healthcare in the us UNIT 1 quizzes

Ace your homework & exams now with Quizwiz!

According to Allen and Summers in their JAMA article "Medicaid Expansion and Health," self-reported health measurements Are consistent with the WHO definition of health Are easier to collect information Have not found more positive results in recent, longer-term studies A and B only B and C only

A and B

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 healthcare services and did not improve physical outcomes D.Both A and B

A and B

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? 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

A and C

According to the KFF article "Beyond Health Care", what are some of the current challenges with addressing social determinants to promote population health? A. Lack of resources within communities B. The Affordable Care Act did not address social determinants C. Reductions in funding for prevention and public health under the Trump administration D. A and C E. None of the above

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%

______% 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 managed care? A. A system of health care delivery that integrates the four basic functional components of health care (financing, delivery, payment, and insurance) B. A type of insurance that seeks to reduce the amount of time physicians spend on patients C. A type of insurance that systematically inspects doctors for high-efficiency care D. A system of heatlh care delivery that emphasizes alternative/holistic treatment options

A. A system of health care delivery that integrates the four basic functional components of health care (financing, delivery, payment, and insurance)

In Reinventing American Health Care, why did Erin's insurance company jack up her premiums? A. Because of her preexisting condition of colon cancer B. Because she did not pay her premiums on time C. Because her doctor asked for increased compensation for his services D. Because the insurance company was about to go bankrupt

A. Because of her preexisting condition of colon cancer

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

What qualifies an enrollee for out-of-pocket catastrophic coverage for Medicare Part D? A. Enrollees are qualified after reaching a specified threshold for out-of-pocket spending on prescription drugs B. Enrollees are qualified if they have a chronic illness and enter hospice care C. Enrollees are qualified if they have incomes <100% of the FPL D.Enrollees are qualified after paying their full deductibles

A. Enrollees are qualified after reaching a specified threshold for out-of-pocket spending on prescription drugs

Which of the following is a feature of managed care? A. Fees and prices for physician services are negotiated beforehand by insurance companies B. Patients receive personal assistants to manage their health care services C. Free medications D. Special advertising privileges for pharmaceutical companies

A. Fees and prices for physician services

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

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 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

How do market justice and social justice differ in their views on health care? A. Market justice views health care as an economic reward whereas social justice views health care as a right B. Market justice views health care as an economic reward whereas social justice views health as an individual responsibility C. Market justice views health care as a social resource whereas social justice views health care as a right D. Market justice views health care as a social resource whereas social justice views health care as a way to ensure the common good

A. Market justice views health care as an economic reward whereas social justice views health care as a right

In the NY times article by Rosenthal, what was the name of the $2,000 procedure Ms. LIttle had to fix a clogged pore? A. Mohs procedure B. Hysterectomy C. Biopsy D.Cataract procedure

A. Mohs procedure

Cost-sharing is designed to reduce what problem? A. Moral hazard B. Cream skimming C. Cherry picking D.Deductibles

A. Moral hazard

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

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

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

According to the 2018 issue brief "The Facts on Medicare Spending and Financing", which of the following statements best describes the general trend in the average annual per capita growth rate of Medicare spending between 2000 and 2017? A. The Medicare spending growth rate decreased B. The Medicare spending growth rate increased C. The Medicare spending growth rate was constant D.The Medicare spending growth rate increased at a constant rate

A. The Medicare spending growth rate decreased

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

How have the federal government and state governments addressed social determinants within the health care system to promote population health? A. The federal government and state governments have provided funding to identify and address social needs B. Stakeholders from non-medical sectors have been prevented from determining local health priorities C. Federal and state governments are moving towards a more socialized medical system by banning private insurance companies D. Support for employment services has been shifted towards funding for education

A. The federal government and state governments have provided funding to identify and address social needs

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 (& 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 (& more

