healthcare 2-11
The projection from "The Facts of Medicare Spending and Financing" predict that the Part A trust fund will be depleted by: 2022 2026 2036 2040 2045
2026
According to the Pew Trust article, when is it predicted that the US will become majority minority? 2040 2050 2070 2100
2050
About how many Medicare beneficiaries are enrolled in Medicare Advantage, according to KFF's Fact Sheet? 20% 25% 40% 50%
40%
Which of the following are additional benefits many Medicare Advantage beneficiaries have, according to the KFF Fact Sheet? Dental Long-term care Vision A and B A and C
A and C
How many Americans does Medicaid cover? A. 1 out of every 5 Americans B. 1 out of every 10 Americans C. 1 out of every 20 Americans D. 1 out of every 50 Americans
A. 1 out of every 5 Americans
What percentage of health care dollars is apportioned for public health? A. 3% B. 10% C. 15% D. 25%
A. 3%
How many people were selected, through lottery, to receive Medicaid through the Oregon Health Insurance Experiment? A. 30,000 B. 45,000 C. 50,000 D. 100,000
A. 30,000
____% of ACA plan networks are narrow meaning that they include ____% or less of physicians in the area A. 75%; 25% B. 25%; 75% C. 50%; 25% D. 25%; 50%
A. 75%; 25%
Why do Asians and Hispanics struggle with eligibility for Medicaid? A. A large proportion of the Hispanic and Asian communities are immigrants B. They do not value health insurance as much as other racial groups C. They have lower incomes than other racial groups D. A large proportion of the Hispanic and Asian communities are not employed
A. A large proportion of the Hispanic and Asian communities are immigrants
What is the difference between a co-pay and co-insurance? A. Co-payments are a fixed dollar amount paid at the point of service, whereas co-insurance is a percentage of the bill paid at the point of service B. Co-payments are a percentage of the bill paid at the point of service, whereas co-insurance is a fixed dollar amount paid at the point of service C. Co-payments are payment schemes in which both the insurer and the insured pay for medical services, whereas co-insurance is a payment scheme in which neither the insurer or the insured pays for medical services D. Co-payments are payment schemes in which both the insurer and the insured pay for medical services, whereas co-insurance is a payment scheme in which only the insurer pays for medical services
A. Co-payments are a fixed dollar amount paid at the point of service, whereas co-insurance is a percentage of the bill paid at the point of service
Premiums, deductibles, co-pays, and co-insurance are all payments made by the insured to promote _____ and reduce _____? A. Cost-sharing, moral hazard B. Adverse selection, cost sharing C. Cream skimming, moral hazard D. Lemon dropping, cost sharing
A. Cost-sharing, moral hazard
Which government department is responsible for implementing Medicaid? A. Health and Human Services B. Food and Drug Agency C. Surgeon General D. Center for Medical Services and Aid
A. Health and Human Services
Which racial group was most likely to be uninsured before the passage of the ACA? A. Hispanic B. Black C. Asian D. White
A. Hispanic
Which is not one of the reforms Mackey suggests in his article The Whole Foods Alternative to Obama Care? A. Increase the salaries of generalists by 20% B. Repeal state laws preventing insurance companies from competing across state lines C. Make costs transparent so consumers understand what health care treatments cost D. Equalize the tax laws so that employer provided health insurance and individually owned health insurance have the same tax benefits
A. Increase the salaries of generalists by 20%
What is one major difference between Healthy People 2020 and previous Healthy People Initiatives? A. It places more emphasis on the social determinants of health B. It identifies health priorities for the nation C. It has the goal of improving quality of life for Americans D. It seeks to involve community partners in health improvement initiatives such as businesses, churches, etc.
A. It places more emphasis on the social determinants of health
In the NY times article by Rosenthal, what was the name of the $2,000 procedure Ms. Little had to a fix a clogged pore? A. Mohs procedure B. Hysterectomy C. Biopsy D. Cataract procedure
A. Mohs procedure
Insurance companies take on ______ financial risk in a fee for service payment scheme vs. a managed care payment scheme A. More B. Less C. Much less D. The same
A. More
What is the primary reason for rising health expenditures? A. New technology B. Less specialization C. More hospitals D. An increase in chronically ill patient populations
A. New technology
The _________ sets recommended prices for medical procedures and consists of mainly ______ A. The Relative Value Scale Update Committee, specialists B. The Relative Value Scale Update Committee, primary care doctors C. Department of Health and Human Services, specialists D. Department of Health and Human Services, primary care doctors
A. The Relative Value Scale Update Committee, specialists
What was the main ruling of the Supreme Court in lawsuits against the Affordable Care Act? A. The Supreme Court ruled that the individual mandate was constitutional, and that the federal government could not force states to expand their state Medicaid programs B. The Supreme Court ruled that the Affordable Care Act could not force insurance companies to cover certain basic services C. The Supreme Court ruled that the Affordable Care Act could not force people to buy health insurance via the individual mandate D. The Supreme Court ruled that employer based insurance was constitutional
A. The Supreme Court ruled that the individual mandate was constitutional, and that the federal government could not force states to expand their state Medicaid programs
What was the main argument of the Dubinsky article "Money Won't Buy You Health Insurance" A. The individual insurance market is in need of reform because it is too expensive and too complicated to navigate B. The individual insurance market is more convenient than employer based insurance C. The individual insurance market unfairly prioritizes needier people D. The individual insurance market is in need of reform because there are too many options to choose from
