Health Services Financing Exam Solutions Manual Solved Correctly Latest Update 2025
Health insurance accounts for the makeup of ___% of the U.S. health dollar (2022) - Answers 72%
Hospital care accounts for ___% of U.S. healthcare spending (2022) - Answers 30%
___% of Americans are covered by em...
Health insurance accounts for the makeup of ___% of the U.S. health dollar (2022) - Answers 72%
Hospital care accounts for ___% of U.S. healthcare spending (2022) - Answers 30%
___% of Americans are covered by employer-based insurance programs - Answers 48.7%
The primary function of insurance - Answers To protect against risk
Risk - Answers the possibility of a substantial financial loss from an event whose probability of
occurrence is relatively small
Four principle of insurance - Answers 1.Risk is unpredictable for the individual insured
2.Risk can be predicted with a reasonable degree of accuracy for a group or a population
3.Insurance provides a mechanism for transferring or shifting risk from the individual to the group
through the pooling of resources
4.Actual losses are shared on some equitable basis by all members of the insured group
Premium - Answers The amount charged by the insurer to insure against specified risks; usually paid on
a monthly basis.
Risk Assessment - Answers The process of modeling and calculating the expected expenses of one group
of people relative to others.
Underwriting - Answers A systematic technique for evaluating, selecting (or rejecting), classifying, and
rating risk.
Experience rating - Answers Risk rating based on historically documented patterns of claims.
Community rating - Answers No underwriting involved; individuals pay same premium regardless of age,
gender, or health status.
Covered services - Answers Services covered by an insurance plan.
Ex ante moral hazard - Answers Behavior changes that occur before an insured event happens and make
that event more likely. EX: leaving the stove on or skipping the flu vaccine
Ex post moral hazard - Answers behavior changes that occur after an insured event happens and make
recovering from that event more expensive. EX: using expensive drugs instead of generics or getting a
knee replacement surgery instead of painkillers
Cost sharing - Answers Portion of the actual cost of medical services paid by the insured, in addition to
the premium.
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