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HCS Exam 2 Questions with Explanations of Answers | latest upate 2024
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HCS Exam 2 Questions with Explanations of Answers | latest upate 2024
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HCS Exam 2 quizlet2Although the ACA will enact sweeping U.S. health care system reforms, one
fundamental element of the system that will remain unchanged is: - ANS-financing of
health care expenditures through a combination of public and private sources
The current highest personal care expenditure in the U.S. is for: - ANS-hospital care
Despite U.S. health care spending exceeding by far, expenditures of 28 other developed
nations, U.S. health outcomes lag far behind. Extensive research has concluded that
reasons for high U.S. high expenditures are: - ANS-overuse of expensive technology
and higher per capita physician visit rates
Major drivers of U.S. health expenditures include: - ANS-advancing medical technology,
growth in the older population, specialty medicine, labor intensity, and reimbursement
system incentives
The basic concept of health insurance is antithetical to the premise on which personal
or property insurance was historically defined because: - ANS-other forms of insurance
were intended to cover individuals against the low risk of unlikely events such as
premature deaths or accidents while health insurance provides coverage for unlikely
events in addition to routine and discretionary services
The establishment of Blue Cross for hospital care and shortly thereafter, Blue Shield for
physicians' services signaled a new era in health care delivery and financing. Which of
the following was not among their major impacts: - ANS-caused for-profit insurers to use
"experience" rather than "community" ratings to establish premiums
The 1973 HMO legislation responded to which of the following national concerns: -
ANS-rapidly increasing Medicare expenditures and concerns about the quality of care
By focusing on insured populations rather than individuals, managed care organizations
can project health service use by: - ANS-demographic factors such as age, gender, and
other factors
The managed care concept called "capitation" refers to: - ANS-physicians agreeing to
provide all medical care an individual requires for a specified time period, for a prepaid
fee
, An aim of managed care is to transfer some measure of financial risk to providers and,
to a lesser extent, to patients. Transferring financial risk to patients is accomplished by: -
ANS-requiring co-pays for specified services
Cost-control initiatives undertaken by managed care organizations to improve
communications with chronic disease patients in the hope of avoiding unnecessary,
costly care are known by the term: - ANS-disease management
The "Managed care backlash" beginning in the 1990s, refers to: - ANS-health care
providers and consumers protesting managed care's restrictive policies on provider
choice, referrals to specialty care and other practices ***HIGH-DEDUCTIBLE HEALTH
PLANS (HDHPS) (out of pocket pays and lower premiums)
The most influential managed care quality assurance organization that accredits many
different aspects of managed care organizations on a voluntary basis is: - ANS-The
National Committee on Quality Assurance (NCQA)
The Healthcare Effectiveness Data and Information Set (HEDIS) may be best described
as: - ANS-a standardized method for managed care organizations to collect, calculate
and report information about their performance to facilitate purchasers' and consumers'
comparisons of different insurance plans on a variety of parameters
The Medicare program enacted in 1965 as Title XVIII of the 1935 Social Security Act is
characterized as the most sweeping social legislation ever enacted by the federal
government because it: - ANS-Was only the second mandated U.S. health insurance
program after worker's compensation and signaled the federal government's entry into
the personal healthcare financing arena
Enacted in 1983, the Diagnosis-related Group payment methodology shifted hospital
reimbursement from the retrospective to prospective basis. The major purpose of this
new payment system was to: - ANS-provide financial incentives for hospitals to spend
no more than needed to produce optimal outcomes for hospitalized patients
In retrospect, implementation of the DRG system demonstrated that: - ANS-hospitals
could profit from instituting more efficient patient care procedures
The Centers for Medicare & Medicaid Services (CMS) "Hospital Compare" web-based
program the primary purpose of:
A. providing comparative price data for specified hospital procedures
B. exposing hospitals' internal system deficiencies that result in medical errors
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