A. The individual insurance market is in need of reform because it is too expensive and too complicated to navigate
Why were some big-name insurers leaving the ACA insurance marketplace according to Abelson? A. The people signing up for their insurance plans were sicker (and more expensive) than expected B. The marketplaces were not providing enough customers C. There was less competition outside of the ACA marketplaces D. None of the above
A. The people signing up for their insurance plans were sicker (and more expensive) than expected
What is the main function of insurance according to Ezekiel Emanuel? A. To protect individuals against large unpredictable financial costs B. To ensure that epidemics do not break out C. To compensate doctors and health workers for their services D. To make sure healthcare is accessible for all
A. To protect individuals against large unpredictable financial costs
What percentage of health care dollars is spent on drugs? A. 3% B. 10% C. 15% D. 25%
B. 10%
In _____ the Medicare program was created to provide health services, but only for those _____. A. 1935; 60+ B. 1965; 65+ C. 1998; 65+ D. 2008; 60+
B. 1965; 65+
Which of the following patients would an insurance company prefer to insure? A. 18 years old, smoker, construction worker B. 20 years old, no pre-existing conditions, athlete C. 45 years old, no pre-existing conditions, family history of diabetes D. 65 years old, cancer and hypertension
B. 20 years old, no pre-existing conditions, athlete
According to Hayes and colleagues in the article from the Commonwealth Fund, which of the following is true about cost sharing in the Hayes et al article from the Commonwealth fund? Group of answer choices A. About 12% of people have "high premium contributions relative to income" B. About 7% of people have "high out of pocket costs relative to income" C. In the Pacific Northwest, high premiums relative to household income are common D. A and C only E. A and B only
B. A and B only
According to Hayes and colleagues in the article from the Commonwealth Fund, what is the "minimum value standard? A. Standard set of services that are exempt from the deductible B. A refundable tax credit available to people whose out-of-pocket spending exceeds a certain percentage of income C. Percentage of medical costs that employer plans must cover D. The minimum number of employer-based plans employees can choose
B. A refundable tax credit available to people whose out-of-pocket spending exceeds a certain percentage of income
How should health care be rationed from a market justice vs. social justice perspective? A. According to social justice, only those who deserve health care should receive it; according to market justice, only those who can afford health care should receive health care B. According to social justice, everyone should have access to health care; according to market justice, only those who can afford health care should receive health care C. According to social justice, only those who deserve health care should receive it, according to market justice, only those who have achieved a certain level of education should receive health care D. According to social justice, everyone should have access to health care; according to market justice, only those who have achieved a certain level of education should receive health care
B. According to social justice, everyone should have access to health care; according to market justice, only those who can afford health care should receive health care
What could increase price transparency in U.S healthcare according to Reinhardt? A. Stricter legislation B. Electronic information technology C. Forcing pharmaceutical companies to list the price for their drugs in their advertisements D. Word of mouth from doctor to patient
B. Electronic information technology
Which of the following is the most common way to obtain insurance for people between the ages of 18 and 64? A. Purchasing insurance directly as an individual B. Employer based insurance C. Medicare/Medicaid D. The Individual mandate
B. Employer based insurance
What is one of the weaknesses of a social justice perspective on health care? A. Proponents of social justice are usually uneducated B. Health care entitlement programs are extremely expensive C. Social justice encourages freeloading D. The social justice perspective does not address inequities in health care
B. Health care entitlement programs are extremely expensive
Which of the following accurately describes the evolution of hospitals from 1890 to present? A. Hospitals were used as housing for the poor and chronically ill; currently hospitals are used to house only those with short-term illnesses B. Hospitals were used as housing for the poor and chronically ill; currently hospitals are well-funded and have the latest treatment technology and specialized interventions to treat many different patients C. Only rich people could afford to use hospitals in the 1890s - now hospitals are accessible to everyone D. Hospital physicians were primarily volunteers in the 1890s - now hospitals only hire salaried physicians
B. Hospitals were used as housing for the poor and chronically ill; currently hospitals are well-funded and have the latest treatment technology and specialized interventions to treat many different patients
What did the Hill-Burton Act of 1946 do? A. It created universal health care in the U.S B. It provided federal funds to construct hospitals across the nation C. It outlawed surgery without anesthesia D. It funded the construction of nursing homes
B. It provided federal funds to construct hospitals across the nation
What is one of the reasons Reinhardt gives for why health care prices in the U.S are higher than in other developed countries? A. Wage control for doctors in other developed countries B. Low bargaining power of insurance companies in the U.S C. Higher quality care in the U.S D. More demand for healthcare services in the U.S
B. Low bargaining power of insurance companies in the U.S
In the NYT article by Lipton and Sack, which lucrative drug did Amgen get a special exclusion for in the "fiscal cliff" bill? A. Tylenol B. Sensipar C. Enbrel D. Nyquil
B. Sensipar
