HCA Healthcare Midterm Study Guide; Questions and Answers 100% Solved
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HCA
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HCA Healthcare Midterm Study Guide;
Questions and Answers 100% Solved
1. Name the four basic functional components of the US healthcare delivery system. What role
does each play in the delivery of health care?
(SHORT ANSWER) Answer-The four basic components are financing, insurance, delivery,...
HCA Healthcare Midterm Study Guide;
Questions and Answers 100% Solved
1. Name the four basic functional components of the US healthcare delivery system. What role
does each play in the delivery of health care?
(SHORT ANSWER) Answer-The four basic components are financing, insurance, delivery,
and payment. Financing pays for the purchase of health insurance. Insurance protects the
buyers of health coverage against catastrophic risks. Delivery of health care enables people to
receive services covered under their health insurance plans. Payment mechanisms allow
providers to receive payments for services delivered to the insured.
2. Name and describe the four key determinants of health in the Blum's model.
(SHORT ANSWER) Answer-In order of most important to least, the four components are
environmental, lifestyle, hereditary, and medical care. Environmental is the shelter and
geographical problems. Lifestyle is behavioral. Hereditary is if you are born with it you cannot
change it. Medical care is access to primary care.
3. Which conditions during the World War II period lent support to employer-based health
insurance in the United States?
(SHORT ANSWER) Answer--Congress imposed wage freezes to control high inflation
which led to employers offering health insurance to their workers.
-Congress ruled that health insurance is necessary to became a part of employee benefits.
-In 1954, Congress amended the Internal Revenue Code to make employer-paid health coverage
nontaxable. In economic value, employer-paid health insurance was equivalent to getting
, HCA Healthcare Midterm Study Guide;
Questions and Answers 100% Solved
additional salary without having to pay taxes on it, which provided an incentive to obtain health
insurance as an employer-furnished benefit.
On what basis were the elderly and the poor regarded as vulnerable groups for whom special
government-sponsored programs needed to be created?
(SHORT ANSWER) Answer--The elderly & poor could not afford the cost of care
-The elderly had higher incidences and prevalence of disease -
-Provision of charity care led to private payers being charged more for cost-shifting/cross
subsidization
5. Who are non-physician providers? What are their roles in the delivery of health care?
(SHORT ANSWER) Answer-Nonphysician primary care providers include nurse
practitioners, physician assistants, and certified nurse midwives. They play a critical role in the
provision of health care, particularly primary care to underserved populations. NPs assists in
pediatric, family, adult, psychiatric, and geriatric programs. PAs assists in evaluating, monitoring,
diagnostic, and therapeutic practices to patients needing medical care. CNMs assists in maternal
and fetal procedures, maternity and child nursing, and patient assessments.
6. According to the Institute of Medicine, what are the four main components of a fully
developed electronic health record (EHR) system?
(SHORT ANSWER) Answer-- collection and storage of health information on individual
patients over time
- immediate electronic access to person and population level information by authorized users
, HCA Healthcare Midterm Study Guide;
Questions and Answers 100% Solved
- availability of knowledge and decision support that enhances the quality, safety, and efficiency
of patient care
- support of efficient processes for health care delivery
7. Discuss the relationship between technological innovation and health care expenditures.
(SHORT ANSWER) Answer-- new technology is expensive to develop
- costs incurred in research and development are included in total health care expenditures
- the overall diffusion and utilization of technology is greater in the U.S
8. Distinguish between information technology (IT) and health informatics. (SHORT ANSWER)
Answer-Information technology (IT) gathers, stores, analyze, and transfers data.
Health informatics uses IT but goes a step beyond by emphasizing the improvement of health
care and focusing on efficiency, accuracy, and reliability of health care delivery.
9. What is Medicare Part B? Discuss the financing and cost-sharing features of Medicare Part B.
Which main benefits are covered under Part B? Which services are not covered?
(SHORT ANSWER) Answer-Medicare Part B is the Supplementary Medical Insurance. It is
completely voluntary. Premium cost sharing between the government and the beneficiary.
Premiums are income based and are subsidized by the government out of general taxes.
The benefits covered under Medicare Part B are various out-patient services, ED services,
transplants, preventative services and wellness exams. It does not cover routine dental care,
hearing aids, cosmetic procedures, or services not related to treatment or injury.
, HCA Healthcare Midterm Study Guide;
Questions and Answers 100% Solved
10. Briefly describe the Medicare Advantage program.
(SHORT ANSWER) Answer-Medicare Advantage plans, also known as Part C, are insurance
plans offered by private companies as an alternative to Original Medicare. If you have Medicare
Part A and Part B you can choose to assign your Medicare benefits to a private company who
will coordinate your healthcare with Medicare Advantage plan. Medicare Advantage plans must
meet or exceed the benefits offered under Original Medicare. There are additional benefits that
aren't covered under Original Medicare that are covered under Part C plans. Medicare
Advantage plans are overseen by CMS, the Centers for Medicare and Medicaid Services.
11. Briefly explain the prescription drug program under Medicare Part D. (SHORT ANSWER)
Answer-- prescription drug plans (PDP): offer only drug coverage and are used mainly by
those who want to stay in original Medicare fee-for-service program
- medicare advantage plan with drug coverage (MA-PD): available to those persons who are
enrolled in Part C if the MCO provides prescription drug coverage- and most do.
12. Discuss the concept of value-based payments.
(SHORT ANSWER) Answer-A payment model that holds healthcare providers accountable
for both the cost and quality of care they provide making reimbursement tied to quality and
cost
13. What are the conditions of eligibility for receiving home health services under Medicare?
(SHORT ANSWER) Answer--The patient is home-bound.
- The patient is under the care of a physician who will establish a home health plan.
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