many significant health and welfare programs, including the Medicare and Medicaid programs.
False
The federal government is not responsible for ensuring that all levels of government have the capabilities to provide essential public health services.
False
True or False? The medical care establishment demonstrated concern for under-served populations addressed during the evolution of health insurance
False
In the United States, National Health Expenditures (NHEs) calculations are used to represent a percentage of the
Gross Domestic Product (GDP)
Which of the following was enacted under the Clinton administration in 1996 and had two primary purposes: to help ensure that workers could maintain uninterrupted health insurance coverage if they lost or changed jobs and to ensure privacy of personal health information?
Health Insurance Portability and Accountability Act (HIPAA)
An approach that serves as a catalyst to compel ministries (or government departments and agencies) to work with the health ministry (or the Department of Health and Human Services in the United States) to address the public health implications and potential unintended consequences that affect the health of individuals, communities, and the nation describes:
Health in All Policies
One of the most significant health policy changes of the past decades occurred with the Reagan administrations. Which of the following answers accurately describes the policy change?
Implementation of the Medicare prospective payment system in hospitals
The Triple Aim framework consists of pursuing which of the following dimensions?
Improving the patient experience of care (including the ability of patients to access high-quality care that patients are satisfied with) Improving the health of the population Reducing the per capita cost of health All of these are correct.
Under the ACA, most Americans were originally required to have health insurance or be penalized with an annual fee. This requirement was known as the
Individual Mandate
Following World War II, the federal government excluded health insurance benefits from wages and excluded workers' contributions to health insurance from taxable income. What was one of the effects of this?
It enabled employees to take wage increases in the form of health insurance fringe benefits rather than cash.
Major drivers of U.S. health expenditures include
Medical technology, growth in the older population, specialty medicine, labor intensity, and volume-based reimbursement incentives.
The most significant health policy development of the past decade, in terms of cost containment and quality improvement, after the ACA is the:
Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)
According to the most recent federal data, which group accounts for more than one-third of all hospital stays and nearly one-half of all days of hospital care?
Persons over the age of 65
Health determinants include which of the following five categories?
Policymaking, social factors, health services, individual behavior, and biology and genetics.
The 1973 HMO legislation responded to which of the following national concerns?
Rapidly increasing Medicare expenditures and overall concerns about the quality of care in both government and private health insurance sectors
Which of the following is a major provision of the Affordable Care Act?
Requires that all new health plans cover certain preventive services, such as mammograms and colonoscopies, without charging a deductible, co-pay, or coinsurance.
Which of the following is a general category of public policy?
Social Economic Foreign policy All of these are correct
The most significant social legislation passed by any Congress in the history of the United States was the
Social Security Act of 1935
Which level of government has significant influences on healthcare delivery and public health through their departments and agencies such as health, insurance, education, and social services
State
Understanding individual parts of a system as well as how these parts interact through recurring patterns to produce a whole describes which theory?
Systems Thinking Theory
Allowing healthcare professionals to assess the interactions and interdependencies among parts of a system and seek out opportunities to generate sustainable solutions describes:
Systems thinking
Which of the following is one of the principal entities through which the federal government enacts its responsibilities in promoting and maintaining health?
The Department of Health and Human Services (HHS) The Veterans Health System (a component of the Department of Veterans Affairs) The Department of Defense Military Health System All of these are correct.
Which of the following supported development health maintenance organizations (HMOs) through grants for federal demonstration projects?
The Health Maintenance Organization Act of 1973
The United States does not have a well-integrated and coordinated healthcare delivery system everyone enjoys. Which of the following describes the major subsystems of United States Healthcare Delivery?
There are multiple subsystems developed either though market forces or as a result of policy initiatives to address the needs of certain population segments
The United States does not have a well-integrated and coordinated healthcare delivery system everyone enjoys. Which of the following describes the major subsystems of United States Healthcare Delivery?
There are multiple subsystems developed either through market forces or as a result of policy initiatives to address the needs of certain population segments.