What is not one of the reasons why the US places great emphasis on medical specialization? A. The proliferation of specialty boards certifying physicians to practice certain types of medicine in the 1930s B. Specialists are more cost-effective than primary care doctors C. Specialists were automatically given a higher rank in the military during WWII D. Medical schools prefer to hire specialists over generalists
B. Specialists are more cost-effective than primary care doctors
Why is it potentially problematic that people spend less on healthcare with high-deductible health plans? A. Doctors need more money in order to make the profession attractive B. They may be forgoing potentially important necessary care in order to spend less C. Cutting costs is illegal D. People spending less on health care spend more on unhealthy habits
B. They may be forgoing potentially important necessary care in order to spend less
In states that chose to expand Medicaid, all adults with incomes at or below ________ of the poverty level are eligible for Medicaid A. 52% B. 90% C. 138% D. 200%
C. 138%
What is reference pricing? A. When patients reference their doctor before purchasing any medical procedures B. When patients compare prices between different specialists and hospitals and select the lower priced option C. A form of cost-sharing in which the patient is responsible for paying the cost of their medical services beyond some low reference price D. A form of cost-sharing in which the patient must pay a pre-determined amount for each medical procedure they obtain
C. A form of cost-sharing in which the patient is responsible for paying the cost of their medical services beyond some low reference price
Based on the Pew Trust article, "Health Care Adjusts to a More Diverse America," which of the following is FALSE about health care disparities? A. Black patients are less likely to receive antiretroviral drugs than white patients B. Increasing the diversity of the physician workforce can help improve trust between physicians and patients C. Every state has adopted health equity standards for medical schools to improve cultural competency and reduce bias in the physician workforce D. Increasing numbers of physicians underrepresented in the workforce may help ease the shortage of physicians in underserved neighborhoods
C. Every state has adopted health equity standards for medical schools to improve cultural competency and reduce bias in the physician workforce
The tax exclusion on employer based health insurance benefits which group the most? A. Black Americans B. Low income C. High Income D. Women
C. High Income
What is the problem with the ACA insurance markets according to Sanger-Katz? A. There are too many insurance plans on the market, making it very confusing for consumers to choose a plan B. The insurance markets are too complicated to navigate for older Americans C. Insurance plans on the market will probably become more expensive and include fewer options D. None of the above
C. Insurance plans on the market will probably become more expensive and include fewer options
According to the Fuchs article on How and Why US Health Care Differs From That in Other OECD Countries, what is the most important reason why US health care is different from other OECD countries? A. Heterogeneity of the US population B. Distrust of the government in the US C. It is relatively easily for "special interests" to hijack the political system D. Medicare and Medicaid exist
C. It is relatively easily for "special interests" to hijack the political system
What is one of the weaknesses of the market justice perspective on health care? A. Market justice ensures that there are no free riders in the health care system B. Market justice perpetuates disparities by ensuring that poorer individuals have better access to healthcare than wealthier individuals C. Market justice does not ensure that individuals who are ill will have the care that they need if they cannot afford it, thus individual health issues can spread into the general society through transmission of contagious diseases D. Proponents of market justice are usually uneducated
C. Market justice does not ensure that individuals who are ill will have the care that they need if they cannot afford it, thus individual health issues can spread into the general society through transmission of contagious diseases
How often are premium payments usually made to an insurance company? A. Daily B. Weekly C. Monthly D. Yearly
C. Monthly
The ACA marketplace attracted more _____ people than expected A. Healthy B. Poor C. Old D. Young
C. Old
What is one of the effects of skyrocketing specialist costs according to Rosenthal? A. Better quality care B. More people purchasing health insurance C. Shortage of primary care doctors D. Longer wait times in hospitals
C. Shortage of primary care doctors
Which of the following limits adverse selection? A. Hand-written note from a medical provider B. High deductible, low premium health insurance plans C. The individual mandate D. Low-deductible, high premium health insurance plans
C. The individual mandate
After the ACA was introduced, the Centers for Disease Control and Prevention (CDC) found that A. The percentage of people under 65 reporting that they liked Obama increased B. The percentage of people under 65 who were having problems paying medical bills increased C. The percentage of people under 65 who were having problems paying medical bills decreased D. The percentage of people under 65 reporting that they liked Obama decreased
C. The percentage of people under 65 who were having problems paying medical bills decreased
How did the U.S government attempt to control the costs of Medicare in the 1980s? A. By increasing payroll taxes B. By increasing the age of eligibility to 65 C. Through a new prospective payment system for Part A D. By temporarily eliminating Part D of Medicare
C. Through a new prospective payment system for Part A
The growth of employer based insurance during the 1940s can be attributed to: A. The inflation of the dollar B. The spread of HCV in the workplace C. Wage controls implemented by the government during WWII D. Increased regulations by the government to ensure worker safety
C. Wage controls implemented by the government during WWII