In "How to Think about 'Medicare for All'", James Morone argues A. Though "Medicare for All" is a politically contentious idea, it deserves serious consideration for its potential to benefit Americans on multiple levels B. A single payer system is the only morally sound system for health care delivery C. "Medicare for All" has been historically proven to be unfeasible D.The only way we can achieve "Medicare for All" is through inter-party collaboration

A. Though "Medicare for All" is a politically contentious idea, it deserves serious consideration for its potential to benefit Americans on multiple levels

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

Stand-alone prescription drug plans are designed to supplement: A. Traditional Medicare B. Medicare Advantage C. Part A D.Part B

A. Traditional Medicare

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 are the four key determinants of health according to the Blum model? A. Environment, nutrition, medical care, heredity B. Environment, lifestyle, heredity, medical care C. Environment, social life, mental health, heredity D. Environment, mental health, level of education, income

B) environment, lifestyle, heredity, medical care

True or false: Medicaid is paid for exclusively by the federal government 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

Which of the following is not among the four basic functional components of the US health care delivery system? A. Financing B. Screening C. Delivery D. Payment

B) screening

What percentage of health care dollars is spent on drugs? A. 3% B. 10% C. 15% D. 25%

B. 10%

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. 45 years old, cancer and hypertension

B. 20 years old, no pre-existing conditions, athlete

What is the 80-20 rule? A. It takes 80 years for an insurance company to make any profit from a 20-year-old patient B. 20% of the insured population accounts for 80% of all health expenditures C. For every 80 dollars spent on medical care, 20 is spent on public health D.80% of primary prevention takes place in 20% of hospitals

B. 20% of the insured population accounts for 80% of all health expenditures

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

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 hystice, 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 does the Part D Low-income subsidy (LIS) program do? A. Assists low-income Medicare beneficiaries in paying for their most expensive drugs B. Assists low-income Medicare beneficiaries with premiums/co-payments for their drug prescription plans C. Covers all drug related expenses for all Medicare and Medicaid beneficiaries D.All of the above

B. Assists low-income Medicare beneficiaries with premiums/co-payments for their drug prescription plans

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

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

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

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 hospital from 1890 to present? A. Hospital 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

According to the 2018 issue brief "The Facts on Medicare Spending and Financing", within the next decade, net Medicare spending is expected to _______ and the Medicare annual spending growth rate is expected to _______ A. Decrease, increase B. Increase, also increase, C. Increase, decrease D.Decrease, also decrease

B. Increase, also increase,

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

Lecture 5 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

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

On which of the following indicators does the U.S perform better than other high-income countries? A. Balance of specialized/non-specialized care B. Patient-centeredness C. Cost of care D, Universal health care

B. Patient-centeredness

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)

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

The stories of Erin, Baltazar, and Wayne in Reinventing American Health Care all address this major theme A. Racism in U.S health care B. The difficulty of covering unexpected/costly medical expenses C. How much easier it is for women to access health care D. How much cheaper it is for Americans to purchase health care compared to citizens of other countries

B. The difficulty of covering unexpected/costly medical expenses

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

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

How is Part B of Medicare financed? A. General revenues B. Payroll taxes C. Beneficiary premiums D.Both A and C

Both A and C - general revenues - beneficiary premiums

What is the major point of Arthur Brook's Ted Talk, A Conservative's Plea?A. Capitalism is more rational than other ideologies B. Capitalism and the free-enterprise system is responsible for great reductions in poverty C. Both capitalists and non-capitalists bring unique tools to the conversation about reducing inequality and poverty D. Both B and C

Both B and C

According to the Schneider article, which of these three features of the American health care system impedes access to health care? A. Low premiums, administrative burden, low-income patient hospital care B. Cost of care, disparities in the delivery of care, long distances from the hospital C. Disparities in the delivery of care, cost of care, administrative burden D. Administrative burden, disparities in the delivery of care, lack of psychiatric care

C) Disparities in the delivery of care, cost of care, administrative burden

What is reference pricing? A. When patients reference their doctor before purchasing any medical preferences 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 predetermined 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

Which of the following is not considered a "provider" in a provider network? A. Hospitals B. Doctors C. Ambulances D. Pharmacies

