Financial Management For Healthcare Organizations

Question 13 pts

Which of the following have been identified as probable causes for the growing increases in health care costs for nearly the past century? (Choose all that apply)

Group of answer choices

D. Increased cost-sharing mechanisms like co-pays and deductibles

C. The increased prevalence of chronic diseases, like diabetes

E. Company-sponsored plans that cover working families

B. Government-sponsored programs like Medicare and Medicaid

A. The development of managed care plans, such as HMOs and PPOs

 

Flag question: Question 2

Question 23 pts

When did home health care come about and grew by over 32% per year?

Group of answer choices

A. 1960 to 1965

F. None of the above

E. 1993 to 2013

B. 1966 to 1973

D. 1983 to 1992

C. 1974 to 1982

 

Flag question: Question 3

Question 33 pts

When was the authorization of the Health Maintenance Organization Act enacted?

Group of answer choices

A. 1960 to 1965

C. 1974 to 1982

B. 1966 to 1973

D. 1983 to 1992

F. None of the above

E. 1993 to 2013

 

Flag question: Question 4

Question 43 pts

When did Congress enact the Employee Retirement Income Security Act (ERISA)?

Group of answer choices

A. 1960 to 1965

F. None of the above

B. 1966 to 1973

D. 1983 to 1992

E. 1993 to 2013

C. 1974 to 1982

 

Flag question: Question 5

Question 53 pts

When were the Balanced Budget Act and its follow-on the Balanced Budget Refinement Act enacted?

Group of answer choices

A. 1960 to 1965

C. 1974 to 1982

F. None of the above

D. 1983 to 1992

B. 1966 to 1973

E. 1993 to 2013

 

Flag question: Question 6

Question 63 pts

Which if the following mandates were explicit in the Emergency Treatment and Labor Act (EMTALA)?

Group of answer choices

D. Hospitals have to stabilize and treat anyone who shows up at the emergency room regardless of ability to pay.

C. Training for HCO staff and employees to receive compensatory benefits if providing care to self-pay and underinsured patients.

E. None of the above

B. Dictates that emergency vehicles are to transport Medicaid patients during emergencies at reduced rates.

A. Requires physicians to provide charity care to uninsured patients presenting at their medical practices.

 

Flag question: Question 7

Question 73 pts

Which category accounts for the largest share of National Health Expenditures?

Group of answer choices

E. Physician and Clinician Services

B. Medicaid

C. Private Health Insurance

D. Hospital Expenditures

A. Medicare

F. Prescription Drugs

 

Flag question: Question 8

Question 83 pts

Which plans are also known as “indemnity insurance?”

Group of answer choices

E. All of the above.

C. Managed Care Plans

B. Fee-for-Service

D. Prepayment Plans

A. Alternative Payment Plans

 

Flag question: Question 9

Question 93 pts

Which type of payment model incorporates a network of physicians and hospitals that shares financial and medical responsibility for providing coordinated care to patients in hopes of limiting unnecessary spending?

Group of answer choices

E. All of the above.

D. Medical Homes

C. Bundled Payments

A. Accountable Care Organizations

B. Discounted-fee-for-service

 

Flag question: Question 10

Question 103 pts

Match the following descriptions of work groups to their relevant work groups.

Periodic payments made by enrollees toward a health plan

Group of answer choices

Out-of-Pocket Limit

Premium

Deductible

Copayment

 

Flag question: Question 11

Question 113 pts

Match the following descriptions of work groups to their relevant work groups.

Maximum amount an enrollee has to spend for in-network health services

Group of answer choices

Copayment

Deductible

Coinsurance

Out-of-Pocket Limit

 

Flag question: Question 12

Question 123 pts

Match the following descriptions of work groups to their relevant work groups.

Amount enrollee must spend before the plan pays for covered items and service

Group of answer choices

Premium

Copayment

Out-of-Pocket Limit

Deductible

 

Flag question: Question 13

Question 133 pts

Match the following descriptions of work groups to their relevant work groups.

A fixed dollar amount paid toward the cost of a covered medical item or service

Group of answer choices

Deductible

Copayment

Out-of-Pocket Limit

Coinsurance

 

Flag question: Question 14

Question 143 pts

Match the following descriptions of work groups to their relevant work groups.

Fees that are refunded to enrollees for underutilization of services

Group of answer choices

Out-of-Pocket Limit

Premium

None of the above

Coinsurance

 

Flag question: Question 15

Question 153 pts

Match the following descriptions of work groups to their relevant work groups.

A percentage of the allowed amount for a covered item or service contributed by the enrollee

Group of answer choices

Copayment

Premium

Deductible

Coinsurance

 

Flag question: Question 16

Question 163 pts

What triggers special enrollment periods under the Affordable Care Act?

Group of answer choices

C. Increases in income and earnings

A. Minimum essential coverage

B. Individual mandates

D. Qualifying events

E. None of the above

 

Flag question: Question 17

Question 173 pts

With catastrophic health plans, an enrollee is protected from extreme out-of-pocket costs but the plans are… [correctly finish the statement]

Group of answer choices

A. have low deductibles and copayments.

B. not required to cover all customary medical conditions.

C. still required to meet the minimum essential benefits under the ACA.

D. being slowly phased out over time so will not be available in the near future.

E. None of the above

 

Flag question: Question 18

Question 183 pts

What is the supplemental insurance plan that is available for purchase to enrollees of original Medicare?

Group of answer choices

D. Medicare Advantage

B. Medigap

A. Medicoverage

B. Medicaid

E. None of the above

 

Flag question: Question 19

Question 193 pts

What does the term “coordination of benefits” mean?

Group of answer choices

E. Intends to reduce the cost of insurance premiums.

A. Resolves the situation of two or more insurance plans covering an enrollee.

C. Ensures that payments do not exceed the total amount of the claims.

F. All of the above.

D. Identifies a primary and secondary order to the plans

G. None of the above.

B. It is meant to avoid duplication of medical bill payments.

 

Flag question: Question 20

Question 20 6 pts

Explain the concepts of adverse selection and moral hazard. Feel free to demonstrate with examples.

 

Flag question: Question 21

Question 217 pts

Explain the concept of benefit buy-downs and its relevance to health insurance.

View keyboard shortcuts

EditViewInsertFormatToolsTable

12pt

Paragraph