The Institute for Health Care Improvement developed a framework for healthcare improvement in response to increasing healthcare costs, quality concerns, chronic health conditions, and an aging population. This framework best describes:
Triple Aim
A "federal system" is both a political and philosophical concept describing how power is given to governments.
True
Health policy is an attempt by the government at all levels to address a public issue, problem, or concern.
True
Local health departments support and deliver health and health-related services and provide direct patient care services in clinics or health centers, referrals for care, and other services mainly focused on underserved populations.
True
PPOs are the most popular form of employer-sponsored health insurance.
True
The federal government maintains broad policymaking and operational responsibilities to promote and protect the health of U.S. citizens while ensuring the implementation of both preventive and protective public health practices.
True
The global coronavirus pandemic has impacted every aspect of the United States healthcare system, including healthcare expenditures.
True
Today, federally sponsored programs in health care account for more than 40% of U.S. personal healthcare expenditures.
True
True or False? All Health systems have common elements or building blocks necessary for a functioning health system despite the unique health determinants and population health.
True
True or False? The American Medical Association opposed "compulsory" (universal) health insurance coverage continuously from the early 1900's through the 1970's
True
True/False? A stakeholder is an individual, group, organization, or entity interested in an issue, topic, or outcome.
True
True/False? Health determinants are the varied factors that affect the health status of populations or groups of people.
True
Daniel Dawes' political determinants of health refer to which of the following?
When a policy issue aligns with a private sector interest or commercial interest and a government value interest, there is a greater likelihood of advancing an effective agenda.
A point-of-service (POS) plan is best described as:
a hybrid HMO and PPO plan.
An integrated delivery system (IDS) is best described as:
a network of organizations that provides, or arranges to provide, a coordinated continuum of services to a defined population and is willing to be held clinically and fiscally accountable for the outcomes and health status of that population.
The shift from a fee-for-service retrospective mode to a pre-paid prospective mode based on patient diagnosis for hospital reimbursement describes:
diagnosis-related groups (DRGs).
George Engel 1970s "biopsychosocial model" was a better way to understand:
disease expression
The Centers for Medicare & Medicaid Services announced in 2007 that it would no longer reimburse hospitals for the costs of "never-events." Such events are best described as
egregious, usually preventable errors that result in death or significant disability, such as surgery performed on the wrong body part.
The original intent of the Children's Health Insurance Program (CHIP) was to
enroll 10 million uninsured children in Medicaid whose family incomes were too high to qualify for Medicaid but too low to purchase private health insurance.
Although the ACA enacted sweeping U.S. healthcare system reforms, one fundamental element of the system that will remain unchanged is
financing of health care through a combination of public and private sources
A health maintenance organization (HMO)
is an organization responsible for the financing and delivery of comprehensive health services to an enrolled population for a prepaid, fixed fee.
The managed care concept called "capitation" refers to
managed care reimbursement that prepays providers for services on a per-member per-month basis whether or not services are used.
The primary reason why the number of uninsured Americans dropped by over one million in 2011 was
newly insured young adults who could continue coverage under their parents' health insurance.
The primary purpose of Medicaid as enacted in 1965 was to
provide health insurance for low-income individuals
The primary purpose of Medicare as enacted in 1965 was to
provide health insurance for older Americans.
"Groups of interacting, interrelated, or interdependent components that form a complex and unified whole best describes a(n):
system
Health care in the United States dramatically improved during the 1900s. In the second half of the century, the technologic advances led to:
the Sabin and Salk vaccines ended annual epidemics of poliomyelitis. the tranquilizers Librium and Valium were introduced and widely prescribed, leading Americans to turn to medicine to cure their emotional and physical ills. the birth control pill was first prescribed and became the most widely used and effective contraceptive method. All of these are correct.
The American Medical Association's initial reaction to Blue Cross hospital insurance plans suggested that the plan
were economically unsound and unethical.
