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FINAL HSM EXAM QUESTIONS WITH CORRECT SOLUTIONS!!
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FINAL HSM EXAM QUESTIONS WITH CORRECT SOLUTIONS!!
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Name: Score:118 Multiple choice questions
Definition 1 of 118
health care premiums will be allowed to vary only based on age, geographic area, tabacco use,
and number of family members
kids can stay on parents plan till 26
required to cover certain preventive services with no cost-sharing
insurers will be required to spend atleast 80% of premiums on medical costs or pay rebates back
to consumers
cant charge people more based on health status or gender
must have a minimum amount of services and caps annual out of pocket spending
Coinsurance
Managed indemnity plans
Moral hazard
ACA changes to private insurance
Definition 2 of 118
describes failures to execute clinical quality of care plans and procedures properly
Misuse of health care
Vertical integration
Overuse of health care
Moral hazard
,Definition 3 of 118
is incurred from services not being reimbursed that are provided with the expectation of being
reimbursed
bad debt
cost
charity care
per diem
Definition 4 of 118
demand is greater than the need
higher quality physicians
overutilization
better quality care
secondary prevention
Term 5 of 118
Medicare Part B
Supplementary medical insurance
covers physicians, outpatient hospital care, lab tests, and medical supplies
prescription drug benefits
surgeries
cardiologist, neurologist
at teaching hospitals, big hospitals
state board must approve applications for new facilities, capital improvements, or high-cost
equipment
,Term 6 of 118
quality assurance
designed to help people purchase their own health insurance, makes coverage for
affordable
1. defining a problem
2. formulating and evaluating alternatives
3. implementing the chosen alternative
4. evaluating the results
the process of conducting ongoing measurement activities in conjunction with the
installation of feedback mechanisms designed for continuous quality improvement
coverage of different groups in a defined service area or community, at the same cost
Definition 7 of 118
includes all care for which no payment was received from the patient nor payer
2 types--charity care and bad debt
hospital prices
charity care
uncompensated care
staff model
Definition 8 of 118
M.D.'s
allopathic are
primary care
iron triangle
moral hazard
, Term 9 of 118
deductible
the annual amount patients must pay for health care expenses before their health insurance
plan covers the cost of care
when individuals with health insurance over consumer health services because they do not
bear the full cost of consuming those services
a specific, measurable target that must be reached within a defined time frame
the part of Medicare Part D reimbursement between basic services and full coverage that is
the medicare beneficiaries' responsibility to pay
Definition 10 of 118
age
gender
race
education
vulnerability factors
risk factors
predisposing factors
relationship factors
Definition 11 of 118
geared toward health, rich clientele
expensive
Foster Care Homes
Continuing Care Retirement Communities
Nursing Homes
Transitional Care Models And Programs
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