How much is the tax exclusion for employer sponsored insurance worth? A. $25,000 B. $250,000 C. $25 million D. $250 billion
D. $250 billion
According to "10 Things to Know About Medicaid," which of the following is FALSE about the Medicaid program? A. Medicaid started out as a cash assistance program for low income families and people with disabilities B. Poorer states have a higher federal match rate than wealthier states C. Medicaid is the second largest item in state budgets D. 2/3 of Medicaid beneficiaries receive care in a fee for service system E. More than one of the above
D. 2/3 of Medicaid beneficiaries receive care in a fee for service system
According to Allen and Summers in their JAMA article "Medicaid Expansion and Health," self-reported health measurements A. Are consistent with the WHO definition of health B. Are easier to collect information C. Have not found more positive results in recent, longer-term studies D. A and B only E. B and C only
D. A and B only
What is one of the successes of Obamacare according to the Sanger-Katz NYT article? A. Wide provider networks B. A simpler healthcare system overall C. Low premiums and cost-sharing for all D. A lower federal deficit
D. A lower federal deficit
Beneficiaries of Medicare must pay A. Deductibles B. Premiums C. Co-insurance D. All of the above
D. All of the above
Why did the professionalization of medicine start later in the US than in some Western European nations? A. Americans emphasized applied science B. Americans neglected basic science research C. Americans emphasized natural history in medical practice D. All of the above
D. All of the above
Why doesn't health care function like other markets? A. Health care costs are unpredictable B. Providers (health care deliverers) know much more about medicine than patients (consumers) do C. Payment comes after care, not before D. All of the above
D. All of the above
The Oregon Health Insurance Experiment found that A. Access to Medicaid decreased financial strain B. Access to Medicaid increased utilization of health care services without improving physical outcomes C. Access to Medicaid decreased utilization of health care services and did not improve physical outcomes D. Both A and B
D. Both A and B
Based on the KFF Briefing on the coverage gap, why are 2.3 million people not covered under the ACA? A. Traditional Medicare does not cover adults without dependent children B. Marketplace subsidies only cover individuals up from 150-400% FPL C. The Supreme Court found compulsory national Medicaid expansion unconstitutional D. More than one of the above E. All of the above
D. More than one of the above
Based off the "10 Things to Know About Medicaid," which group contributes the most to Medicaid spending? A. Children B. Adults C. Elderly D. People with disabilities
D. People with disabilities
Which of the following does not describe a fundamental principle of insurance? A. Risk is unpredictable for the individual insured B. Risk can be predicted with a reasonable degree of accuracy for a group or population C. Insurance provides a mechanism for transferring or shifting risk from the individual to the group through the pooling of resources D. Risk can be eliminated by insuring a large group or population
D. Risk can be eliminated by insuring a large group or population
Which of the following is not an avenue through which insurance can be obtained? A. Purchasing insurance directly as an individual B. Employer based insurance C. Medicare/Medicaid D. The Individual mandate
D. The Individual mandate
What is one solution Aaron Carroll suggested to fix the Obamacare marketplaces? A. The government should make it illegal for insurers to leave the marketplace B. The government should provide incentives to smaller insurers to enter the marketplace C. The government should let market forces work to correct the problem D. The government should increase subsidies for plans on the marketplace
D. The government should increase subsidies for plans on the marketplace
The percentage of revenue from premiums spent on medical expenses is known as ______ A. Minimum essential coverage B. Out of pocket expense C. A preexisting condition D. The medical loss ratio
D. The medical loss ratio
When is the deadline for states to expand Medicaid? A. 2020 B. 2025 C. 2030 D. There is no deadline for states to expand Medicaid
D. There is no deadline for states to expand Medicaid
Why was Donna Dubinsky's family denied health insurance the first time she applied? A. They couldn't afford to pay the premiums B. They applied after the deadline C. Her family was too large D. They had pre-existing conditions
D. They had pre-existing conditions
Which of the following is FALSE, based on the KFF briefing on changes in health coverage after the ACA? A. Before the ACA, most uninsured individuals had at least one full-time worker in the family B. The uninsured rate for some populations increased in between 2016 and 2018 C. Blacks are more likely to fall in the coverage gap than whites D. Undocumented immigrants cannot enroll in Medicaid but can purchase insurance on marketplace exchanges E. None of the above
D. Undocumented immigrants cannot enroll in Medicaid but can purchase insurance on marketplace exchanges
Why do many hospitals not provide adequate translation services according to the Pew Trust article, "Health Care Adjusts to a More Diverse America"? A. Translation services are expensive B. Medicaid does not reimburse translators in every state C. Federal law that requires translation accommodations is poorly enforced D. More than one of the above E. All of the above
E. All of the above
According to KFF's brief "The Facts on Medicare Spending and Financing," how is Part B primarily financed? A. Payroll Taxes B. General Revenue C. Premiums D. A and B E. B and C
E. B and C
True or false: Medicaid is paid for exclusively by the federal government True False
False
True or False: Employer based insurance is tax-free
True
True or False: It is illegal for an insurance company to sell a Medigap plan to someone who is covered by Medicaid?
True
True or False: Medicaid coverage is comparable to private insurance
True
True or False: Overall, the general public has a favorable view of Medicaid.
