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HMGT Test 1, Questions and answers, 100% Accurate, rated A+
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HMGT Test 1, Questions and answers, 100% Accurate, rated A+ ?!?!?!?!?!?!? HOW TO READ THE CARDS ?!?!?!?!?!?!? - -1.) CHAPTER 1 2.) CHAPTER 2 3.) CHAPTER 3 5.) CHAPTER 5 D.) DEFINITION (Everything was taken directly from slides and definitions are based on what Dr. Jim emphasized on in ...

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  • February 21, 2023
  • 19
  • 2022/2023
  • Exam (elaborations)
  • Questions & answers

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HMGT Test 1, Questions and answers,
100% Accurate, rated A+

?!?!?!?!?!?!? HOW TO READ THE CARDS ?!?!?!?!?!?!? - ✔✔-1.) CHAPTER 1

2.) CHAPTER 2

3.) CHAPTER 3

5.) CHAPTER 5

D.) DEFINITION



(Everything was taken directly from slides and definitions are based on what Dr. Jim emphasized on in
class)



1.) Why is cost containment an elusive goal of US health care delivery? - ✔✔-- Size/Complexity - 16.4M
Employees; 18% of GDP

-Market-oriented/Free-market Economy - Private/Public Funding



1.) What are the two main theoretical objectives of a health care delivery system? - ✔✔--All Citizens
obtain Health Care Services when needed

-Health Care Services should be cost effective & high quality



1.) What are the four basic theoretical functional components of the US health care delivery system?
How do they interact with one another? - ✔✔-better image page 6 in textbook



1.) What are the primary reasons employers provide health insurance for their employees? - ✔✔--
Employment Benefit in-lieu of salary - tax avoidance

-Help maintain healthy work-force - i.e. Productivity/presenteeism

-Reduce Turnover rate - Attraction/Retention of Talent

,1.) Why do some US residents/citizens live without health insurance? - ✔✔--Individual autonomy -
choices of income allocation

-Poverty & Low Healthcare Literacy

-Not offered by Employer or High % Premium sharing



1.) How does the Affordable Care Act (ACA) impact US residents/citizens live without health insurance? -
✔✔--Requires all Americans to have health insurance

-Expansion of Medicaid Eligibility for coverage

-Development of Subsidized Health Insurance Marketplace

-Requirements for Health Insurers (lifetime limits, age limits)



1.) What is managed health care? What is a managed care organization (MCO)? - ✔✔--Supporting
Employer-sponsored Health Insurance to control utilization by employees

-Employee/Enrollee Member Benefit Plan Design - includes Deductibles, Co-Pays, Benefits & Provider
Network Limits

-Negotiated Payments (Fee Structures) for Providers



1.) Why is the US heal1th care market called an "imperfect market"? - ✔✔-In a Free (Perfect) Market:

-Consumer Demand - sensitive to Price

-Supply Levels - sensitive to Demand

-Information & Transparency is Required



1.) What is the intermediary role of health insurance in the delivery of health care in the US? - ✔✔--
Negotiates the Rate of Fees (i.e. Provider Fee Schedule) that Employers will pay providers

-No incentive to control costs or quality

-Introduces the "Moral Hazard"

-Delivery of health services can result in demand creation (self-assessed need)



1.) Name the major players in the US health care delivery system? - ✔✔--Physicians & Hospitals

-Business

, -Government

-Labor

-Consumers

-Payers/Insurers

-Pharma



1.) What are the key roles for government in the US health care delivery system? - ✔✔--Purchase Health
care services for elderly & poor

-Public Health - domestic threats (i.e. Zika, Ebolz, W. Nile, TB, Syphilis, STDs, Measles, Mumps, Influenza,
etc.)

-Public Policy - Expansion of Coverage, Research, etc.

-Regulation of Fee Market - Consumer Protection



1.) Why is it important for health care managers and policy makers to understand the intricacies of the
US health care delivery system? - ✔✔--Changes in one area inevitably impacts other areas - unintended
consequences

-Opportunities for synergies

-The power of innovation, technology and research to structurally change the system



1.) Explain the difference between National Health Insurance and National Health System? - ✔✔--
National Health Insurance

-National Health System



D.) National Health System - ✔✔-Government-controlled and managed health care delivery and
payment



D.) National Health Insurance - ✔✔-Government-sponsored health insurance, but the delivery system is
private



1.) Explain the definition of Socialized Health Insurance (SHI)? - ✔✔-Government-mandated
contributions by employers and employees, integrated by government mandates and regulations

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