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.
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12pt