True
Which vulnerable group makes up the largest proportion of Medicaid enrollees? A. Children B. The elderly C. The disabled D. Parents
A. Children
According to "The Uninsured" what is the primary barrier to obtaining health coverage? A. Cost B. Lack of information C. Lack of interest D. Eligibility requirements
A. Cost
According to the KFF 2019 Overview of Medicare, what is the most common form of supplemental Medicare coverage? A. Employer-sponsored insurance B. Medigap C. Medicaid D. None of the above
A. Employer-sponsored insurance
In the future, the percentage of Medicare beneficiaries enrolled in Medicare Advantage is expected to: A. Increase B. Decrease C. Match the percentage of enrollees in traditional Medicare D. Stay the same
A. Increase
Penny is a senior living in a nursing home. Which of the following does Medicaid help Penny pay for? A. Long term care B. Transportation to and from work C. Acupuncture D. COBRA insurance
A. Long term care
What is a "Benchmark Plan" according to KFF's brief on Medicare Part D? A. Low Income Subsidy plan where beneficiaries pay a portion of the premium B. Low Income Subsidy plan where beneficiaries pay no premium C. Enhanced drug plan that covers insulin at a monthly copayment of $35 D. A type of Medicare Advantage prescription drug plan
B. Low Income Subsidy plan where beneficiaries pay no premium
Based on information from KFF's Overview of Medicare Part D, which of the following is true about cost-sharing? A. Beneficiaries pay 25% of drug costs for both brand name and generics during the initial and coverage gap phases B. Manufacturers pay 70% of the costs for generic drugs during the coverage gap phase C. During the catastrophic coverage phase, the plan pays for 80% of drug costs D. A and B E. B and C
A. Beneficiaries pay 25% of drug costs for both brand name and generics during the initial and coverage gap phases
What is the key difference between traditional indemnity insurance and managed care? A. Managed care controls costs and utilization by integrating the financing, insurance, delivery, and payment functions of insurance B. Traditional insurance had narrower hospital networks and allowed patients to see only a few pre-selected doctors C. Managed care is less common than traditional indemnity insurance D. Managed care is less profitable than traditional indemnity insurance
A. Managed care controls costs and utilization by integrating the financing, insurance, delivery, and payment functions of insurance
Cost-sharing is designed to reduce what problem? A. Moral Hazard B. Cream skimming C. Cherry picking D. Deductibles
A. Moral Hazard
Which part of Medicare covers in-patient services? A. Part A B. Part B C. Part C D. Part D
A. Part A
How is Part A of Medicare primarily financed? A. Payroll taxes B. General revenues C. Beneficiary Premiums D. Both A and C
A. Payroll taxes
What did the RAND Health Insurance Experiment demonstrate? A. People with high cost-sharing utilized less healthcare but were not less healthy for it B. People with low cost-sharing utilized less healthcare and were more healthy for it C. People with high cost-sharing utilized less healthcare and were more healthy for it D. People with low cost-sharing utilized less healthcare and were not less healthy for it
A. People with high cost-sharing utilized less healthcare but were not less healthy for it
Allen and Summers in their JAMA article "Medicaid Expansion and Health," claims that since the expansion of Medicaid: A. Population-level mortality has declined B. In-hospital mortality has declined C. Long-term control of diabetes has improved D. None of the above
A. Population-level mortality has declined
Which MCO is the least stringent when it comes to accessing out-of-network care? A. Preferred Provider Organizations B. Point of Service C. Health Maintenance Organizations D. Exclusive Provider Organizations
A. Preferred Provider Organizations
2/3 of Medicare beneficiaries are enrolled in: A. Private managed care plans B. Public managed care plans C. Public fee-for-service plans D. Private fee-for-service plans
A. Private managed care plans
Rank the following programs in terms of their overall cost to federal/state governments A. Social Security > Medicare > Medicaid B. Medicaid > Medicare > Social Security C. Medicaid > Social Security > Medicare D. Social Security > Medicaid > Medicare
A. Social Security > Medicare > Medicaid
True or False: Disabled people account for the most Medicaid spending compared to other eligibility groups A. True B. False
A. True
What was one of the key findings from the Commonwealth Fund Biennial Health Insurance Survey? A. Medicaid enrollees have more access to healthcare than privately insured individuals B. Medicaid enrollees fare better than uninsured and privately insured individuals when it comes to paying medical bills C. Medicaid enrollees have less access to healthcare than privately insured individuals D. Medicaid enrollees fare worse than uninsured and privately insured individuals when it comes to paying medical bills
B. Medicaid enrollees fare better than uninsured and privately insured individuals when it comes to paying medical bills
Which part of Medicare pays for outpatient services? A. Part A B. Part B C. Part C D. Part D
B. Part B
________ are more likely to fall into the coverage gap A. Non-Hispanic Whites B. Racial minorities C. Children D. The elderly
B. Racial minorities
What are the four main models for organizing an HMO? A. High-cost, Low-cost, Mid-cost, No-cost B. Staff, Group, Network, Independent Practice Association (IPA) C. Reduce, Reuse, Recycle, Repeat D. Network, Community, Group, Advising
B. Staff, Group, Network, Independent Practice Association (IPA)
What is Project Search? A. A Medicaid program which seeks to identify people under the age of 25 with developmental disabilities and provide them with physiotherapy B. A Medicaid waiver program that places people with developmental disabilities in an internship with a job coach C. A Medicaid program that provides low-income families with free public transportation D. None of the above
B. A Medicaid waiver program that places people with developmental disabilities in an internship with a job coach