C. Ambulances

Which of these patient outcomes is easiest to measure according to the Health Related Quality of Life (HRQL) conceptual model? A. Functional status B. Symptom status C. Biological and physiological variables D. Overall quality of life

C. Biological and physiological variables

Which of the following is not a trend discussed in Victor Duch's article on trends in US healthcare? A. Increased number of women physicians B. Decreased number of in-patient hospital stays C. Decreased role of the federal government in health D. Rising health expenditures

C. Decreased role of the federal government in health

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

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 easy for "special interests" to hijack the political system D. Medicare and Medicaid exist

C. It is relatively easy 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 health care than wealthier individuals C. Market justice does not ensure that individuals who are ill 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 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

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

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

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

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

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

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 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

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

How did the US 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

Which is not one of the two main objectives of a health care delivery system? A. To enable all citizens to obtain health care services when needed B. To have cost-effective health care services that meet established standards of quality C. To compensate all doctors as much as possible for their services

C. To compensate all doctors as much as possible for their services

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

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

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

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 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

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

What is the "Health in All Policies" approach? A. Requiring all hospitals to staff a social worker B. Encouraging neighborhoods to assess and address their environmental impact C. Requiring all politicians to get a flu shot D. Identifying how multiple sectors affect health and engaging diverse partners to promote health and equity, as well as other sector-specific goals

D. Identifying how multiple sectors affect health and engaging diverse partners to promote health and equity, as well as other sector-specific goals

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

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 of population

D. Risk can be eliminated by insuring a large group of population

Why does cost containment remain an elusive goal in US health services delivery? A. Wide availability of cheap medical technology B. It is difficult to get doctors to cooperate with insurance companies C. General inflation D. The US healthcare system is fragmented, and each player seeks to price services at a level that is beneficial to themselves rather than the whole system

D. The US healthcare system is fragmented, and each player seeks to price services at a level that is beneficial to themselves rather than the whole system

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

Which is an advantage of the market justice approach to the healthcare system? A. Most people cannot afford to pay for medical costs out of pocket B. It is difficult to rely on experience or comparison shopping when purchasing insurance C. Insurance companies are profit-making institutions whose primary goal is to not to improve the health of their clients D. There are much lower administrative costs in private insurance than in single-payer systems

D. There are much lower administrative costs in private insurance than in single-payer systems

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

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 did the per capita spending rate for Medicare decrease between 2010-2017? A. The ACA was able to reduce Medicare payments through delivery system reforms B. The Trump administration capped Medicare payments C. An influx of younger, healthier beneficiaries 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 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

What are Medicare Advantage plans? A. Supplemental insurance plans that allow Medicare beneficiaries to purchase prescription drugs B. Insurance plans that allow Medicare beneficiaries who are also on Medicaid to opt out of one or both government programs C. The cheapest option for Medicare beneficiaries D.Private Insurance plans contracted by Medicare which cover Part A, Part B, and usually Part D benefits for Medicare beneficiaries

D.Private Insurance plans contracted by Medicare which cover Part A, Part B, and usually Part D benefits for Medicare beneficiaries

Which is not one of the benefits of "Medicare for All" in the Morone article? A. Internationally, single-payer health systems are much less expensive than multi-payer B. "Medicare for All" can help address longstanding economic inequality C. "Medicare for All" is more morally defensible than our current patchwork system D.Single-payer health systems encourage bold innovations in medical technology

D.Single-payer health systems encourage bold innovations in medical technology

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

Which of the following populations is not eligible for Medicare? A. Those diagnosed with end-stage renal disease B. Those aged 65+ C. Those with permanent disabilities D.Those with parents who are eligible for Medicare

D.Those with parents who are eligible for Medicare

True or False: Medicaid is the largest source of insurance coverage for America

False

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

Health insurance tends to benefit those with serious health conditions the most

What is the effect of healthy young people choosing not to purchase health insurance?