What is the effect of competition (between insurers) on hospital network sizes in the Obamacare insurance market? A. Increased competition in the Obamacare insurance markets leads insurers to offer narrower hospital networks B. Decreased competition in the Obamacare insurance markets leads insurers to offer narrower hospital networks C. Decreased competition in the Obamacare insurance markets leads insurers to offer wider hospital networks D. Competition has no effect on hospital network size
B. Decreased competition in the Obamacare insurance markets leads insurers to offer narrower hospital networks
According to the KFF 2019 Overview of Medicare, which of these services is not covered by any part of Medicare? A. Prescription drugs B. Dental services C. Skilled nursing care D. Home health visits
B. Dental services
What does self-referral entail? A. Doctors only refer patients to other doctors within their professional networks B. Doctors refer patients to expensive treatments for which they stand to make a financial gain C. Doctors continually refer patients back to their own clinics for unnecessary check ups D. All of the above
B. Doctors refer patients to expensive treatments for which they stand to make a financial gain
True or False: Medicaid is a federally funded program that is managed by the states A. True B. False
B. False
Federal matching funds for Medicaid are _______ to states at a ______ rate A. Not guaranteed; variable B. Guaranteed, variable C. Guaranteed, fixed D. Not guaranteed, fixed
B. Guaranteed, variable
According to Allen and Summers in their JAMA article "Medicaid Expansion and Health," what is one reason by researchers look at condition-specific health outcomes, as stated by Allen and Sommers in their 2019 JAMA article? A. They are not affected by patient characteristics B. Health insurance tends to benefit those with serious health conditions the most C. It is easy to get data from medical records D. It is an equally plausible method for all health conditions
B. Health insurance tends to benefit those with serious health conditions the most
In the Wall Street Journal Article entitled "A Device to Kill Cancer, Life Revenue" what was the name of the expensive treatment purported to cost Medicare $1 billion? A. Naloxone B. Intensity-Modulated Radiation Therapy C. Cognitive Behavioral Therapy D. Antiretroviral Therapy
B. Intensity-Modulated Radiation Therapy
According to Shi & Singh, what is the main problem with Medicaid? A. The program is too small and only covers a fraction of the indigent population it was meant to serve B. It does not provide enough reimbursement for providers, so many providers are not willing to serve Medicaid patients C. The constant exit and reentry of beneficiaries as their eligibility changes D. Not many people know about Medicaid and the benefits it offers
B. It does not provide enough reimbursement for providers, so many providers are not willing to serve Medicaid patients
State Medicaid programs are able to experiment with a variety of approaches to administering Medicaid because A. The ACA shifted all costs for the Medicaid program to the states B. States are able to apply for waivers from the department of Health and Human Services which allow them to diverge from Medicaid rules C. In National Federation of Independent Business v. Sebelius, the Supreme Court ruled that states did not have to expand Medicaid D. The constitution prioritizes states rights over federal authority
B. States are able to apply for waivers from the department of Health and Human Services which allow them to diverge from Medicaid rules
Which region in the United States has the highest proportion of states who chose not to expand Medicaid and the highest numbers of uninsured adults? A. The North B. The South C. The East D. The West
B. The South
According to Bagley and Frakt, what is one potential downside of one-size-fits-all insurance? A. This type of insurance allows individuals with different incomes to purchase different insurance B. This type of insurance does not incentivize high-value low-cost treatments C. This type of insurance decreases care-seeking D. This type of insurance is logistically difficult to implement
B. This type of insurance does not incentivize high-value low-cost treatments
Which of the following is NOT a legislative or regulatory change that favors Medicare Advantage of traditional FFS Medicare based on Mark Miller's NYT article? A. MA has an additional, more flexible enrollment period B. MA plans have an out-of-pocket maximum while FFS Medicare does not without Medigap C. The federal government's reimbursement rate per patient is lower with MA compared to FFS Medicare D. MA plans can get bonuses for high quality ratings E. None of the above
C. The federal government's reimbursement rate per patient is lower with MA compared to FFS Medicare
How does lack of health insurance impact health care? A. The uninsured are more likely to visit their doctors' office regularly since they are more likely to fall sick B. The uninsured are less likely to visit the emergency room for care C. The uninsured are more likely to underutilize preventative services, postpone care, and be diagnosed at later stages of disease than the insured D. It is unknown whether or not lack of insurance impacts health care
C. The uninsured are more likely to underutilize preventative services, postpone care, and be diagnosed at later stages of disease than the insured
How does per capita federal spending on Medicare Advantage compare to traditional Medicare? A. Federal per capita payments to Medicare Advantage are more than payments to traditional Medicare B. Federal per capita payments to Medicare Advantage are less than payments to traditional Medicare C. Federal per capita payments to Medicare Advantage are roughly equal to traditional Medicare D. It is unknown how federal per capita spending on Medicare Advantage compares to traditional Medicare
C. Federal per capita payments to Medicare Advantage are roughly equal to traditional Medicare
According to the KFF Health Coverage and Care of Undocumented Immigrants, which of the following statements is true regarding health care for undocumented immigrants? A. They can obtain specialty care through community health centers B. They tend to spend more on healthcare compared to US born citizens C. Many delay seeking necessary care due to large out-of-pocket costs D. Medicare can help offset costs when providing emergency care to undocumented immigrants
C. Many delay seeking necessary care due to large out-of-pocket costs
Which of the following is not an advantage of Medicare Advantage? A. Medicare Advantage plans are required to place limits on out-of-pocket spending unlike traditional Medicare B. Medicare Advantage plans usually provide extra benefits not offered through traditional Medicare like dental/eye care C. Medicare Advantage plans offer hospice benefits, unlike traditional Medicare D. Most Medicare Advantage plans have integrated coverage for prescription drugs
C. Medicare Advantage plans offer hospice benefits, unlike traditional Medicare
Based on the KFF Fact Sheet on Medicare Advantage, which of the following is FALSE? A. The vast majority of Medicare Advantage plans include prescription drug coverage B. Three insurers make up more than 50% of Medicare Advantage enrollment C. Most beneficiaries with a special needs plan live in long-term care institutions D. Medicare group plans are partially funded by Medicare and partially by employers or unions
C. Most beneficiaries with a special needs plan live in long-term care institutions
A ____ plan is a flexible managed care plan that allows enrollees to choose out-of-network providers, but for a higher cost that in-network providers. A _____ plan is a more rigid managed care plan that does not usually cover any expenses associated with out-of-network providers A. HMO; IPA B. PPO: IPA C. PPO; HMO D. ACA; IPA
C. PPO; HMO
The ACA insurance markets were created to help insure which group of people? A. People on Medicare B. People on Medicaid C. People without employer-based insurance or government insurance D. People who are currently unsatisfied with the cost of their insurance plans
C. People without employer-based insurance or government insurance
In the Boston Globe article by Tracy, what was the major issue Nancy Petro had with her new insurance coverage through Obamacare? A. Petro did not agree with her new doctor about treatment options and she was not allowed to seek care from her old one B. Petro found that her premiums were too expensive C. Petro had to travel too far to receive treatment D. Petro's insurance company engaged her in frivolous lawsuits against state insurance regulators
C. Petro had to travel too far to receive treatment
What is one of the failures of Obamacare listed by the Sanger-Katz NYT article? A. Less people have insurance now than before B. Obamacare has increased inequality in healthcare C. Provider networks in many insurance exchange plans are extremely narrow D. Iatrogenic disease is on the rise
C. Provider networks in many insurance exchange plans are extremely narrow
Which of the following is a reason why Medicare spending is projected to increase in the next 10 years according to the KFF's 2019 brief? A. Increased number of specialist visits per enrollee B. Increased number of benefits covered under Medicare C. Rising healthcare prices D. Rising administrative expenses E. More than one of the above
C. Rising healthcare prices
What was the effect of introducing the prospective payment system and DRGs on the length of hospital stays? A. There was no change in the length of hospital stays B. Only slightly shorter hospital stays C. Shorter hospital stays D. Longer hospital stays
C. Shorter hospital stays
According to the KFF Briefing on the coverage gap, which region of the US has the highest percentage of adults in the coverage gap? A. Northeast B. Midwest C. South D. Pacific Northwest
C. South
According to the NYT article by Creswell, why have the number of coronary procedures been controllable, unlike the unfettered growth of stent procedures in limbs? A. Stent procedures are more difficult and more prestigious for up-and-coming doctors who want to prove themselves B. Coronary procedures are more difficult and time intensive whereas stent procedures in the limbs are easier to schedule and quicker to perform C. There is a consensus among doctors about how and when to treat blockages in the heart but little consensus among doctors about how and when to treat blockages in limbs D. There is no discrepancy between the number of coronary procedures and stent procedures in the limbs among cardiologists
C. There is a consensus among doctors about how and when to treat blockages in the heart but little consensus among doctors about how and when to treat blockages in limbs
Who falls into the "coverage gap" for health insurance? A. Those who qualify for an exemption from the individual mandate B. Those who live south of the Mason-Dixon line and who previously qualified for Medicaid prior to the passage of the ACA C. Those who live in states that have not expanded Medicaid and do not qualify for Medicaid or subsidies on the insurance market D. Undocumented immigrants
C. Those who live in states that have not expanded Medicaid and do not qualify for Medicaid or subsidies on the insurance market
Todd and Erin are in the Medicaid coverage gap. What does this mean? A. Todd and Erin are fully insured by Medicaid for all medical expenses because they have a child that qualifies for CHIP B. Todd and Erin must forfeit their Medicaid insurance plans after their child turns 18 C. Todd and Erin make just enough to not qualify for Medicaid under its old rules but do not make enough to qualify for ACA subsidies to purchase insurance D. Todd and Erin make just enough to get coverage for basic medical necessities but cannot afford to cover emergency medical services
C. Todd and Erin make just enough to not qualify for Medicaid under its old rules but do not make enough to qualify for ACA subsidies to purchase insurance
Medicare Advantage enrollees tend to pay ________ premiums and have _______ health on average than traditional Medicare enrollees A. lower, worse B. higher, worse C. lower; better D. higher, better
C. lower; better
According to Laura Ungar's article, "The Deep Divide: State Borders Create Medicaid Haves And Have-Nots," what is one main objective people, such as Patrick Ishmael of the Show-Me Institute, have against Medicaid expansion? A. The federal government is not contributing enough funds B. Expanding Medicaid will not improve overall health C. It is not the government's place to provide healthcare D. It will put too much strain on the state's budget
D. It will put too much strain on the state's budget