Higher insurance premiums for all, both healthy and sick

Which is not one of the reforms Mackey suggests in his article The Whole Foods Alternative to Obama Care?

Increase the salaries of generalists by 20%

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? The federal government is not contributing enough funds It is not the government's place to provide healthcare It will put too much strain on the state's budget

It will put too much strain on the state's budget

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. Embrel D. Nyquil

Sensipar

Which of the following is not an avenue through which insurance can be obtained?

The individual mandate

How many people were selected, through lottery, to receive Medicaid through the Oregon Insurance Experiment? A. 30,000 B. 45,000 C. 50,000 D. 100,000

a) 30,000

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

Since the expansion of Medicaid, A. Eligibility for pregnant women and children has increased B. Eligibility for pregnant women and children has decreased C. Eligibility for pregnant women and children has remained the same D.Eligibility for pregnant women increased, then decreased

a) eligibility for pregame's women & children increased

What is one major difference between Healthy People 2020 and previous Healthy People Initiatives It places more emphasis on the social determinants of health 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

According to the Victor Fuch's article on trends in US health care, which of the following has contributed the most to an increase in health expenditures? a) New medical technology b) Higher insurance premiums/deductibles c) Better quality health care d) Increases in in-patient hospital care

a) new medical technology

True or False: People with lower socioeconomic status face worse health outcomes A. True B.False

a) true

True or false: death rates for white, middle aged Americans are rising A. True B. False

a) true

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

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

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

all of the above

Implementation of work requirements for Medicaid eligibility in Arkansas has raised concerns because A. Many enrollees were not successfully contacted about the new requirements B. It is unclear whether or not enrollees understand how to use the online portal necessary for reporting work C. Disenrollment resulting from the new requirements may lead to gaps in care D.All of the above

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

all of the above

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+

True or false: In-patient hospital care has significantly increased since 1980, causing massive increases in health expenditures. A. True B. False

b) false

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 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 have health care reformers switched from the term "single payer" to "Medicare for All," according to the 2019 Oberlander article in Millbank Quarterly? a-Canada's version of medicare has been extremely successful b-It connects proposals to medicare, a highly successful and popular program c-Proposed plans mimic the existing structure of medicare d-Proposed plans will expand medicare to all americans

b-It connects proposals to medicare, a highly successful and popular program

Which politician proposed "Medicare for All" in 2017? A. Donald Trump B. Bernie Sanders C. Barack Obama D.Nancy Pelosi

bernie sanders

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%

Which is not one of the effects of increased specialization among physicians? A. Greater health expenditures B. Increase in the number of years of required training C. Better quality health care D. Restructuring of medical education

c) better quality health care

Which of the following has the least impact on one's risk of premature death? A. Social and environmental factors B. Individual behavior C. Health care D. Genetics

c) health care

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) 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

c) percentage of medical costs that employer plans must cover

What is Health Related Quality of Life? (HRQL) A. Factors which affect one's functionality in the workplace B. All economic, political, cultural, and spiritual factors that affect quality of life C. The aspects of quality of life that relate specifically to a person's health D. All factors which affect function

c) the aspects of quality of life that relate specifically to a person's health

The 2019 Oberlander article in the Millbank Quarterly says that in a hybrid model of Medicare for All: a-Medicare advantage would be eliminated b-There would be no market for supplemental coverage c-Universal coverage would be achieved through both public and private insurance d-Would expand medicare to all americans

c)Universal coverage would be achieved through both public and private insurance

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 vulnerable group makes up the largest proportion of Medicaid enrollees? A. Children B. The elderly C. The disabled D.Parents

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

cost

Medicaid covers all of the following except: Long term care dental/eye care Prescription drug Acupuncture

d) acupuncture

According to the Urban Institute article, which of the following factors affects health? A. Education level B. Race C. Income D. All of the above

d) all of the above

Beneficiaries of Medicare must pay A. Deductibles B. Premiums C. Co-insurance 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