According to the NYT article by Grabowski, the effects of lowering Medicaid reimbursements for nursing homes include: A. More hospitalizations for elderly adults B. Reductions in staffing for nursing homes C. Lower Medicaid premiums for low-income individuals D. A & B
D. A & B
Medicaid covers all of the following except: A. Long-term care B. Dental/eye care C. Prescription drugs D. Acupuncture
D. Acupuncture
According to Chernew and Frakt, Medicare/Medicaid federal spending has increased because of A. Growth in the number of beneficiaries B. Price inflation C. Growth in health care utilization D. All of the above
D. All of the above
According to Chernew and Frakt, how might Medicare spending be constrained to control government expenditures? A. Increase the age of eligibility B. Increase patient spending at the point of service C. Reduce payments for overpriced services D. All of the above E. A and C only
D. All of the above
According to Hayes and colleagues in the article from the Commonwealth Fund, which of the following are contributing to the rise in out-of-pocket expenses for people with employer-based coverage? A. Higher deductibles B. Higher copayments C. Higher co-insurances D. All of the above
D. All of the above
According to Laura Ungar's article, "The Deep Divide: State Borders Create Medicaid Haves And Have-Nots," how has Medicaid expansion benefited those who qualify, as stated by Matt Bednarowicz in "The Deep Divide: State Borders Create Medicaid Haves And Have-Nots?" A. Avoiding expensive medical fees B. Can get psychiatric and preventative care C. Allows people to remain productive members of society D. All of the above
D. All of the above
Compared to uninsured individuals, Medicaid enrollees A. Receive preventative care services at a higher rate B. Get cancer screening tests at a higher rate C. Rate their health care higher D. All of the above
D. All of the above
How did the ACA decrease adverse selection? A. The individual mandate B. Requiring people to buy health insurance during set periods of time C. Offering subsidies D. All of the above
D. All of the above
Medicaid covers a broad range of services including: A. The ACA's 10 essential health benefits B. Early Periodic Screening Diagnosis and Treatment (EPSDT) C. Home care D. All of the above
D. All of the above
How is Part B of Medicare financed? A. General revenues B. Payroll taxes C. Beneficiary premiums D. Both A and C
D. Both A and C
What are the three main payment mechanisms within managed care? A. Capitation, discounted fees, Pay-for-performance B. Salaries, Pay-for-performance, Capitation C. Discounted feeds, Pay-per-procedure, Pay-for-performance D. Capitation, discounted fees, salaries
D. Capitation, discounted fees, salaries
Which of the following is not a reason given by Creswell to justify the high frequency of procedures on peripheral vessels? A. Operating on peripheral vessels ultimately saves Medicare money by preventing more serious conditions B. Operating on peripheral vessels ultimately saves Medicare money because these procedures can be done outside of a hospital, unlike heart procedures C. Peripheral artery treatments are less risky than heart procedures D. Coronary heart disease is not immediately dangerous, but blockages in peripheral arteries can be life threatening
D. Coronary heart disease is not immediately dangerous, but blockages in peripheral arteries can be life threatening
According to the KFF briefing on changes in health coverage after the ACA, which population had the largest increase in coverage following the enactment of the ACA? A.Whites B. Blacks C. Asians D. Hispanics E. AIANs
D. Hispanics
According to the KFF Fact Sheet on Medicare Advantage, the COVID-19 pandemic: A. Led to an increase in Medicare reimbursement in hospitals with higher shares of MA enrollees than FFS B. FFS Medicare has expanded access to transportation, telehealth, and other services covered by some MA plans C. Both FFS Medicare and Medicare Advantage have waived cost-sharing for COVID-19 treatment for patients admitted to the hospital D. Medicare Advantage plans must cover services at out-of-network providers that participate in FFS Medicare E. More than one of the above
D. Medicare Advantage plans must cover services at out-of-network providers that participate in FFS Medicare
According to Mark Miller's NYT article, why is it best to buy a Medigap plan right after you enroll in Medicare? A. Medigap cannot deny you coverage for the first six months B. Medigap plans become unavailable later C. Medigap plans can charge you higher premiums if you have pre-existing conditions D. More than one of the above E. All of the above
D. More than one of the above
What change(s) has the Trump administration made to the ACA according to "Changes in Health Coverage by Race and Ethnicity Since the ACA? A. Elimination of the individual mandate B. Elimination of funding for FQHCs and primary care initiatives C. Reduction in outreach and enrollment assistance for ACA marketplaces D. More than one of the above E. All of the above
D. More than one of the above
Compared to privately insured individuals, Medicaid enrollees: A. Have better perceived quality of care B. Get same-day appointments at a higher rate C. Both A and B D. None of the above
D. None of the above
Who are dual eligible beneficiaries? A. People that are eligible for both Medicaid and CHIP B. People that are eligible for Medicaid, and later in life become eligible for Medicare C. People that are eligible to receive benefits from both federal and state Medicaid programs D. People that are eligible for both Medicare and Medicaid
D. People that are eligible for both Medicare and Medicaid
According to the KFF 2019 Overview of Medicare, which part of Medicare covers physician visits? A. Part A B. Part B C. Part C D. Parts A and B E. Parts B and C
E. Parts B and C
True or False: According to the KFF Health Coverage and Care of Undocumented Immigrants, individuals with DACA status are eligible to enroll in Medicare, Medicaid, or CHIP
False
True or False: The 2019 KFF brief found that the percentage of Medicare beneficiaries enrolled in Medicare Advantage has decreased from 2008
False
True or False: The ACA eliminated discrepancies in coverage between Whites and people of color.
False
True or False: The majority of Medicare beneficiaries are enrolled in Medicare Advantage.
False
True or False: the majority of uninsured people are not eligible for Medicaid and subsidized insurance in the marketplaces
False