How many states have a Section 1115 waiver to condition Medicaid eligibility on work requirements? A. Two B. Three C. Four D.Five

d) five

Why was Donna Dubinsky's family denied health insurance the first time she applied? A. They couldn't afford to pay the premiums B. The applied after the deadline C. Her family was too large D. They had pre-existing conditions

d) they had pre existing conditions

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- lower federal deficit

When is the deadline for states to expand Medicaid? A. 2020 B. 2025 C. 2030 D.There is no deadline for state to expand Medicaid

d- there is no deadline for state to expand medicaid

According to the 2019 Oberlander article in the Milbank Quarterly, "Medicare for All", plans for creating a Medicare-like public option a-Would directly expand the current medicare program b-Would allow people aged 50 and older to enroll in medicare c-Are all very similar in terms of who would be able to enroll d-Create a new public option that expands on the ACA

d-Create a new public option that expands on the ACA

According to the KFF 2019 Overview of Medicare, which of these services is not covered by any part of Medicare? Prescription drugs Dental services Skilled nursing care Home health visits

dental services

According to the KFF 2019 Overview of Medicare, what is the most common form of supplemental Medicare coverage? Employer-sponsored insurance Medigap Medicaid None of the above

employer sponsored insurance

According to the KFF Health Coverage and Care of Undocumented Immigrants, individuals with DACA status are eligible to enroll in Medicare, Medicaid, or CHIP - true or false?

false

True or False: Medicaid is a federally funded program that is managed by the states

false

True or False: the majority of uninsured people are not eligible for Medicaid and subsidized insurance in the marketplaces

false

True or false: Medical care is a relatively strong determinant of health compared to other social determinants? True False

false

True or false: The majority of Medicare beneficiaries are enrolled in Medicare Advantage. A. True B.False

false

Where does financing for Part D primarily come from? A. Payroll taxes B. Income taxes C. Beneficiary premiums D.General revenues

general revenues

How are Parts B, C, and D of Medicare benefits primarily financed?

general revenues (taxes from state/federal government)

Which racial group was most likely to be uninsured before the passage of the ACA? A. Hispanic B. Black C. Asian D. White

hispanic

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

none of the above

In which region of the country were the greatest increases in eligibility for Medicaid observed between 2000 and 2016? A. Northeast B. South C. West D.Midwest

northeast

Which part of Medicare covers in-patient services? A. Part A B. Part B C. Part C

part A

Which part of Medicare pays for outpatient services? A. Part A B. Part B C. Part C D.Part D

part B

How is Part A of Medicare primarily financed? A. Payroll taxes B. General revenues C. Beneficiary Premiums D.Both A and C

payroll taxes

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

population level mortality has declined

⅔ of Medicare beneficiaries are enrolled in: A. Private managed care plans B. Public managed care plans C.Public fee-for-service plans

private managed care plans

________ are more likely to fall into the coverage gap A. Non-Hispanic Whites B. Racial minorities C. Children D.The elderly

racial minorities

Rank the following programs in terms of their overall cost to federal/state governments: - medicare - medicaid - social security

social security> medicare> medicaid

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

the south

True or False: Is it illegal for an insurance company to sell a Medigap plan to someone who is covered by Medicaid?

true

True or False: Overall, the general public has a favorable view of Medicaid.

true

True or False: The ACA eliminated discrepancies in coverage between Whites and people of color.

true

True or false: Disabled people account for the most Medicaid spending compared to other eligibility groups

true

True or false: Employer based insurance is tax-free A. True B. False

true

True or false: Medicaid covers disabled individuals.

true

True or false: The government plays a significant role in financing health care services in the United States?

true


Related study sets

Religion Chapter 3 the Old Testament

View Set

Simulation Lab 11.1: Module 11 Harden PC with Group Policy Editor

View Set

ANAT Unit 3 - M20: Blood Supply to the Brain, meninges, ventricles, and CSF

View Set

Four Types of Nursing Assessments

View Set

Chapter 48 disorder of musculoskeletal function: trauma infection and neoplasm

View Set